Ask a Pediatrician: Should I Give My Kid ADHD Medication?

My vibrant, funny, sharp-as-a-tack 9-year-old son has been diagnosed with ADHD, and while it's not affecting his academics, it is very evident both at home and at school that it's hard for him to complete tasks and stay focused. As a result, we all spend a lot of time scolding him for not doing the thing he's supposed to be doing. My husband and I are considering putting him on ADHD medication, but we're worried it will dull his personality or prevent him from learning crucial life skills like focus and organization. Any advice?

Whether or not to start your child on ADHD medication can be a tough decision. There are several factors to consider from the physical health and general wellness perspective that are good to think about; let’s take a look at some of the implications of ADHD medication for a child’s life and body that you should keep in mind when choosing a treatment plan for your kiddo.

When young children start to exhibit ADHD symptoms (inattentiveness, impulsivity, hyperactivity), it is reasonable to begin treatment with behavior therapy first. Many issues caused by ADHD can be improved without adding medicine, especially in mild cases and children under 6 years old. Those between ages 6 and 11 can be treated with medicine and/or behavior therapy. Older children and adults are more readily treated with medicine, but even in that age range, therapy is often incredibly helpful. The rule of thumb is that the earlier a child is diagnosed, the more likely that behavioral interventions will stick. So, if you are considering ADHD medication, make sure to have explored behavior therapy options first—with children of all ages.

ADHD medication helps children by improving brain chemical activity to assist with attention, activity level and impulsivity. Usually, these substances are stimulants that stay in the system from 4 to 12 hours. There are non-stimulant options, but these are prescribed more rarely, when the more common choices don’t prove to be effective. Some side effects are possible, especially during the first few weeks of use, when the child’s body is acclimating to the new drug. If these symptoms persist, your health provider should adjust the medication dose accordingly. Often this is all it takes in order for the medicine to be tolerated well, but it’s important to understand the common side effects that we see.

Eating Habits

A common side effect of ADHD medication is a decrease in appetite which can sometimes result in weight loss. Many patients may not feel hungry while the medication is in effect during the day, and forcing them to eat is not a healthy solution. For children, poor appetite may result in slight and temporary growth delays in comparison to their peers, but they will catch up before adulthood. Concern about eating and diet should not be a deterrent to ADHD medication, but parents need to be aware of these possible implications and be ready to adjust accordingly. For instance, it’s a good idea to provide your child with a filling, nutritious breakfast before administering the first dose of medication to give them enough energy to make up for what might be a lighter lunch. Calorie dense foods for the win!

Sleep Quality

Children starting ADHD medication often report difficulty ‘turning off the brain,’ falling asleep, and staying asleep. Just like with the appetite concerns, these side effects usually self-regulate after the body gets used to the medication, but they can be bothersome at first. If the sleep problems are severe, talk to your child’s health provider about switching to a non-stimulant option. Also, remember to model and encourage healthy sleep hygiene, or practices that improve sleep habits: consistent exercise, reduced caffeine intake, and minimized screen time.

Pre-existing Conditions

Another possible side effect of ADHD medicine is elevated heart rate and blood pressure. In healthy patients, these effects are rarely a point of concern. However, if your child has a pre-existing condition that is related to cardiovascular health, such as a heart defect, it is very important to let your health provider know about this and evaluate the risks of starting ADHD medication. Some other conditions to consider are allergies or sensitivities to stimulants, family history of substance abuse or cardiovascular disease, overactive thyroid, and severe anxiety.

When considering giving ADHD medication to a child, parents often think about how it will affect their child at school. However, from a general wellness perspective, I urge all parents to think about how this choice will affect their kid’s life as a whole. Aside from academic effects, they will likely feel differences in their social interactions. Their relationships with friends and family members may improve and change because of the new ways that their brains process information and emotion.

Another thing to keep in mind concerns the inevitable changes to daily routines—ADHD medication should be taken at regular times, so be ready for an adjustment to the structure of the day. Reach out to your insurance provider about prescription coverage so that once started, the medicine isn’t interrupted by delays in coverage due to authorization requirements or distribution amounts.

At the end of the day, there is no simple answer to the question of whether or not parents should choose to give ADHD medication to their children. There are multiple factors to think about when making this decision, and your child’s pediatrician, teachers and pediatric mental health professionals are all good resources to tap into when considering the pros and cons. Whatever this parent decides, working closely with their child’s support team is the key to making the next step go as smoothly as possible.

Dr. Christina Johns is a pediatrician + Senior Medical Advisor at PM Pediatric Care, the largest pediatric urgent care group in the U.S.