ADHD Diagnosis and Treatment: Straight Answers to Your Questions

Why has the prevalence of ADHD diagnoses increased?

According to research studies, the prevalence of ADHD diagnoses has increased due to ease of diagnosis and high demands for compliance in classrooms. The youngest children in each grade are considerably more likely to be diagnosed with ADHD than their older peers, which suggests that many children are being diagnosed with ADHD who are simply being asked to perform beyond their neurocognitive maturity.

Are there inconsistencies in ADHD diagnosis across regions?

Yes. CDC surveys have found that the percentage of children under 17 who have ever received an ADHD diagnosis varies dramatically by region of the country. Some southern states reach rates as high as 16.6%, which is roughly three times that in most western states. These findings suggest that there are highly inconsistent practices in diagnosis across different regions.

What are the most commonly prescribed stimulants for ADHD?

The most commonly prescribed stimulants for ADHD are amphetamines, methylphenidate, and lisdexamfetamine.

Are stimulant medications the first-line treatment for ADHD?

Yes, stimulants are the first-line treatment for ADHD due to their significantly higher efficacy than non-stimulants. Non-stimulants are generally used only in individuals who don’t tolerate stimulants.

Are there any non-stimulant ADHD medications?

Yes, atomoxetine, clonidine, and guanfacine are non-stimulant ADHD medications, but they are rarely used as they produce only modest improvements in symptoms when used in isolation.

Are ADHD medications safe?

Stimulants taken as prescribed for ADHD are safe in the short term (i.e. under 2 years) with very few exceptions. However, it is important to apply caution prescribing stimulants when children are under 8 years old, and over a period of years, as studies do not rule out 2nd and 3rd order potential negative side effects.

Does medication work for ADHD?

Yes, studies investigating the effect of a single dose of methylphenidate on individuals with ADHD have found marked improvements in neuropsychological functioning in relation to their unmedicated ADHD peers. Comprehensive meta-analyses of the literature provides strong evidence for protective effects of stimulant treatment of ADHD across several categories, such as decreased risk of substance misuse and improvements in academic performance.

Can ADHD be treated without medication?

Yes, there are other interventions that should be considered either in place of or in addition to pharmaceuticals, such as academic accommodations, increased physical exercise, parental education, limiting sugar / processed food, and good sleep hygiene. A combination of behavioral interventions and medication produces the most significant improvement in functioning and reduction in symptomatology.

What is the difference between Ritalin and Adderall?

Ritalin and Adderall have very similar effects in the body, but there is a slight difference in their mechanism of action. Both medications inhibit transporters that are responsible for the reuptake of dopamine and norepinephrine from the synapse, thus increasing their extracellular concentration. Adderall, however, has the additional effect of increasing the release of dopamine from the neuron, and produces a modestly larger increase in dopamine concentration.

Is it ethical to medicate children for ADHD?

It is not ethical to medicate children without careful diagnosis, for the convenience of parents and teachers, or merely to give a child a competitive advantage academically. A critical prerequisite for writing a stimulant prescription for a child must be that it is medically indicated, necessary, and in the child's best interest.