ADHD is one of the neurodevelopmental disorders with the most extensive and rigorous treatment research. Current evidence supports a multimodal approach: the combination of medication (when indicated), psychosocial interventions, school support and parent training is significantly more effective than any isolated treatment.
ADHD
ADHD treatment: a complete guide for families on medication and interventions
ADHD medication: what the science says
Stimulants (first line): Methylphenidate (Ritalin, Concerta, Medikinet) — the most studied drug in children; available in immediate-release (4-5h) and extended-release (8-12h) formulations. The MTA study showed optimised methylphenidate is the most effective isolated intervention for ADHD symptoms. Lisdexamfetamine (Vyvanse) extended-release (12-14h).
Non-stimulants (second line): Atomoxetine (Strattera) — gradual effect (4-8 weeks) but continuous; indicated when stimulants are not tolerated. Guanfacine (Intuniv) — particularly useful for hyperactivity and emotional dysregulation.
Side effects: what families worry about
Families' main concern: Effect on appetite and growth, and the possibility of dependence. Research is clear: stimulants for ADHD do not generate dependence when used therapeutically at prescribed doses. The effect on growth is modest and typically recovers.
Neurofeedback, omega-3 and other approaches
| Intervention | Evidence | Assessment |
|---|---|---|
| Methylphenidate / Lisdexamfetamine | Very high | First line |
| Parent training | High | First line under 6y |
| Omega-3 (EPA+DHA) | Moderate (small effect) | Safe complement, modest benefit |
| Neurofeedback | Moderate (inconsistent) | May be helpful; not first line |
Frequently asked questions
European (EAGG) and American (AAP) clinical guidelines recommend stimulant medication from age 6. In 4-5 year olds with severe ADHD, parent training is the first option; medication is considered only if training is insufficient and impairment is significant.
With the right medication and correct dose, the result is the child being "themselves but with more capacity to function". If the dose is too high, a "flattening" effect may appear. In that case, the dose or medication should be renegotiated with the paediatric neurologist or psychiatrist.
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