ADHD Treatment When ADHD Medications Are Not Working for Your Child By Vincent Iannelli, MD facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Vincent Iannelli, MD Medically reviewed by a board-certified physician Updated on February 05, 2020 Print ADHD Overview Symptoms Causes Diagnosis Treatment Living With In Children PhotoAlto/Antoine Arraou - Brand X Pictures/Getty Images Medications for treating symptoms of attention deficit hyperactivity disorder (ADHD) can be very effective for children, making it easier for them to pay attention in school, maintain friendships, and navigate life. But sometimes, it's hard to find the right medicine and the right dosage, with the fewest side effects. With some careful adjusting, however, it's usually possible to find a program that works. ADHD Medications There are different medication choices for ADHD. Most medications are stimulants, but that is not your only option. Stimulants The most commonly prescribed ADHD medicines are Adderall (amphetamine and dextroamphetamine); Ritalin (methylphenidate ); Focalin (dexmethylphenidate); and Concerta (methylphenidate extended-release tablets). All of these drugs are stimulants, which are thought to work by increasing levels of a neurotransmitter in the brain called dopamine. Dopamine is associated with motivation and attention, among other things. For many people with ADHD, stimulant medications both boost concentration and the ability to focus while at the same time curbing hyperactive and impulsive behaviors. For the most part, ADHD drugs work. According to the ADHD treatment guidelines of the American Academy of Pediatrics (AAP), most children will respond to one of the stimulants. When a medication doesn't work or causes intolerable side effects, the options are usually to adjust the dose, either up or down, or switch to another medication. For example, if Adderall isn't relieving a child's symptoms or is making them cry a lot, then lowering their dosage or having them try one of the other stimulant medications may solve the problem. Managing Side Effects of ADHD Medications Non-Stimulant Medications A non-stimulant medication called Strattera (atomoxetine) is sometimes a good option for a child who isn't tolerating a stimulant. Some doctors also prescribe Strattera along with a stimulant, making it possible to lower the dose of the stimulant drug enough that it no longer causes side effects. Other alternative medications used to treat ADHD include the medications Catapres (clonidine) and Tenex (guanfacine). These can be effective for impulsivity, hyperactivity, and sleep disturbances. When Medication Doesn't Work Sometimes a child doesn't respond to two or three different stimulant medications and continues to do poorly. It may be that the ADHD diagnosis is wrong and that something else is causing the symptoms the child is experiencing. In this case, the AAP advises pediatricians to evaluate the child's diagnosis. It is also recommended to have the child tested for a coexisting condition such as depression, bipolar disorder, or a learning disability or behavioral problem. A Word From Verywell If you have a child with ADHD, putting various medications and dosages to the test to find what will work for him can be frustrating. Don't hesitate to ask your pediatrician any questions you might have about effectiveness and timing (sometimes adjusting when the doses are taken can make a big difference). Let the doctor know about any side effects you believe are associated with your child's treatment. Don't be afraid to push for changes. There are many options available. Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Wolraich M, Brown L, Brown RT, et al. ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007-22. American Academy of Pediatrics. ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007-1022. doi:10.1542/peds.2011-2654 Additional Reading Briars L, Todd T. A review of pharmacological management of attention-deficit/hyperactivity disorder. J Pediatr Pharmacol Ther. 2016;21(3):192-206. Spencer TJ, Brown A, Seidman LJ, et al. Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies. J Clin Psychiatry. 2013;74(9):902-17.