Therapy that addresses both psychological and social issues (called psychosocial therapy), usually combined with medications, is the treatment approach of choice to alleviate ADHD symptoms.
Medications known as psychostimulants, such as dex-troamphetamine (Dexedrine), pemoline (Cylert), and methylphenidate (Ritalin), are commonly prescribed to control hyperactive and impulsive behavior and increase attention span. These medications work by stimulating the production of certain neurotransmitters in the brain. These medications are usually well-tolerated and safe in most cases, but possible side effects of stimulants include nervous tics, irregular heartbeat, loss of appetite, and insomnia.
For children who do not respond well to stimulant therapy, and for children who clearly suffer from depression as well as ADHD, tricyclic antidepressants (a group of drugs used to treat depression) may be recommended. Examples of these antidepressants include desipramine (Norpramin, Pertofane) and amitriptyline (Elavil). Reported side effects of these drugs include persistent dry mouth, sedation, disorientation, and cardiac arrhythmia (an abnormal heart rate), particularly with desipramine. Other medications prescribed for ADHD therapy include buproprion (Wellbutrin), an antidepres-sant; fluoxetine (Prozac), an SSRI antidepressant (a group of medications used to treat depression by directing the flow of a neurotransmitter called serotonin); and carbamazepine (Tegretol, Atretol), an antiseizure drug. Clonidine (Catapres), a medication used to treat high blood pressure, has also been used to control aggression and hyperactivity in some ADHD children, although it should not be used with Ritalin. Because a child's
<u response to medication will change with age and matura-"H tion, ADHD symptoms should be monitored closely and — prescriptions adjusted accordingly.
Psychosocial therapies g Behavior modification therapy uses a reward sys-
sx tem to reinforce good behavior and task completion and /hy can be implemented both in the classroom and at home. cit A tangible reward such as a sticker may be given to the efi child every time he completes a task or behaves in an n-d acceptable manner. A chart may be used to display the .2 stickers and visually illustrate the child's progress. When § a certain number of stickers are collected, the child may 5 trade them in for a bigger reward such as a trip to the zoo or a day at the beach. The reward system stays in place until the good behavior becomes ingrained.
A variation of this technique, cognitive-behavioral therapy, may work for some children to decrease impulsive behavior by getting the child to recognize the connection between thoughts and behavior, and to change behavior by changing negative thinking patterns.
Individual psychotherapy can help an ADHD child build self-esteem, provide a place to discuss worries and anxieties, and help him or her to gain insight into behavior and feelings.
ADHD children perform better within a familiar, consistent, and structured routine with positive reinforcements for good behavior and real consequences for bad behavior. Family, friends, and caretakers should all be educated on the special needs and behaviors of the ADHD child so that they can act consistently. Communication between parents and teachers is especially critical to ensuring an ADHD child has an appropriate learning environment.
A number of alternative treatments exist for ADHD. Although there is a lack of controlled studies to prove their efficacy, proponents report that they are successful in controlling symptoms in some ADHD patients. Some of the more popular alternative treatments include:
• EEG (electroencephalograph) biofeedback. By measuring brainwave activity and teaching the ADHD patient which type of brainwave is associated with attention, EEG biofeedback attempts to train patients to generate the desired brainwave activity.
• Limited sugar intake. However, data indicate that this method does not actually reduce symptoms.
• Relaxation training.
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Are You Depressed? Heard the horror stories about anti-depressants and how they can just make things worse? Are you sick of being over medicated, glazed over and too fat from taking too many happy pills? Do you hate the dry mouth, the mania and mood swings and sleep disturbances that can come with taking a prescribed mood elevator?