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ADHD Medications: What is a Parent to do?

The number of articles and books devoted to the topic of Attention Deficit Hyperactivity Disorder (ADHD) and the use of medications is enormous. It seems that everyone has an opinion on the matter; some are well-informed, while others are merely well-intentioned. The predicament is that the overabundance of conflicting information is resulting in the fear and paralysis of many parents of ADHD children. It is clearly becoming much more difficult for parents to make medication decisions on behalf of their children. At some point, every parent of an ADHD youngster will have to make a decision regarding the use of medications for treatment. Parents need some basic rules to follow to help with this arduous task.
I receive many phone calls every day from parents who want to know if they should put their son or daughter on an ADHD medication. My answer tends to be the same for almost all of them: in order to be able to make that decision, we have to know what the diagnosis is. A thorough evaluation is the first and most essential step in the process. It is impossible to treat any condition without knowing what you are treating. It is not prudent to “try a medicine to see if it works.” That is an inappropriate way to proceed and can actually be harmful. Many children who appear to have some ADHD symptoms actually have a different condition, such as anxiety or depression. Furthermore there are some kids who have anxiety in addition to the ADHD. In either scenario, it is essential to determine the diagnosis prior to initiating any kind of medication trial.
Once the diagnosis has been established, the second step is to weigh the benefit of medication treatment against the risks of its negative effects. The potential benefit of medication treatment of ADHD has been documented in numerous studies that have been successfully replicated by many researchers. At the same time, every medication has potential side effects. It is important to understand the different potential negative effects. Some are merely nuisance side effects that go away after a few days while others are more problematic. In order to proceed with a medication trial, the potential benefit should outweigh the potential negative effects.
Once the diagnosis of ADHD has been established and it has been determined that the potential benefit outweighs the potential negatives, the parents need to understand the risks of not treating the ADHD. Many studies have been conducted to examine the consequences of untreated ADHD. It is clear that there are numerous potential consequences such as academic failure, peer rejection, depression, accidents, substance abuse, etc…These consequences are significant and are typically not transient; they tend to continue to manifest into adolescence and adulthood.
If you are a parent of an ADHD child or teenager you need to understand these three basic rules before you proceed with trying a medicine for your son or daughter. It is also critical to work with a clinician with whom you are comfortable and who is able to explain the diagnosis of ADHD and how the diagnosis was determined. The decision to use medication can be an arduous one, but if you follow some basis rules and you work with a knowledgeable clinician the process will be much easier. One of the things that I emphasize in the book "Making the Connection: A Parent’s Guide to medication in AD/HD" is that this decision needs to be thought through and that it is never an emergency to start an ADHD medication.

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