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Treatment of ADHD

Medication and behavioral treatments are both widely used to treat ADHD. While medication is often the first-line treatment, patients who receive behavioral treatments—typically therapy, parent training, or neurofeedback—often ultimately need less medication or are able to stop using it entirely. At the same time, several influential studies have concluded that the two treatment approaches may work best in tandem.

What is the best treatment for ADHD?

The best treatment plan for ADHD is unique to the individual, and typically includes a mix of medication, therapy, and/or lifestyle changes. Effective treatment should address both the underlying symptoms—like impulsivity or distractibility—as well as the resulting behavioral and social challenges (such as difficulties making friends, managing time, and poor self-esteem).

ADHD Medications

The most commonly used ADHD medications are stimulants such as Ritalin and Adderall. Non-stimulants like Strattera or certain classes of antidepressants can be used for those who don’t respond to stimulants or cannot tolerate them.

Whatever medication is used, it's important to receive the correct dosage, since ADHD medications, and stimulants in particular, can worsen other conditions that may co-occur with ADHD, including bipolar disorder, obsessive-compulsive disorder, and anxiety.

What stimulants are used to treat ADHD?

The main stimulant medications used to treat ADHD fall into two broad categories: methylphenidates and amphetamines.

Methylphenidate: Ritalin, Concerta, Daytrana, Focalin, Quillichew, Quillivant, Metadate

Amphetamine: Adderall, Dyanavel, Vyvanse, Dexedrine

Are stimulant medications dangerous?

Stimulant medications have been in use for decades, and though they may trigger side effects (such as headaches or irritability), most research has concluded that they are generally safe when taken appropriately. Children and adults with pre-existing heart conditions should work closely with their doctor, as stimulants can increase blood pressure or heart rate and may be dangerous for this group. Stimulants may also trigger tics, manic episodes, or, in rare cases, psychosis. In most cases, lowering the dose or changing medications should alleviate the issue.

Behavioral Treatments

Behavioral therapy is thought to be the most effective non-medical approach for children with ADHD. It typically trains parents to respond consistently to their child’s negative behaviors and help them set and meet goals, while teaching the child coping techniques and social skills. A common refrain in the ADHD community, “pills don’t teach skills,” highlights the fact that while medication may control symptoms of hyperactivity or inattention, it cannot necessarily help a child learn how to behave appropriately or break negative habits. Behavior therapy aims to fill that gap.

For adults and older children with ADHD, cognitive behavioral therapy is most often used. CBT therapists can help adults develop stronger emotional regulation, overcome bad habits, and confront negative patterns of thinking and poor self-esteem that may be impeding their success.

Can therapy help with ADHD?

Yes. For children, behavior therapy (typically with a parent-training element) has proven to be effective in many cases; for adults, CBT has been shown to help develop organizational skills and address maladaptive thought patterns. Other less structured forms of psychotherapy may also be useful for repairing damaged self-esteem and rebuilding relationships harmed by negative ADHD behaviors.

Is it possible to treat ADHD without medication?

Yes. Although most head-to-head studies have concluded that medication is generally more effective than other standalone treatments, it can trigger unpleasant side effects and is not necessary to manage ADHD. A combination of therapy, exercise, meditation, and dietary changes have proven effective for many children and adults with ADHD. Emerging research also suggests that technological treatments—such as specialized video games, brain training programs, or neurofeedback—may improve ADHD symptoms; most experts, however, argue that more research is needed.

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