Children who have attention deficit hyperactivity disorder (ADHD) often take prescription medicine as part of their treatment plan. Doctors usually start out prescribing a psychostimulant medicine. These medicines have a long record of safety. Stimulates help kids with ADHD with impulse control, attention, and other behavioral issues. Treating ADHD also reduces the increased risk for substance use disorder. This disorder is more common in kids with ADHD.

The most common stimulants prescribed are variations of the stimulant called methylphenidate. Amphetamine-based stimulants are also used. But these are used less often because of more severe side effects.

Psychostimulants act quickly, over 1 to 4 hours. This fast action helps children in school because ADHD can interfere with attention in class. Some psychostimulants are longer acting. They work for up to 9 hours and need to be taken only once a day.

Sometimes nonstimulant medicines may be used to treat ADHD in children. These include:

• Atomoxetine
• Guanfacine
• Clonidine
• Antidepressant medicines, such as bupropion, desipramine, and imipramine

Your doctor will determine your child's need for medicine. They will choose the best medicine for your child. This is done after evaluating your child's symptoms, age and health, and your preference.

Before ADHD medicine is started, your child will be checked to be sure they meet certain standards for treatment. These can include:

• A health history that focuses on the heart, plus a family history and physical exam
• Height, weight, blood pressure, and heart rate
• Exam and tests to rule out bipolar disorder. This can be made worse with stimulant medicines.
• Information for common side effects linked to ADHD medicines. These include belly pain, sleep patterns, and appetite.
• Substance use evaluation. Children with symptoms of substance use will be referred for evaluation and treatment for addiction before certain ADHD medicines are prescribed.

The doctor will set up education about medicine use if these standards are met. This can include talking about:

• The medicine choice and why this medicine is being recommended
• The medicine dose, how often it should be given, and frequency of follow-up visits.
• The risks and benefits of treatment
• Possible physical and emotional side effects
• How long treatment is expected to take
• The behaviors and physical symptoms the family should watch for and report

Psychostimulant medicines can cause side effects. But most are mild and ease with time. Side effects include trouble sleeping, decreased appetite, stomachache, headache, and nervousness. Some children's hyperactive behaviors may increase for a short while when the medicine's effects wear off.

The FDA has ordered that medicine guides for parents be included with prescriptions for psychostimulants. That's because of reports of sudden death in children and teens with heart problems who were taking these medicines for ADHD. A slightly increased risk for paranoia, mania, or hearing voices also happens in children who take these medicines.

The best time for your child to take a long-acting, once-a-day medicine is just after breakfast. Shorter-acting medicines are best taken 30 to 45 minutes before a meal, such as before breakfast and before lunch.

Medicine can be taken during the week and stopped on the weekend. Your doctor can discuss if this is advised for your child. Some children don't do well stopping medicine for 2 days. They develop behavior problems. Medicine also is often stopped during the summer months when school is out. Your doctor can talk with you about the right schedule for your child.

Some experts (and parents) criticize what they see as an overuse of psychostimulants. But these medicines have been proved to work well and be safe for treating ADHD. Other treatment choices may be harder to follow and work less well. And sometimes they are not easily available to families. Other choices to psychostimulant medicines include:

• Behavioral counseling
• Educational support with smaller classes and personal attention
• Tutoring
• Training in social skills

Psychostimulants often are used along with other therapy and educational plans in the school. This includes behavioral and psychological treatment. For your child's benefit, it's important to work with school staff. Coordinated approaches and appropriate support can be provided to both you and your child.

Some parents have turned to alternative treatments, such as biofeedback, megavitamins, and blue-green algae. Talk about any alternative treatments with your doctor before trying them. This is even more important if your child is also taking medicines at the same time.

Whatever the treatment, if your child has ADHD, they may have trouble focusing even when they are adults. Most children outgrow the hyperactivity and impulsiveness of their younger years. They may still have trouble getting organized or finishing long-term projects as adults.