More good news: There are a wide variety of treatments available for ADHD, including medication, counseling and behavior therapy, and lifestyle changes. The right options for you or your child often depend on age, symptoms, and similar factors. In its most recent clinical practice guidelines, the American Academy of Pediatrics (AAP) recommended behavior therapy and medication for children ages 6 and older. For younger children, the AAP recommends behavior therapy as a first-line treatment, before medication. That’s because medication can have more side effects in younger children, and the long-term effects of ADHD medication on very young children have not been well studied, according to the Centers for Disease Control and Prevention (CDC). In adults, medication is often a key component of ADHD treatment, according to the Mayo Clinic. Along with taking medication, people with ADHD may benefit from skill-building interventions, as well as counseling to improve both their behavior and social skills. Here’s what you should know about the treatment options for ADHD. Overall, studies show that medications, either stimulants or nonstimulants, reduce ADHD symptoms better than a placebo. But it’s important to note that research on the long-term effects of these drugs — particularly the long-term side effects — is still limited. There’s also a lack of head-to-head trials comparing the safety and effectiveness of medication to nonmedication treatments, such as cognitive behavioral therapy. Although experts don’t know exactly how ADHD medications work, it’s believed that they may help by increasing the amount of the neurotransmitters dopamine and norepinephrine in the brain, according to Russell A. Barkley, PhD, a retired former clinical professor of psychiatry at the Virginia Commonwealth University Medical Center in Richmond and author of When an Adult You Love Has ADHD. The most common types of prescription medications used to treat ADHD are:
Stimulant Drugs for ADHD
Stimulant medications are the most commonly prescribed drugs for ADHD, according to the Cleveland Clinic. Stimulants are available in immediate-release and extended-release forms, Cleveland Clinic experts note. They come as a pill, capsule, liquid, or skin patch. Stimulants can cause side effects, such as stomachache, weight loss, irritability, decreased appetite, and insomnia, according to the Cleveland Clinic. Some stimulants may increase the risk of developing heart problems or psychiatric problems like anxiety or depression. And particularly in teens and adults, there is a risk of misuse of these medications, including taking too much, inappropriately using them, or sharing them with friends. Some common stimulant medications used to treat ADHD include:
Amphetamine (Adderall)Methylphenidate (Concerta)Methylphenidate patch (Daytrana)Dextroamphetamine (Dexedrine or Dextrostat)Dexmethylphenidate (Focalin)Methylphenidate (Ritalin)Lisdexamfetamine (Vyvanse)
Nonstimulant Drugs for ADHD
Nonstimulant drugs are sometimes used along with, or as an alternative to, stimulants, according to the Cleveland Clinic. The first nonstimulant for ADHD, atomoxetine (Strattera), was approved in 2002, according to the U.S. Food and Drug Administration (FDA). Nonstimulants don’t carry the same risk of misuse as stimulants, and their effects can last up to 24 hours, note Cleveland Clinic experts. Other common nonstimulants include:
Guanfacine (Intuniv)Clonidine (Kapvay)Viloxazine (Qelbree)
Strattera carries a black box warning because studies show that children and teens taking it are slightly more likely to develop suicidal thoughts, according to the FDA (PDF).
Antidepressants for ADHD
Although not approved by the FDA specifically for the treatment of ADHD, antidepressant drugs are sometimes used, alone or in combination with a stimulant, to manage the condition, according to the National Institute of Mental Health (NIMH). Although antidepressants are often safe and effective, the FDA issued a warning in 2004 stating that the use of antidepressants in children and teens may, rarely, lead to an increased risk of suicide. Antidepressants sometimes prescribed for ADHD, according to the Cleveland Clinic, include:
Nortriptyline (Pamelor)Desipramine (Norpramin)Imipramine (Tofranil)Bupropion (Wellbutrin)
Common forms of counseling include:
Behavior Therapy
Behavior therapy is a form of counseling in which children or adults with ADHD learn behavior-changing strategies and coping skills for dealing with difficult situations, according to the NIMH. It can help improve organizational and time-management skills, as well as reduce disruptive behaviors. The therapy may involve practical, organizational assistance, as well as learning how to better self-monitor behavior, NIMH experts say. Parents can also work with a psychologist, social worker, or licensed counselor to learn strategies to help their children, which is referred to as parent behavior therapy or parent training, according to the CDC.
Psychotherapy
This type of treatment involves consulting a psychologist or psychiatrist about ADHD-related issues, identifying negative patterns of behavior, and learning ways to manage symptoms, say experts at the Mayo Clinic in Rochester, Minnesota.
Family Therapy
This form of therapy helps parents, spouses, siblings, and others who have a loved one with ADHD, according to the Mayo Clinic.
