Most children are returning to onsite learning this year. While this is good news, it can bring back challenges to children diagnosed with attention deficit hyperactivity disorder (ADHD), their families, and their teachers.
One challenge of treating ADHD continues to be the onset and duration of action of the ADHD medications. According to the CDC, stimulants are the best known and most widely available treatments for ADHD with 70-80% of the children treated with them showing fewer symptoms. Short and long-acting stimulants are available with the treatment goal being to find the most efficacious drug that also causes the least bothersome side effects. Short-acting drugs are released immediately and last about 4 hours, while long-acting drugs are released over time and last up to 14 hours.
Although both types of stimulants reduce the symptoms of ADHD, they may start or wear off at inopportune times. For example, if a child receives a short-acting drug in the morning before school, its effect will likely disappear by the afternoon while they are still in school. Similarly, a child can be given a long-acting drug in the morning. This drug has the disadvantage of not kicking in until the child arrives at school, leaving breakfast and the morning routine chaotic, and still dealing with it wearing off around homework or bedtime. These problems can be stressful for the child, parents, and teachers as neither provides optimal coverage throughout the child’s waking hours.
How do you optimize onset and duration of action? What percent of your ADHD patients are prescribed both short-acting (immediate release, IR) and long-acting (extended release, ER) therapies?
CDC: Treatment of ADHD. Source, accessed September 10, 2021.
CHADD, “Peaks and Troughs: Uneven Medications & ADHD”, Attention Magazine Fall 2017 (source)
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Bhagwan Bang, MIZELL MEMORIAL HOSPITAL4yrThe choice and optimal treatment will depend on how long parents want the meds to work , when is the most difficult time for the child , and whether child Show More -
Nicholas Goetsch4yrI like the approach of a long acting stimulant in the morning and adding a short acting in the late afternoon to facilitate children getting their homework done and still Show More
