The different ways of treating ADHD, and how they can be used for children, adolescents, and adults, are outlined below.

Medication

Medications for ADHD produce a short-lived improvement after each dose, but they are not a permanent cure. They create a short period when someone who has ADHD can concentrate better, be less impulsive, feel calmer, and learn and practice new skills.

There are three types of medication for ADHD:

• methylphenidate,
• dexamfetamine, and
• atomoxetine.

In the UK, all three of these medications are licensed for use by children and adolescents. Adults who were diagnosed with ADHD as children are licensed to use atomoxetine. However, there are no medications currently licensed for treating newly diagnosed adults, or for use specifically in adults. If you have been diagnosed with adult ADHD, your GP and specialist can discuss which medications and therapies may be suitable for you.

Medications for ADHD are controlled drugs, which means their availability and use is more closely controlled than other prescription medicines. If you, or your child, is prescribed one of these treatments, you will probably be given small dosages at first, which may then be gradually increased.

You or your child will need to return to your GP for regular check ups to ensure that your treatment is still working effectively. If you or your child has shown an improvement and the condition appears stable, your GP may recommend a break from treatment, for example, over a weekend, or during school holidays. These 'medicine holidays' help to assess how you or your child can manage without the medicine.

Methylphenidate - Ritalin, Equasym, Concerta XL

Methylphenidate, which comes in brands called Ritalin, Equasym and Concerta XL, are the most commonly used medications for ADHD in the UK. They are known as psychostimulants, or central nervous system (CNS) stimulants. It is not completely clear how they work, but it is thought that they stimulate a part of the brain that changes mental and behavioural reactions.

Methylphenidate can be used by children, with ADHD, who are over the age of six, and adolescents. Although methylphenidate is not licensed for use in adults, it is thought to work in much the same way, and may be taken under proper supervision from your GP and specialist. Methylphenidate cannot be taken by women who are pregnant, or breast feeding, and it should not be taken if you, or your child, has glaucoma, a tic, or Tourette's syndrome.

Methylphenidate can be taken as either immediate release tablets, which are small doses taken 2-3 times daily, or as modified release tablets, which are taken once a day, usually in the morning, and gradually release the dose throughout the day.

Ritalin and Equasym are immediate release tablets, and Concerta XL is a modified release tablet. Your GP and specialist may recommend Concerta XL if you, or your child, need the treatment to last into the evening. It may also be convenient for children who may not be able to take multiple doses at school. However, the doses of methylphenidate in Concerta XL are larger, and may not be suitable for young children.

Methylphenidate can cause side effects, which may include:

• a small increase in blood pressure and heart rate,
• loss of appetite, which can lead to weight loss (if your child is prescribed methylphenidate, your GP will monitor their weight to ensure that they are growing properly),
• trouble sleeping,
• dry mouth,
• headaches,
• stomach aches, and
• mood swings.

There are ways to ease these side effects, for example, loss of appetite may be avoided by taking the medication with a meal or snack. Adolescents and adults should avoid drinking alcohol during treatment because this can make the side effects worse.

Dexamfetamine - Dexedrine

Dexamfetamine comes in a brand called Dexedrine, and works in the same way as methylphenidate. It is also classed as a psychostimulant, or CNS stimulant, and may be particularly effective in controlling hyperactivity. Dexamfetamine can be used by children over the age of three, and adolescents, and although it is not licensed for use in adults, it is thought to work in much the same way, and may be taken under proper supervision from your GP and specialist.

Dexamfetamine cannot be taken by women who are pregnant, or breast feeding, and it should not be used if you, or your child, has epilepsy or kidney problems.Dexamfetamine is usually taken as a daily tablet, and may have side effects that are similar to those of methylphenidate.

