Treating ADHD Without Stimulants
Parents might consider other drug choices and behavior management therapy
Stimulant drugs aren't the only way to tackle a child's ADHD, says Ronald Brown, a pediatric ADHD expert at Temple University. Parents vexed by today's news that heart monitoring is advised for children prescribed stimulants may want to consult their pediatrician about nonstimulant alternatives and behavior management therapy, a nonmedicinal treatment that's been shown in studies to manage symptoms as effectively as drugs can. Other drug choices include:
- Strattera. This nonstimulant medication acts on norepinephrine, a neurotransmitter in the brain, Brown says. Side effects may include nausea, appetite suppression, dizziness, fatigue, and mood swings.
- Antidepressants are also used to manage ADHD and can enhance attention and concentration. Side effects may include insomnia, dizziness, irritability, and constipation. Some types of antidepressants may carry serious heart risks, and others can't be used by people prone to seizures.
- Blood Pressure Drugs. Certain antihypertension drugs are also used to treat the hyperactivity and behavioral problems associated with ADHD, Brown says. Since they lower blood pressure, stopping medication abruptly is never advised; doing so can cause blood pressure to spike, which can be deadly.
Used alone or along with medication, behavior management therapy is typically overseen by a child psychologist and hinges upon parents and teachers who consistently reward children for good behavior and punish undesirable behavior. For younger children, that might mean treats as rewards and timeouts for punishment; for older kids, it might mean car-driving privileges or loss of those rights. But there are downsides to this treatment route: It's labor intensive, and insurers often won't foot the bill, as they would for medication. Nonetheless, Brown says, today's news serves as a reminder that medication "should be used judiciously. There are other treatments available that are evidence based, and that should be provided."
Reader Comments
Other Treatments
I refused to put my 9 year old on medication. It really is strange that the author only includes more medication that has equivalent or worse side-effects.
We did a program called Play Attention. It's like bio feedback, only better.
Behavior modification
1) Whatever ADHD program works for your child, it is silly to talk about behavior modification as the one non-medication treatment. Parents come in for help because a child who truly has ADHD doesn't stop and think about consequences before acting.
2) Even when stimulants work, they are not enough; I tell kids that just as glasses help you see but don't make you look, medications make you ABLE to suppress impulses and sustain focus, but you have to choose to do so.
3) Pet peeve: there are other qualified child psychotherapy professionals who are not "psychologists." Please say mental health professional, psychotherapist, or list clinical social workers and counselors.
spanking was used historically
Before spanking was considered abuse, we didn't need to drug our kids to make them be good. We simply were spanked and went on. I remember a boy getting a spankin in kindergarten. It only took one time for one boy, the rest of us were good the rest of the year, with no drugs.
drugs don't work for everyone
my 8 year old son has tried three different medications and each one has simple drove him crazy. they worked for the first three weeks then he started getting aggressive and it was so scary to watch. the doctors make you feel guilty if you don't put them on meds. we will not be putting our son thought anymore. i now firmly believe that no drugs is the best way forward.
Drugs
Everything was tried on me. Diets, behavior modification, rewards systems, punishment systems. I tried very hard, and all I ever got was disappointment.
When in my 30's I tried Strattera and after 3 weeks started seeing improvement. Ever since then my life has been going up. Before strattera life was very difficult, now I am happy and moving forward in my career.
I know it wont work for everyone, but unlike the Feingold diet it has unbiased studies to back it up. There is something to be said about consistent, reproducible results.
Treatments
The confusing aspect of ADHD, is that since almost everything makes them worse..... then almost everthing has the potential to make them better. e.g. Captain Crunch for breakfast might make an ordinary kid a little sleepy 3 hrs later, it will make an ADHD hit the roof. Does this mean sugar is the answer? No, just that the vulnerability makes so many treatments seem like "the" treatment.
Also despite some thoughts to the contrary, these ADHD kids are still human after all. the dilemma of "lead a horse to water." And the psychiatrist lightbulb joke "has to want to change." still applies to them as it does to us all. Getting into trouble is very very stimulating for these kids and any kid. Hence the immediate negative feedback of a spanking does have some merits. In a society that allows kids to spit on the teacher and laugh..... and get away with it......drugs and prison in that kid's future.
Drugs to counteract drugs
Unfortunately, ADHD kids get lumped together. Each child/adult is wired very differently and they react differently to treatment. My 14 year old was diagnosed ADHD by age 5 and displays characteristics of "rage" ADHD. After 7 years of diet, drug, in-patient/out-patient therapy, bio-feedback and behavior modification - we stopped everything. We committed 30 days to cleanse all the drugs out of his system (no different than recovery for an addict) and started fresh with a stimulant.
