ADHD treatment options

ADHD medications

There are few options for ADHD medications, and your health care provider can help you select the right type and dosage to effectively manage symptoms while avoiding serious side effects. If side effects become intolerable, talk to your doctor right away about adjusting your dosage or trying a new drug.

The two main classes of ADHD medications are stimulants and nonstimulants.

Stimulants

Stimulants (like Adderall and Ritalin) are the most common and effective medications for ADHD and can reduce symptoms in 70% of adults and 70% to 80% of children. They work by increasing the dopamine and norepinephrine levels in your brain, allowing you to stay more focused and alert.

There are immediate-release stimulants, which last up to four hours and are typically used on an as-needed basis, and extended-release stimulants, which can last up to 16 hours. Immediate- and extended-release drugs can be used on their own or in conjunction with one another, according to the Cleveland Clinic.

Common side effects of stimulant medication include:

• Appetite suppression
• Weight loss
• Poorer sleep quality
• Headaches
• Stomachaches
• Irritability
• Anxiety

Nonstimulants

Nonstimulant medications, like Strattera and Qelbree, are somewhat effective in reducing ADHD symptoms, and they’re typically used for patients who can’t take or tolerate stimulants.

These drugs work by increasing norepinephrine, a neurotransmitter that increases attentiveness and decreases hyperactivity. However, according to the Child Mind Institute, some of these drugs can take three to four weeks to start working, and they only reduce symptoms in roughly half of patients who take them.

Common side effects of nonstimulant ADHD medications:

• Vomiting or nausea
• Headaches
• Stomachaches
• Trouble sleeping
• Anxiety

Can antidepressants treat ADHD?

Antidepressants are occasionally prescribed to treat ADHD, although they aren’t approved by the Food and Drug Administration (FDA) for this purpose. In some cases, antidepressants may be prescribed to increase dopamine and norepinephrine levels, or they may be paired with stimulants to treat patients with co-occurring conditions like depression and anxiety, according to the Cleveland Clinic.

» MORE: Symptoms of ADHD in kids

Behavioral and cognitive behavioral therapy

Because people with ADHD often find it hard to regulate their behaviors and emotions, psychotherapy is also commonly used as a treatment. Behavioral therapy and cognitive behavioral therapy (CBT) are the two most effective approaches when used in conjunction with stimulant medication.

• Behavioral therapy: Behavioral therapy is often the first treatment recommended for children with ADHD, especially those under six years old. This approach is most commonly used to train parents in behavior management so they can address ADHD symptoms at home by promoting positive behaviors and decreasing the prevalence of negative behaviors. Once the child is older, most providers recommend pairing behavior therapy with stimulant medication.
• Cognitive behavioral therapy (CBT): For adults, CBT is the most widely used therapy for ADHD. It’s often effective on its own and when used in conjunction with medication. Cognitive behavioral therapy addresses negative thought patterns that can occur in ADHD patients and seeks to reframe them to help lessen the effects of symptoms like procrastination, lack of motivation, low self-esteem and anxiety.

How to manage ADHD

Making lifestyle changes can also reduce the severity of ADHD symptoms and support treatments like medication and therapy. Below are some of the most important changes you can make to address ADHD.

• Better sleep: A lack of sleep can negatively affect your mood and attention span, and improving the quality and regularity of your sleep can help. Try limiting screens one hour before bed, taking supplements like melatonin and implementing a sleep routine (e.g., taking a warm shower or reading) right before bed.
• Exercise: Regular exercise can improve your mood and promote brain growth, which improves concentration, executive functioning and memory — all areas ADHD affects.
• Improved diet and nutrition: A balanced diet can help your brain get the nutrients it needs and stabilize blood sugar levels, which can improve mood and focus. Specifically, try to minimize the consumption of alcohol altogether, limit caffeine in the afternoon and cut back on refined sugar.
• Time outdoors: According to research, spending time in nature — or even just looking at pictures of nature — has been shown to improve one’s attention span, and when children with ADHD spend time outdoors, parents report a reduction in symptoms.
• Stress management: There are three types of ADHD: hyperactive-impulsive, inattentive and combined. Managing stress is important for everyone, but it’s particularly crucial for those with inattentive ADHD. Try mindfulness meditations, breathing exercises, journaling or using an app like Calm or Headspace to reduce stress levels and improve sleep.
• Organization: ADHD can negatively affect your working memory, motivation and planning abilities. Using organization systems can help. Try using external reminders, like calendar notifications, phone alerts, timers to break work sessions into manageable chunks or a color-coding system for your calendar and to-do list.

Holistic treatments for ADHD

While medication and psychotherapy are the two most effective methods to treat ADHD, alternative treatments may be used to supplement these treatments.

Consider the following if you’re looking for additional ways of managing your ADHD symptoms:

• Meditation and mindfulness: According to the World Journal of Psychiatry, meditation and mindfulness practices can benefit your mental and physical health and are effective when paired with CBT or medication to reduce residual inattention.
• Nutritional supplements: Studies show that taking omega-3 and omega-6 fatty acid, vitamin D and magnesium supplements can help reduce ADHD symptoms.
• ADHD coaching: An ADHD coach can help you address issues around planning, organization and time management. Coaching can also help you implement new strategies you can use to overcome challenges and carry out daily tasks.
• Neurofeedback: Neurofeedback is a newer approach to treating conditions like ADHD. It works by tracking and measuring brain waves using electroencephalography (EEG), then training the brain to improve areas like focus and attention. Although more studies need to be done on this treatment, early evidence suggests it’s effective when used alongside medication and psychotherapy. Some researchers suggest it could even be a viable alternative to these conventional methods.

Comparing different ADHD treatment options

Stimulant medications are by far the most effective treatment option for ADHD, but rarely is medication alone enough to address all symptoms. Ideally, patients use a combination of treatments that includes medication, therapy, skills training and lifestyle changes.

Finding the right treatment plan takes trial and error. Consider factors like your age, the severity of your symptoms and whether you have any co-occurring conditions that limit your medication options. For example, one patient might do well on a combination of Adderall and ADHD coaching, while another who can’t tolerate the side effects of stimulants might benefit more from a nonstimulant drug like Strattera and weekly CBT sessions.

The most important thing you can do is work closely with your health care provider to monitor your symptoms and make changes to your treatment plan when needed.

Some newer treatment options like neurofeedback, brain training games and transcranial magnetic stimulation (TMS) — which stimulates the brain using electrical currents — are still in the early stages of research. If you’re interested in these emerging treatments, ask your health care provider for more information.

Bottom line

There are several effective treatments for addressing ADHD symptoms. The two most common are stimulant medication and psychotherapy, though most patients find the best results with a multifaceted approach that includes complementary treatments like ADHD coaching, lifestyle changes and meditation.

If ADHD symptoms are left unmanaged, they can have detrimental effects on your life. If you or someone you love is struggling to manage ADHD symptoms, research your options and work closely with your health care provider to find the right treatment for your individual needs.

Early intervention is key, and ongoing ADHD treatment should be a collaborative (and regularly reevaluated) process that involves families, educators and health care providers. Ultimately, finding the right treatment options benefits not just the person who’s affected by ADHD but also those who support them.