At what age can you start using ADD/ADHD medications?
None of these medications have a formal “indication” (i.e., approval by the FDA) for use in children under the age of 6 years. However, experienced physicians like myself are frequently called upon to evaluate and treat preschoolers. Oftentimes, these are some of the most challenging situations.
Children who present with ADD at this age often have profound attentional weaknesses that are associated with extreme temperamental traits and significant developmental delays.
In my experience, if the attentional component of these children’s problems is not treated with medication, it is unlikely progress can be made to correct or remediate other associated difficulties.
Therefore, in many of these circumstances, I have carefully and successfully used the stimulants and the non-stimulant, Strattera. I have had particular success using the stimulants Dexedrine and Dextrostat in ADD preschoolers who have associated language delays. Because children at this age generally can’t swallow pills, it may be necessary to use medications like Metadate that can be sprinkled on food. It is my opinion that only the most experienced clinicians should take on this difficult population.
Equally challenging are those ADD preschoolers whose behaviors are difficult to distinguish from normal. Some degree of distractibility, short attention span, and impulsivity can be the norm in children 3 to 6 years.
Do we just wait and hope he grows out of it?
Does failure to identify and begin treatment put the child at risk for learning failure, behavior control difficulty, poor peer relationships, and low self-esteem?
These are difficult questions. Again, my bias is that they require the expertise of a physician highly experienced with ADD. If, after a thorough evaluation, such a clinician is able to make the diagnosis of ADD, then there is no good reason to delay treatment with these medications.
Can these medications be used in adults with ADD?
All of the medications used to treat ADD are just as effective in adults as they are in children and adolescents. The underlying biological differences that cause the symptoms of ADD remain relatively stable from childhood through adult life.
Therefore, it makes sense that if the medications can help correct these differences in childhood, they should be able to do the same in adults.
At the present time, Strattera is the only medication that has a formal indication for use in adults. However, all of the stimulants have been used safely for many years in the treatment of ADD adults.
Obviously, the dosage levels required for adults are often different from those that are effective for children. Similarly, some of the side effects children and adults experience are different. In all other respects, however, use of these medications is the same in adults and children.
You’re not alone if you’re nervous about ADD/ADHD medication. Public debate, often fueled by bias and misinformation, has stirred up a cloud of fear around effective medication treatment options. In our practice, we’ve seen time and again that medication can be a powerful tool in treating ADD. Don’t miss 7 Keys to Successful (and Safe) Medication Treatment for ADD!