Signs ADHD Medications Are Not Working for Your Child

Medications for ADHD (attention-deficit hyperactivity disorder) such as Concerta, Adderall, Ritalin, and others sometimes don't work. Understanding the signs and next steps can help your child get the support they need to function at their best.

Signs ADHD Medications Are Not Work for Your Child

In order to determine if your child's medication is effective, it is important to first determine what the drug is intended to do. ADHD medications are often prescribed to help kids manage impulsive behaviors, balance energy levels, improve attention, and regulate emotions.

Some signs that your child's ADHD medication might not be working include:

• Intolerable side effects: You might notice that medication helps your child with attention and behavior, but it may result in side effects that your child cannot tolerate. Such side effects can vary, but may include changes in appetite, stomach upset, nausea, or problems sleeping.
• No change in symptoms: ADHD medications affect people differently. Some medicines may quickly result in changes in behavior, attention, and energy levels, while some might take longer to have an effect. However, if your child doesn't seem to be experiencing adequate relief, it is essential to talk to their doctor.
• Returning or worsening symptoms: In other cases, you might find that a medication works for a while but then seems to lose efficacy over time. If your child's symptoms seem to be returning or worsening, talk to their doctor about other medications that your child can try.

Types of ADHD Medications

Medications for attention-deficit/hyperactivity disorder (ADHD) can be very effective, helping kids pay attention in school, maintain friendships, and navigate life.

Finding the right medicine and dosage with the fewest side effects can be difficult. However, a healthcare professional usually can find a program that works after some careful adjusting. There are many medication choices for ADHD, both stimulant and non-stimulant.

Stimulants

The most commonly prescribed ADHD medications are stimulants. Some are methylphenidate-based:

• Ritalin and Ritalin LA (methylphenidate)
• Focalin and Focalin XR (dexmethylphenidate)
• Concerta (methylphenidate), an extended-release tablet that can be taken once daily
• Jornay PM (methylphenidate), which is given at bedtime so the clinical effects begin in the morning
• Daytrana (methylphenidate), a transdermal patch worn for nine hours and then removed

Others are amphetamine-based:

• Adderall and Adderall XR (dextroamphetamine and amphetamine), mixed amphetamine salts
• Dexedrine and Dexedrine Spansules (dextroamphetamine)
• Vyvanse (lisdexamfetamine), which is taken once daily
• Mydayis (dextroamphetamine and amphetamine), an extended-release form that can also be taken once daily
• Dyanavel XR (amphetamine), a once-daily extended-release medication available as an oral suspension or tablet for children age six and up

These stimulants are thought to work by increasing levels of a neurotransmitter, or chemical messenger, in the brain called dopamine. Dopamine is associated with motivation and attention, among other things. For many people with ADHD, stimulant medications boost concentration and focus while curbing hyperactive and impulsive behaviors.

Non-Stimulant Medications

Non-stimulant medications are typically considered when stimulants can't be used for reasons such as side effects and ineffectiveness.

Strattera (atomoxetine) is sometimes an option for a child who isn't tolerating a stimulant. Some doctors prescribe Strattera along with a stimulant to lower the dose of the latter enough that it no longer causes side effects.

Other medications for ADHD include the non-stimulants Catapres (clonidine), Tenex (guanfacine), and Qelbree (viloxazine). These can be effective for impulsivity, hyperactivity, and sleep disturbances.

When Medication Doesn't Work

When a medication doesn't work or causes intolerable side effects, the options are usually to adjust the dose or switch to another medication

For example, if Adderall isn't relieving a child's symptoms or is causing unwanted side effects, a healthcare provider might decrease the dosage or prescribe another stimulant medication.

However, sometimes a child doesn't respond to two or three different stimulant medications and continues to have symptoms. In this case, the AAP advises pediatricians to reevaluate the child's diagnosis to make sure the symptoms don't stem from something else and to screen for comorbidities such as depression, bipolar disorder, learning disabilities, and behavioral problems.

What Parents Can Do

If you have a child with ADHD, putting various medications and dosages to the test can be frustrating. Don't hesitate to ask your pediatrician about things such as effectiveness and timing. Sometimes adjusting when the doses are taken can make a big difference.

Some non-medication strategies can help some kids manage their behavior, as well. These options are often used alongside medications, including behavior therapy, parent training, and school interventions.