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ADHD Medications (cont.)

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General treatment guidelines from The American Academy of Pediatrics

For preschool-aged children (4 to 5 years old): Evidence-based behavior therapy is recommended. However, medication may be added if there is no improvement. Methylphenidate is recommended over amphetamines or non-stimulants.

For school-aged children (6 to 11 years old): FDA-approved ADHD medications and/or behavior therapy are recommended. A stimulant is recommended over atomoxetine, guanfacine, and clonidine.

General considerations for choosing a stimulant

Consider low-dose short-acting medications for children younger than 6 years old to minimize dose-related side effects.

Long-acting medications may be used in children over 6 years, starting at a low dose and titrating for maximum efficacy while minimizing side effects. Long-acting or extended-release dosage forms may improve adherence and are less likely to be misused.

A combination of long-acting and short-acting medications may provide extra coverage when needed such as for completion of homework after school.

Non-stimulant ADHD medications

Atomoxetine may be preferred for patients with a history of substance abuse. Clonidine or guanfacine may be chosen if there are unacceptable side effects, major comorbidities, or a poor response to stimulants or atomoxetine.

For adolescents (12 to 18 years of age): FDA-approved ADHD medications and behavior therapy are recommended, preferably together.

Medically Reviewed by a Doctor on 8/19/2014


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