Attention-deficit/hyperactivity disorder is characterized by an inability to concentrate, restlessness, impulsive and sometimes inappropriate behavior. Treatment of ADHD is mainly comprised of a mixture of behavioral therapy and medication. Some recommend that behavioral therapy should be started before giving any medications. Starting both treatment options at the same time will be more helpful in controlling the symptoms of ADHD children
Medical treatments don't cure ADHD, but they help control the symptoms; increase the ability to concentrate and decrease impulsive behavior. A stimulant is the first line therapy for treatment for ADHD. Meaning, it's the first drug that doctors prescribe to their patients, and if it doesn't prove to be effective, they try other drugs. Stimulants are the most commonly used medicines in the treatment of ADHD. They are effective in about 70% of adults and children. The primary concern some people have is that they may lead to addiction, but the doses used for the treatment of ADHD is too small to cause substance dependence. However, there should be caution in prescribing them for people with a history of drug addiction. Some of the most common symptoms include tics, nausea, and vomiting, increased blood pressure, loss of appetite and headaches. Stimulants work by stimulating the release of certain chemicals in the brain (noradrenalin and adrenalin)
Atomoxetine is a non-stimulant drug; it doesn't stimulate the release of brain chemicals, but it decreases their elimination. It may be used in the treatment of patients with a history of- or tendency towards substance abuse as well as people with tics and individuals with multiple mental health disorders. It's sometimes used as a second treatment option, if stimulant therapy is not effective from the start or if it started out productive but then stopped working. It is important to mention that it is less efficient in reducing the symptoms than stimulant drugs.
Bupropion is used for the treatment of depression, and it helps people who are trying to quit smoking by decreasing how much they crave nicotine. It's less commonly used for ADHD. The dose used to treat depression is also used to treat ADHD. It may be used as a second treatment option when stimulants fail to work. Venlafaxine Is another promising drug that can be used in patients who don't tolerate the other drugs or find them ineffective. A recently published review supported that it may be useful as a short-term treatment of ADHD.
These include desipramine, imipramine, nortriptyline. However, most of the studies focused on the use of desipramine. Some studies showed that it helped the treatment of symptoms in children with ADHD. However, a recent review found the quality of evidence from these studies to be low or very low. Desipramine may lead to loss of appetite, while nortriptyline might lead to increased weight. Another area of concern is the fact that it has cardiovascular side effects; it increases heart rate and blood pressure. Other side effects include a headache, blurring of vision, increased sweating and fatigue.
Including Clonidine and guanfacine, these drugs are used for treating high blood pressure they usually take from 7 to 14 days to show their effect. They have a sedative effect which makes them an excellent choice for patients who show a form of aggressive behavior. The main precaution is if the patient needs to stop taking the drugs, they have to do so gradually. If Alpha2 agonists are stopped suddenly, they will cause rebound hypertension. Rebound hypertension means that the once controlled blood pressure starts to become high again, upon abrupt stoppage of the drug. Rebound hypertension is dangerous and can lead to blindness or organ damage.
- Modafinil is a drug that helps to increase wakefulness, and it has been shown to be consistently able to reduce the symptoms of ADHD in children. It is possible that it can be used as another treatment option. - Divalproex: in a 2009 study that compared a placebo to Divalproex in reducing the aggressive behavior in children between (6-13) years old who have attention deficit hyperactivity disorder. At first, the kids took a stimulant therapy for five weeks. Then, half of them were randomly chosen to take Divalproex, While the other half were given a placebo. Divalproex was shown to have a bigger effect over the placebo.
Behavioral therapy is quite effective in helping children with ADHD have better control over themselves and obtain a higher self-esteem. It's advisable to try behavioral therapy as a first line treatment before starting any medications. Preschooler (children under six years old) benefit from behavioral therapy the most when their parents undergo training to help the children have a better life. Parents will learn how to communicate well with their children, which will contribute to bringing the parents and their children closer. They will also learn how to provide discipline and structure to help their children succeed in school.
School-based consultations have proven to be useful for children with ADHD. They help the children improve how well they do at school. These consultations may be done at a school level, or it could be done on an individual level with equal results. It's important to keep in mind that the ADHD children tend to show signs of anxiety and depression. Consultations help the child deal with any negative emotions he may have. Telepsychiatric consultations are helpful for parents, who live in rural areas and who may not have access to regular psychological consultation.
Many studies have been conducted on the role of diet in ADHD children. It is advisable for children with ADHD to eat a healthy and balanced diet. An improved diet will help improve their overall health and quality of life. It may also contribute to reducing the symptoms of ADHD. Eliminating the consumption of some color and flavor, artificial food additives has also been proven to be effective in some children. Increasing the intake of Omega-3 fatty acids may help as well and will contribute to improving cardiac health. Omega-3 fatty acids are also found in food like salmon and tuna. However, the traditional diet usually lacks in Omega-3 sources, that's why Fish oil supplementation have become an important source.
Physical activity is quite useful for children with ADHD. It helps increase their ability to concentrate, decreases impulsive behavior, reduces restless behavior and enhances social skills. Physical activity may include any sports like basketball, swimming, soccer or even dancing. The activity of going out and having a short walk helps increase the children's ability to concentrate. Children should do any form of exercise for at least an hour per day. Regular physical activity can also help with the symptoms of ADHD along with the conventional treatment, mainly behavioral therapy and medications.
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