Dealing with ADHD: What You Need to Know

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Is your child in constant motion? Does he or she talk incessantly? Or have trouble focusing and prefer to daydream?

Then your child may have attention deficit hyperactivity disorder, or ADHD.

This disorder often begins between the ages of 3 and 6 years, according to the National Institute of Mental Health (NIMH). And it’s not just a childhood disease: ADHD may continue through the teenage years and into adulthood (see sidebar). According to the Centers for Disease Control and Prevention (CDC), approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.

Three types of ADHD are recognized:

inattentive (trouble focusing, following instructions, and finishing tasks)
hyperactive-impulsive (constantly on the go, talking excessively, and interrupting others)
combined (symptoms of both inattention and hyperactivity-impulsivity)

Diagnosing the Disorder

Studies show that the number of children being diagnosed with ADHD continues to increase, from 7.8% in 2003 to 11.0% in 2011, according to the CDC. Tiffany R. Farchione, M.D., a child psychiatrist at FDA, reviews drugs to treat ADHD. She explains that the increase may be due to a greater public awareness of the disorder and psychiatric illnesses in general.

Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with the disorder. In addition, boys are more likely to have the hyperactive-impulsive type, which is easier to spot than the quieter child who is inattentive, says Farchione.

If you suspect your child might have ADHD, see your family doctor or pediatrician, suggests Farchione. Your child’s vision, hearing, and anything else that may contribute to inattention should also be checked. The doctor may diagnose ADHD or refer your child to a mental health specialist for evaluation.

Treatments

FDA has approved two types of medications—stimulants and non-stimulants—to help reduce the symptoms of ADHD and improve functioning in children as young as 6 years.

It may seem counterintuitive, Farchione says, but despite their name, stimulants, which contain various forms of methylphenidate and amphetamine, actually have a calming effect on hyperactive children with ADHD. They are believed to increase brain levels of dopamine—a neurotransmitter associated with motivation, attention, and movement.

FDA has also approved three non-stimulants to treat the symptoms of ADHD: Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). These provide a useful alternative for children who do not tolerate stimulants well. Talk with your health care professional about what medications may be best for your child.

In addition to medication, some children with ADHD receive behavioral therapy to help manage symptoms and provide added coping skills. Moreover, concerned parents can reach out to their children’s schools and community support groups for information and guidance on how to cope with ADHD behavior. “It’s helpful to engage with the different individuals who are involved in a child’s life when managing the disorder,” Farchione says.

Testing the Effects of Medication in Younger Children

FDA-approved medications currently on the market have been tested for safety and effectiveness in clinical trials of children ages 6 and above. But once a drug has been approved and is on the market, FDA is now asking for clinical trials with participants of children as young as 4 and 5, Farchione says.

“This is a fairly new policy,” she adds. “We know ADHD medications are being prescribed for younger children, and we think it’s essential that the data from clinical studies reflect the safety and effectiveness for this age group.”

Consequences of Not Treating

Left untreated, ADHD can have serious consequences.

A child may fall behind in school, encounter difficulties in friendships, and have conflicts with parents, says the American Academy of Child and Adolescent Psychiatry.

Studies show that children with untreated ADHD have more emergency room visits and are more likely to have self-inflicted injuries than those treated for the disorder. Untreated adolescents with ADHD are more likely to take risks, such as drinking and driving. And they have twice as many motor vehicle accidents as those who are treated.

ADHD: Not Just for Kids

Studies suggest that approximately 4% of adults may have attention deficit hyperactivity disorder (ADHD). The symptoms of ADHD in adults are the same as those in children, but they manifest somewhat differently. Adults with ADHD may have poor time management skills and trouble with multi-tasking, become restless with downtime, and avoid activities that require sustained concentration.

A diagnosis of ADHD in an adult is given only when it’s known that some of the symptoms were present early in childhood, usually under the age of seven.

“For some adults, a diagnosis of ADHD can bring a sense of relief,” says psychiatrist Tiffany Farchione. Receiving a diagnosis allows adults to understand the reasons for their problems, and treatment can help them to deal with challenges more effectively.

This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.