Comprehensive Treatment of ADD/ADHD

Treatment for ADD/ADHD can consist of medications or behavioral therapy, or a combination of both. Treatment is individually customized to meet the needs of the patient. Studies have shown that medications and behavioral therapy are safe and effective and do more than just relieve the symptoms of ADD/ADHD, they improve the patient’s ability to follow rules as well as improve relationships with peers and parents.

Usually the most effective treatment approach is a multidisciplinary one, with multiple elements that work together and complement each other. These elements include:

  • Education about diagnosis and treatment
  • ADHD medication
  • Behavior therapy
  • School/teacher involvement
  • School/counselor involvement
  • Employer accommodations

Which are the different types of ADD/ADHD medications?

Stimulants medications are the most common psychopharmacological treatments for ADD/ADHD. They include:

Methylphenidates:
  • Ritalin
  • Metadate
  • Concerta
Amphetamines:
  • Dexedrine
  • Dextrostat
  • Adderall.

Also, a new drug called Vyvanse is another amphetamine that is reported to last longer and is less addictive than other medications.

Other FDA-approved drugs:

Nonstimulants:
  • Strattera
  • Intuniv

Note: Strattera affects levels of the brain chemical norepinephrine, which can help control ADD/ADHD symptoms. Intuniv affects certain brain receptors in the brain to improve concentration and impulsivity. Both of these medications have a lower risk of abuse and dependency than stimulants.

Antidepressants:
  • Wellbutrin
  • Effexor
  • Effexor XR

Note: Antidepressants can have a positive effect on three major components of ADD/ADHD: inattention, impulsivity, and hyperactivity. They are a good option for those who do not react well to stimulants. They increase the levels of norepinephrine and serotonin in the brain, and can improve mood and concentration in patients.

Tricyclic antidepressants:
  • Pamelor
  • Aventyl
  • Tofranil
  • Norpramin
  • Pertofrane
  • Wellbutrin

Note: These medications are somewhat inexpensive, but can cause some unpleasant side effects, such as dry mouth, constipation, or urinary problems.

SSRIs:
  • Lexapro
  • Zoloft
MAO inhibitors:
  • Nardil
  • Parnate

Note: These antidepressants are rarely used because of significant and sometimes dangerous side effects. They can interact dangerously with foods and other medications but may be beneficial for patients for whom other medications have failed.

What are the side effects of ADD/ADHD medications?

Side effects happen usually at the beginning of the treatment program and may be short-lived.

The most common side effects of stimulant medications include:

  • Acne
  • Decreased appetite/weight loss
  • Headaches
  • Anxiety
  • Sleep problems
  • Social withdrawal
  • Stomach paints

Nonstimulant drug side effects include:

  • Abdominal pain
  • Fatigue
  • Headaches
  • Sleepiness
  • Upset stomach

Antidepressant side effects include: 

  • Heart rate and rhythm changes
  • Dry mouth
  • Headaches
  • Drowsiness.

Note: These drugs require careful monitoring. Changing the dosage, frequency or medication can control side effects.

How does behavioral therapy work for ADD/ADHD?

With behavioral therapy, a licensed mental health professional will work with the patients, parents and teachers, if applicable, to train the parties in behavior management. There is an emphasis on appropriate behavior and call to ignore minor inappropriate behavior. Effective incentive programs are designed, and immediate, consistent consequences are applied in the form of removing privileges. Behavioral therapy needs to be tailored to the patient’s specific needs.

Some elements of behavioral therapy include:

  • Goal setting -- Specific goals are set and accomplished, such as completing a chore, finishing an assignment, playing well with others, sitting still in one place, etc.
  • Rewards and consequences – The patient receives rewards or consequences for his or her actions. Negative behavior is handled with time out or loss of privileges.
  • Consistent long-term therapy – Goal setting, rewards and consequences need to be applied consistently until the child adopts these behavioral changes appropriately.

What is the role of nutrition and vitamins in treating ADD/ADHD?

A well-balanced diet is important for optimal health. However, studies do not support the theory that dietary factors or a vitamin deficiency actually causes or helps ADD/ADHD.

How is ADD/ADHD treated in adults?

Adults can also benefit from a multidisciplinary approach to treatment. This includes:

  • Cognitive behavioral therapy (CBT)
  • Medication
  • Support groups and education
  • Skill training

Contact Fifth Avenue Psychiatry

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3 East 85th Street
New York NY 10028
T. 212-734-0506

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