Two years later - did I wind up with the perfect child? No. Hardly. But my son was looking back at me without a souless stare. He's not as successful as he could be. At his age, he needs to want it as much as I want it for him, with some guidance. Today we focus on finding his success and self treatment as he enters adulthood.
So, while the artilcle references options to stimulant therapy, it should be noted they are "options". As parents, we need to educate ourselves and our community, and do what is right for the child. Remember the Dr's are offering their opinions for treatment. We should respect other parent's right to treat their child as they see appropriate. You are fortunate if the treatment you sought worked for your child!
ADHD W/O STIMULANTA
I haven't read this
ADHD
I HAVE AN 8yr. OLD GRAND-SON THAT HAS BEEN ON ADHD MEDS FOR 2yrs. OUR MAIN PROBLEM IS THE SCHOOL, THEY JUST DO NOT TRY WITH CHILDREN. THEY TOLD US HE WAS IN A SPECIAL ED. CLASS, COME TO FIND ALL IT WAS WAS A DETENTION CLASS. THEY WERE NOT TEACHING HIM ANYTHING!!
WANDA STORY
ALBANY, GEORGIA
meow
meow, meow meow meow I am a cat
look at me meow
I sit here and stare at you
where is my food
where is my toy
why are you reading this?
meow meow meow meow
oy boy
ADHD and Bi-Polar
My daughter was diagnosed with adhd when she was 6yrs old. She has been on Ritalin and Adderall over the past 8yrs. When she turned 13 she was diagnosed with Bi-Polar and since then she has been in 2 behavioral hospitals and 1 Six month long-term facility to get put on meds to treat both ADHD and Bi-Polar. I saw a little improvement when she came home, but since then it is gone. She is on Ambilify, and Tenix. Is there anything else for the Bi-Polar and ADHD that is safe for her to take. She is 14 and is very smart. Her grades are suffering, and her attitude is awful. She feels that what she does is always right and if someone else does the same thing that they should be punished. She is also in thearpy. If you have any suggestions !!!!!!!!!!
adhd med's and schools
My son has been on medication for 2 years now and I thank God everyday for a wonderful teacher who helped us try other options before medication. My son's first grade teacher was so helpful and is still supportive to this day. She gave him things to occupy his hands while she taught and gave him wiggle room. She was also a huge support with his school and administration. We have a SST team at our school, student support team, that we meet with and gave our view of his issues and problems with classes. We discovered that our son is very intellegent and was reacting to the fact he knew the info being taught and was bored. Once we had an IQ test run and got results , 6yr 15days / iq 160, we were better able to focus on his needs. However, after the birth of his baby brother he took a down hill turn and we had to make the choice to put him on medication. The 1st day he took it was very enlightening and also a shock that we had put our ideas of ADD meds and the way society looks at ADD kids ahead of the health and happiness of our child and family. I am also thankful for my son's doctor, she listens to us and helps us make good choices on med's. We have just switched to Vyvance which last much longer, prior his Metadate cd ran out at 3:00 pm everyday. Now we can get through homework, dinner, bath and reading/family time without tears.
It is a personal choice and a hard choice to make to put your child on medication, however I now see it as a disservice to my son to have waited so long to get him the help he needs. Now he can act, react, control and function normally in his day to day activities.
ADHD meds or not
I have a son who has been treated for his issues with behaviour modification. He had tried Strattera but it didn't help and I just did not want the risk of the stimulants. I have a step son who has been in on 4 meds in 3 years and also on some non-traditional therapies. I really believe the best treatment is caring parents. I have worked in mental health as a nurse and in medical areas as a nurse. In both I witnessed a greater number of parents wanting medications to do their job of parenting. Yes, these kids need move attention but instead most get more drugs. I believe that 75% of the kids diagnosed are not ADHD or ADD but AGP (absence of Good Parenting) When I was a kid you did get spankings but you also got sent outside to play and to use up some of the energy. Kids now sit too much (hence part of the obesity problem) and watch TV and do video games too much. Yes, the TV and the games engage them so they do not " bother their busy parents" But isn't that part of parenting to engage the kids and guide them. I think so many times great kids get labeled ADHD because the parents and sometimes the schools don't want to put forth the effort to bring the child up. Meds should really be the last thing we try. And in response to the spanking comment. Not all spanking is termed abuse, only that which is too harsh or leaves marks. I know from experience my Grandma could give me a rememberable spanking with her hand that left no visible mark but gave me a memory I did not want to repeat!. Parents need to clarify with their local DFACs office what is allowed and exercise more of their rights as parents and not more of their rights as drug pushers.