Atomoxetine - Strattera

Atomoxetine comes in a brand called Strattera, and it works differently to methylphenidate and dexamfetamine. It is known as a selective noradrenaline uptake inhibitor, which means that it increases the amount of a chemical in the brain called noradrenaline. This chemical passes messages between brain cells, so by increasing the amount, it is thought that atomoxetine aids concentration and helps to control impulses.

Atomoxetine can be used by children, who have ADHD, and are over the age of six, and adolescents. It is also licensed to be used by adults who are continuing treatment following adolescence. However, it is not licensed to be used in adults who have been newly diagnosed with ADHD, but as it thought to work in the same way, your GP may prescribe it to be taken under their supervision. Atomoxetine cannot be taken by women who are pregnant or breast feeding, and it should not be taken if you, or your child, has glaucoma.

Like methylphenidate and dexamfetamine, the use of atomoxetine must be closely monitored by your GP and specialist. Some studies have shown that a small number of children and young people who take atomoxetine, are more likely to think about suicide, so if either you, or your child, begin to feel depressed or suicidal while taking this medication, you should see your GP to ask about switching to a different one. Also, in very rare cases, there is evidence that, Strattera can cause liver damage, so you should see your GP for regular check ups if you, or your child, is taking this treatment.

Atomoxetine comes in tablet form that you or your child takes once or twice a day. The tablets are long-acting, so your child will not need to take them at school. It may be prescribed as an alternative to methylphenidate, or dexamfetamine, if you or your child has a tic or Tourette's syndrome.

Atomoxetine can cause side effects which may include:

• a small increase in blood pressure and heart rate,
• nausea,
• waking early in the morning,
• dizziness,
• stomach aches,
• painful urination, and
• irritability.

If you or your child needs to be prescribed a medication for ADHD, your GP and specialist will take several factors into account before recommending a treatment. These factors will include any other conditions that you, or your child, may have, the side effects of each treatment, and whether or not the dosage times interfere with school or work.

Therapy

As well as taking medication, several different therapies can be useful in treating ADHD in children, adolescents, and adults. Therapy is also effective in treating any additional problems, such as conduct or anxiety disorders, that may appear alongside ADHD. The therapies outlined below can be carried out with the help of counselors, psychiatrists, psychologists, or social workers.

Psychotherapy

Psychotherapy is known as a 'talking' therapy, which means that you, or your child, will be encouraged to discuss your ADHD and how it affects you. It can help children, adolescents and adults to make sense of being diagnosed with ADHD, and can help you to cope and live with the condition.

Behaviour therapy

Behaviour therapy provides support for carers of children with ADHD, and may involve teachers as well as parents. Behaviour therapy usually involves behaviour management, which uses a system of rewards and penalties to encourage your child to try and control their ADHD.

If your child has ADHD, you can identify types of behaviour that you want to encourage, such as sitting at the table to eat. Your child is then given some sort of small reward for good behaviour, and a small penalty for poor behaviour. For teachers, behaviour management involves learning how to plan and structure activities, and to praise and encourage children for even very small amounts of progress.

Parenting skills training

If your child has ADHD, parenting skills training can help you learn specific ways of talking to your child, and playing and working with them, in order to improve their attention and behaviour.

Social skills training

Social skills training involves your child taking part in role-play situations, and aims to teach them how to behave in social situations by learning how their behaviour affects others.

Other methods of treatment

There are other ways of treating ADHD that many people with the condition find helpful in controlling it, such as cutting out certain foods and taking certain supplements. However, there is no medical evidence that these methods work.

If you or your child has ADHD and you want to try an alternative method of treatment, alongside medication and therapy, you could try cutting out certain foods. Sugar and caffeine are often blamed for aggravating hyperactivity, and some people may have intolerances to wheat or dairy products that may add to their symptoms. However, talk to your GP before changing yours, or your child's, diet.

Alternatively, you could try a supplement, such as omega 3, ginkgo, or zinc, to help you or your child's symptoms. However, you should always talk to your GP before taking a supplement, and remember that supplements should not be taken indefinitely.