Parents and two children having breakfast
Parents and two children having breakfast

Part 2: Starting ADHD medication

You’ve probably spent weeks or months thinking about medication, and you've now decided that it is time to try it.

Need to know

You’ve probably spent weeks or months thinking about medication, and you’ve now decided that it is time to try it. Although medication is considered to be the first-line treatment for ADHD, you can still understandably be hesitant about starting your child on medication. 

The medication journey is certainly not an easy one. For many, it can take a few different medications and dosages to get it right, but for some, the path ends without finding a suitable option. Before your child starts taking medication, it’s important to understand that finding the right medication, dosage, and schedule for your child can take time.

Why it’s important

You will need to work closely with your child’s doctor, as your child may need to try different types of medication or combinations of medications to find what works best for them. When your child starts taking ADHD medication, there are a few things you can expect throughout the first few weeks:

Dosing and schedule: Your paediatrician may adjust the dosage over time to get the best results and minimise possible side effects. It’s important to follow these instructions carefully, as taking too much or too little medication can affect its effectiveness. The medication schedule may also be adjusted based on the desired outcome. For example, if the goal is to manage symptoms primarily during school hours, you can talk to the paediatrician about your child taking medication only on school days.

Side effects: Like all medications, ADHD medications can cause side effects. Common side effects include decreased appetite, trouble sleeping, and stomach upset. These side effects are usually mild and go away after a few days or a couple of weeks. If your child experiences more severe side effects, such as chest pain or difficulty breathing, contact your doctor immediately.

Improvement in symptoms: In many cases, ADHD medication can lead to significant improvements in your child’s symptoms. You may notice that your child is better able to focus, pay attention, and control their impulses. If you don’t notice a change, then perhaps the medication or dosage needs to be reviewed.

It’s important to note that between 50% and 67% of kids with ADHD also have another co-occurring condition. ADHD symptoms may sometimes mask or obscure the presence of co-occurring conditions, making it more challenging to identify them. Starting medication may quiet some of the ADHD symptoms like hyperactivity or ability to focus, but if your child is still struggling, you might want to consider the possibility that they have another underlying condition. Read more about co-occurring conditions. 

Regular check-ins with doctor: Your doctor will likely want to schedule regular check-ins to monitor your child’s progress and adjust the medication as needed. If you notice any significant changes in your child’s behaviour or mood, it’s important to contact your doctor. In some cases, a change in medication or dosage may be necessary. You should also contact your doctor immediately if your child experiences any of the following:

  • Chest pain or difficulty breathing
  • Severe headaches or blurred vision
  • Fainting or seizures
  • Allergic reaction, such as rash or hives

Tips and strategies

Book in follow-up appointments ahead of time – seeing a paediatrician can take weeks or months because of waitlists. Plan ahead and book in regular check-in appointments within a few days of starting or changing medication. This will give you the opportunity to discuss and address your concerns early.

Talk to your child about the medication – Talking to your child about medication in a way that is age-appropriate can have many benefits around teaching them about self-care, self-advocacy, and self-acceptance. 

  • Explain ADHD in kid-friendly terms: Start by explaining what ADHD is and how it affects their daily life. Use language that your child can understand and relate to. For example, you use a story to explain how your child’s brain works.
  • Discuss the benefits and potential side effects: Talk to your child about how ADHD medication can help them manage their symptoms and improve their ability to focus and learn. Be sure to also discuss the potential side effects of the medication and how they might feel after taking it. Here are some examples of what you can say:
    1. medication is like glasses for people who have trouble seeing – it can help you focus and learn better
    2. medication can help fast brains slow down – it strengthens your breaks so you can stop in time to think and avoid tricky situations.
    3. medication can make your mouth a little dry or it might make you feel like you aren’t hungry – Your body is growing so it’s important to eat and drink throughout the day to make sure you have lots of energy to learn and play
  • Answer any questions your child may have: Be prepared to answer any questions your child may have about ADHD medication. Encourage them to ask questions and make sure they feel comfortable expressing any concerns they may have
  • Be positive and supportive: Finally, be positive and supportive throughout the conversation. Let your child know that you’re there to help them and that you’ll be with them every step of the way

Check your child can swallow the medication – some medications need to be swallowed whole, which is no easy feat for a child. A good way to prepare your child and teach them this skill is to practise swallowing a tic tac. Other medications can be crushed, and kids are happy to take them mixed into yoghurt, or in a spoonful of honey or with another sweet food. Don’t forget to ask your doctor how your child needs to take their medication to ensure you administer it correctly. Read more about how to manage medication refusal.

Monitor your child – Keep track of how your child is responding to the medication using the Keywell app. While ADHD medication can be safe and effective, it’s important to keep an eye out for any changes in your child’s behaviour or mood. Here are a few things to look out for: 

  • Changes in appetite or weight: ADHD medication can cause decreased appetite, which can lead to weight loss. If your child is losing weight rapidly or refusing to eat, it’s important to talk to your doctor about it.
  • Mood changes – While medication can improve ADHD symptoms, it can also affect your child’s mood and behaviour. Some children may become more irritable or emotional when taking medication, while others may become more withdrawn. If you notice any significant changes in your child’s behaviour, speak to your doctor immediately.
  • Sleep Problems – ADHD medication can cause trouble sleeping. If your child is having trouble falling asleep or staying asleep, their doctor might need to review the medication, dosage and schedule.
  • Tics – In rare cases, ADHD medication can cause tics or involuntary movements. If your child develops tics, book an appointment to speak with your doctor.

Food and drink – stimulant medication can be an appetite suppressant, so ensuring your child eats before taking their medication, can help with stomach aches and weight loss. Drinking regularly is also important to avoid headaches at the end of the day. Having a healthy and protein rich snack after school may help ease “hanger” symptoms and medication rebound. Avoid vitamins or food containing ascorbic acid or vitamin C an hour before and after you give your child ADHD medication, as they interfere with how the medication is metabolised.

References

  1. Treatment of ADHD
  2. Attention-Deficit/Hyperactivity Disorder – treatment and therapies
  3. Side Effects of ADHD Medication
  4. Comorbidity in Children and Adolescents with ADHD
  5. How to Talk with Your Child About Starting ADHD Meds
  6. When Your ADHD Medication Stops Working
  7. Attention-Deficit/ Hyperactivity Disorder (ADHD): Parents’ Medication Guide
  8. ADHD medication for kids: Is it safe? Does it help?
  9. ADHD Medication Q&A: Side Effects, Dosages, Precautions & More

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