Wednesday, November 25, 2009

Brain & Behavior

Treating ADHD Without Stimulants

Parents might consider other drug choices and behavior management therapy

Posted April 21, 2008

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:

Video: ADHD
Video: ADHD
  • 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."

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