He Attention deficit disorder and hyperactivity (ADHD) is one of the neurological disorders with the greatest impact in childhood due to its high prevalence. Between 2 and 5% of the child population suffers from it. When parents give us a diagnosis of ADHD in our children, we feel two very different emotions at the same time. On the one hand, we are relieved that we finally understand the cause of their learning, behavior and socialization problems. But, on the other hand, we are filled with anguish when they speak to us of the need for drug treatment: what are the risks and benefits of medication in ADHD children? Will it have negative consequences in the future? What side effects does it have? Will your personality change?
The decision about whether to medicate a child with ADHD must be made by the parents, in agreement with the specialists who treat the child, and always assessing the pros and cons of drug treatment. For this reason, it is important as parents to know what the pharmacological treatment of ADHD consists of and what risks and benefits it entails.
Before entering the world of children's pharmacology, we must shake off prejudices and take into account that the brain is an organ like any other and it may need medication for its proper functioning. If our child were diabetic, we probably wouldn't even consider refusing to give him insulin.
On the other hand, an effective pharmacological therapy will always be regulated by a specialist in child psychiatry or a neuropediatrician, who, after basing himself on the characteristics of the child, his medical history and his needs, will decide which drug is best suited to each case.
The duty of the specialist is to guide the parents, but we are the ones who will finally make the decision to opt for drug treatment or not. It is an important decision that should not be trivialized. Therefore, we must be informed about the risks and benefits of each drug.
The most commonly used drugs for the treatment of ADHD are stimulants, like methylphenidate. This type of drug increases the levels of dopamine in the brain, a neurotransmitter that plays a critical role in attention and concentration. The best known within this group are the Rubifen and the Concerta.
These drugs help improve our children's impulsive and hyperactive behavior, as well as their attention span, vigilance, and learning. But they also have certain costs such as loss of appetite, irritability, insomnia, as well as the appearance of tics or headaches. These side effects are usually very mild and occur with greater intensity and frequency at the beginning of treatment, but usually after a few weeks they usually disappear.
On the other hand, we have antidepressant treatment. The word antidepressant sounds a bit strong when it comes to children, it is normal for parents to be reluctant to them. They are usually used when stimulants have not been effective or when ADHD has depressive symptoms or significant states of anxiety. We have different subtypes, the most used are:
- The Tricyclics. such as Imipramine or Clomipramine, which have the same benefits as stimulant drugs, but which would present greater side effects such as: dry mouth, drowsiness or insomnia, dizziness, hand tremors, tachycardia or sweating, and on rare occasions it can also cause alterations cardiovascular
- Selective Serotonin Reuptake Inhibitors (ISSR), such as Prozac. They are usually used when depressive symptoms appear and the side effects are not as noticeable as tricyclics.
Finally, we would have Neuroleptics or antipsychotics, such as Haloperidol. This treatment has more significant side effects than those of the previous groups and is only recommended in cases where ADHD occurs comorbidly with more serious disorders, such as Negative Defiant Disorder, Impulse Control Disorders or Gilles de la Tourette.
ADHD is a chronic condition, but treatment can help considerably to reduce symptoms and make our children's day-to-day life easier. Pharmacological treatment, together with psychological therapy, will help the child to develop his personal strengths and provide him with resources to function successfully in his day-to-day life.
'If you judge a fish by its ability to climb trees,
He'll live his whole life thinking he's useless. '
Text: Úrsula Perona, child psychologist and disseminator.
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