Is it ADHD?
Our son, now 13, has been on medicine for about ten years. A year ago he got so out of hand, we hospitalized him for 5 days. Less than a month later, it was suggested to us by the school psychologist that he might have Aspergers Syndrome. We had
never heard of this before. We changed psychiatrist and done some homework, and he has since been diagnosed with AS.
If the professionals, Dr., are not listening to you, please find someone that will and
that will help your child, because they may have other problems.
His 16 y.o. brother is also ADHD and doing good on medicine.
Every child is different and needs different approaches.
Where does ADHD come from?
I believe that society of today is the creator of the ADHD epidemic.
We have heard the stories; teaching children at an early age will enhance and play an important part in their brain development. From the beginning, a child is like a sponge, absorbing, learning, growing and developing their brain in response to their surrounding environment. So why do we have so many more cases now than ever before?
I feel that the development of child’s brain in the early years is being modified by too much non interactive visual stimulation. Since the 60’s, society as created non-thinking, visual addiction and we adults have been programmed to continue this downward spiral. We will actually use the TV as a babysitter/entertainment to occupy our kids and feed our own addiction.
Just watch a child looking at a tv or video game. They are inattentive to their surroundings and their energy level is not being used, creating the hyperactive effect we see in kids. This along with the antiquated teaching process that the schools use, by wanting kids to sit all day, behave and stay quiet, plus our adult world of moving faster and faster and us adults being exausted, is making our children be diagnosed with ADHD. After all if it does not fit the mold, then something must be wrong with it.
This is what is creating the health demise of our generation, with obesity, depression, and yes lack of attention(ADD). We use to only have this in our homes, and only at night. Now we see it 24 HRS a day, all around us, in the car with HD tv, video games, computers, internet, and on us with ipod, MP3 players and cell phones.
Corporate society in the attempts to make a buck is actually hurting the human body. But in the end it's us, with our addiction, that is the problem. Life around us is boring, we need to have more excitement, more speed, more of everything because if we don't we become depressed. Gee, it sounds almost like the symptoms of an addict when they can’t get their fix.
ADD
Hi-
I am a 30 year old with ADD. I too found this article lacking in depth and insight.
People with ADD often have tremendous gifts, but because we are not normal and can't do a lot of normal things (like sit in class and take notes), we often fail at things other kids can do easily.
So here is the key: find out what your child's GIFTS are. Celebrate those. Nurture and develop those.
The key to a good life with ADD is developing strengths. Of course, working on weaknesses is important too (like organizational skills).
Michael Phelps (7-time gold medal winner at 2004 Olympics), David Neeleman (FOunder of JetBlue Airlines), and Paul Orfalea (CEO of Kinko's) are just three out of thousands of successful ADD adults who have accomplished great things.
Find those gifts and celebrate them....
How Do I Save My Child?
I have a beautiful 21 yr. old daughter (youngest of 7) who has been diagnosed with a brain tumor, ADHD, Tourette's Syndrome, Obsessive-Compulsive Disorder and BiPolar. She has been prescribed at least 20 different medications to treat some or all of her illnesses. If a medication works well for OCD, it increases problems with bipolar and on and on and on. She was once 4th in the U.S. in gymnastics and a competitive ballet dancer. She is no a SSI recipient who has had over 40 jobs in the past few years. She takes geodone, luvox and was recently prescribed 300 mg. of Adderall per day. SHe had an extremely violent mania episode which resulted in the breaking of a window. She faces charges of criminal damaging, resisting arrest, disorderly conduct, and assault of a police officer. Prior to this situation, she did not have a criminal history. Her first diagnosis was ADHD. The others have been added over the years. I am so sad for all the parents trying to help their children. It seems this area of medicine is "hit or miss".
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nonstimulant treatments
I am disappointed that in a discussion of nonstimulant treatments you did not mention the Feingold diet, which has been a successful treatment for people with ADHD for over 30 years, nor did you mention that essential fatty acids and other supplements are beneficial - in many cases as good as the stimulants (Harding 2003). Certainly these are safer approaches to try than any of the drugs. You may see the science supporting these treatments at http://www.feingold.org/Research/adhd.html
Apr 21, 2008 23:44:01 PM [permalink] [report comment]