Social Skills Training
This type of training or intervention helps children learn appropriate behaviors in social settings, say Mayo Clinic experts. This can include learning how to manage peer relationships, improve social problem-solving skills, and decrease socially disruptive behaviors. For children, according to the CDC, these measures may involve:
Creating and following a regular routine for meals, naps, and bedtimeFrequent physical activity and time spent outdoorsKeeping all areas of the home organized and uncluttered, and having a designated place for toys, clothing, and school materials so that your child is less likely to lose themRemoving distractions, such as TVs and cellphones, especially when your child is doing homeworkUsing simple words, direct eye contact, and clear commands when giving a child instructionsFinding ways to boost self-esteem, such as sports and other extracurricular activitiesHelping children break down large tasks into smaller, less overwhelming onesShowing affection frequentlySetting boundaries compassionately, which includes recognizing and validating the child’s struggle and giving positive feedback for effort and small accomplishments while also being clear, consistent, and firm about what kinds of behaviors are not allowed
For adults, lifestyle accommodations, according to Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), can include:
Twenty to 30 minutes of aerobic exercise (meaning activities that get your heart pumping, like walking, jogging, cycling, or gardening)Making and sticking to routinesHaving visible, physical reminders of deadlines, upcoming events, and tasks at hand, such as calendars, to-do lists, alarms and reminders on cellphones, or sticky notesGetting enough sleep and practicing good sleep hygiene, which can include waking up and going to bed at the same time each night and avoiding screen time an hour before bedKeeping designated workspaces free from distractions, such as phones, TV, or leisure reading booksMaintaining designated spots for keys, bills, and important paperworkBreaking large tasks into smaller onesTaking predetermined work breaks, which are often most helpful when they follow a difficult or focus-intensive task. Green breaks, or taking breaks in nature, can give you a sense of calm and improve your focus.
Some complementary therapies for ADHD could include:
Dietary Strategies
Diets for ADHD symptoms can involve eliminating sugar, wheat, milk, eggs, food colorings, or food additives. But in general, cutting back on sugary foods like candy or sugar-sweetened drinks like soda is a good idea. Prior research has shown that eating simple sugars and processed foods can have adverse cognitive and behavioral effects on children and adults over time. Although eating too many sugary, processed foods may impact behavior, there’s currently no evidence that sugar causes ADHD, and very limited evidence that cutting back on these foods can help manage the core symptoms of ADHD. That said, making small, healthy changes to your diet can still benefit your overall health. If you’re considering making any significant dietary changes, be sure to talk to your doctor before doing so.
Omega-3 and Omega-6 Fatty Acids
Although the manufacturers of many popular dietary and herbal supplements, like zinc and ginkgo biloba, claim that their products can help treat ADHD, many lack scientific support and can cause unwanted side effects, according to a review published in Child and Adolescent Psychiatric Clinics of North America. Omega-3 or omega-6 fatty acid supplements could potentially make a difference for people with ADHD, but research on their effectiveness has yielded mixed findings thus far. For instance, the aforementioned review suggested that omega-3 fatty acids may modestly improve ADHD symptoms. But a clinical trial, published in 2017 in European Child & Adolescent Psychiatry, showed that omega-3 supplementation offered no benefit among children with moderate ADHD. Other data, published in 2016 in the Journal of Attention Disorders, suggested that omega-3 or omega-6 fatty acid supplements don’t affect ADHD symptoms, but they may improve how the body tolerates stimulant medication. Although there’s currently not enough evidence to say definitively whether omega-3 fatty acids can treat the core symptoms of ADHD, omega-3s are still important for people with neurodevelopmental disorders like ADHD. In general, dietary omega-3 fatty acids, found in foods like salmon and walnuts, are believed to boost brain and heart health.
Yoga or Meditation
Practicing yoga or mindfulness — a type of meditation that helps people focus on the present moment rather than the past or future — may help children with ADHD better manage their symptoms, according to CHADD. The potential benefits include an improved ability to pay attention and get along with peers.
Neurofeedback
This strategy involves having a child focus on certain tasks while connected to a device that tracks brain wave patterns. Thus far, the scientific evidence for its effectiveness has been mixed. Larger, higher-quality, and longer-term studies are needed to determine whether this is an effective treatment option for ADHD, according to CHADD.
Game-Based Digital Therapeutic Devices
In 2020, the FDA cleared the EndeavorRx device for marketing as the first game-based digital therapeutic device geared toward improving attention function among children ages 8 to 12 with primarily inattentive or combined-type ADHD. Although not yet widely used in the treatment of ADHD, the device is available by prescription and is intended to be used in conjunction with a treatment plan that includes therapy delivered by a mental health professional, medication, or educational interventions, according to the FDA. According to its manufacturer, the device is not intended to be used as a standalone treatment or in place of medication. This association is led by adults with ADHD and offers a free ADHD Starter Kit, as well as virtual support groups, to help those with the condition understand and live successfully with their diagnosis. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) This organization participates in state and federal advocacy efforts for policies related to ADHD, and offers resources for adults with ADHD, parents of children with ADHD, and educators. Learning Disabilities Association of America (LDA) With a mission to help people with ADHD lead successful, self-determined lives, the LDA engages in ADHD-related advocacy on a local, state, and federal level, and offers educational resources about this condition. Check out its guides and booklets for ADHD, including an ADHD action guide. Learn More About ADHD Resources and Commonly Used Terms Related to ADHD Additional reporting by Deborah Shapiro and Christina Vogt.
