Coping With Side Effects of ADHD Medicine for Children

5 year old boy reading a book in the dark
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If your child is on medicine for his ADHD symptoms, you may hear some complaints about stomachaches or headaches. Some kids experience a decrease in appetite. Others begin to have difficulty falling asleep at night. These are all common side effects of stimulant medications.

Though side effects may occur, especially in the first few weeks of treatment, most will disappear on their own as your child’s body adjusts to the medication. “For most children, the benefit of treatment outweighs any potential side effects,” says Michael Goldstein, MD, neurologist and vice president of the American Academy of Neurology.

In the meantime, here are some simple strategies parents can implement to minimize common side effects.

Stomach Aches

To help reduce stomach complaints, have your child take his medicine with food or following a meal.

Headaches

Like stomach aches, headaches may be helped by taking the medication with food. Sometimes, however, headaches can be caused by a mineral deficiency; some children with ADHD have been found to be deficient in magnesium, which may result in headaches.

What Experts Say

“Equally important is to make sure your child is eating a balanced diet that is naturally rich in magnesium, B vitamins, and other helpful nutrients.”

— Jennifer Shu, MD, a pediatrician and author

Decreased Appetite

Give your child healthy, calorie-dense snacks throughout the day, especially at peak appetite times. Try apples or bananas with peanut butter, cheese and crackers, protein bars, a hard-boiled egg and a slice of toast, muffins and a glass of milk, or some similar healthy snack. Additionally you can talk with your child’s doctor about planning for the medication dosage to be taken after mealtimes.

Difficulty Falling Asleep

Sleep issues in children with ADHD are a common occurrence. Sometimes the stimulant medication affects sleep. Other times, the restlessness that accompanies ADHD causes difficulty falling asleep.

A good sleep routine is also very important. Make this time a special time. Begin to settle down about at least half an hour before bedtime. While it might not be time to go up to bed yet, it is helpful to have your child engage in quiet activities. It can be hard to transition from playing basketball or a fast-paced computer game to going straight to bed. Have your child move to activities such as reading, putting together puzzles, or coloring in preparation for bedtime.

Establish a bedtime routine—have your child use the bathroom, wash his hands, brush his teeth, get into his pajamas, listen to soothing music, read a book, then say goodnight. Try to have your child go to bed at the same time each night and keep a regular wake-up time in the morning.

If your child seems to have more difficulty falling asleep after starting medication, you may also want to ask the doctor if you can administer the medication earlier in the day or discontinue an afternoon or evening dose.

Contacting Your Child's Doctor

If these strategies do not alleviate side effects, be sure to consult with your child’s doctor. Additional side effects you will want to discuss include increased anxiety, irritability, and tics (involuntary motor or vocal movements, such as excessive eye blinking, facial grimaces, muscle tensing, coughing, or throat clearing, among others).

The doctor may address the specific preparation of the stimulant, as this can be an important factor in managing side effects, particularly sleep disturbance and agitation/irritability.

For example, Concerta (methylphenidate, in a long-acting Ritalin-similar preparation) may be used in the morning with an addition of a short-acting Ritalin in the early afternoon to allow for fuller day coverage and an afternoon dose that wears off before bedtime. In addition, an individual may sometimes have more or fewer side effects on Ritalin (methylphenidate) versus Adderall (mixed amphetamine salts). These are all issues your child’s doctor can assess.

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