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Dr Partha Banerjea

Author: Dr Partha BanerjeaConsultant Child & Adolescent Psychiatrist

Most experts agree the most effective way to treat the core symptoms of ADHD and any associated problems is to use a combination of different approaches which normally include:

  • Medication
  • Behavioural therapy / psychotherapy
  • Parenting support

A key objective of treatment is to reduce the chances of a child developing an additional behavioural disorder – such as oppositional defiance disorder. Whilst parents are understandably concerned about seeking a diagnosis, doing so can increase everyone’s understanding of the child’s needs and ensure the child is given the best start in life.

Medication for ADHD

Medication for ADHD is not a cure but instead helps manage the symptoms commonly associated with ADHD / ADD. Children and teenagers who take ADHD medication report feeling calmer, better able to concentrate and focus at school as well as feel less impulsive.

There are two types of medications commonly used for children with ADHD:

  1. Stimulants: whilst it might seem counterintuitive to use stimulant medication to help a child manage impulsive or hyperactive behaviours, they are considered to be some of the most effective and first line treatments for ADHD in the UK. They are thought to affect the way that dopamine, a key chemical in the brain, is processed.
  2. Non-stimulants: selective noradrenaline reuptake inhibitor (SNRI) work in a slightly different way and can be used for children when stimulant medication does not work. These medications work by increasing the about of noradrenaline, which is a chemical that is key for concentration and impulse control.

Which is the right medication for my child?

There is no easy way to know – it can be a case of trial and error and seeing which medication gives the best results. Only clinicians who are specifically trained in administering ADHD medications are able to prescribe and it can take several months to find the right medication and the correct dosage for your child.

What to expect once your child starts ADHD medication:

  • Side effects – as with any medication there can be side effects. These can include:
    • Increase in blood pressure / heart rate
    • Decreased appetite
    • Problems falling to sleep
    • Stomach ache
    • Mood swings / irritability
  • Regular review appointments – it’s important your child is carefully monitored during the initial stages of ‘titration’. This may mean fortnightly or monthly appointments until the correct dose is reached.
  • Annual reviews – it is important your child receives physical checks (height, weight, blood pressure and heart rate) at least once a year (every 6 months is more common). An annual review with the prescribing clinician is also required to make sure the dose is remaining effective
  • Prescribing – whilst GPs are normally happy to continue prescribing, once the correct dose is established, this is by no means guaranteed, so it is always worth checking with your GP before commencing treatment to see what your local NHS services provide.

Early intervention gives the best outcomes in terms of long term self-esteem, social functioning and academic attainment.


Behavioural therapy and psychotherapy

Behavioural therapy can be really effective at helping children with ADHD overcome some of the difficulties they experience on a daily basis. Whilst medication can decrease the impulse to do something, behavioural techniques teach new behaviours.

Social, academic and behavioural skills are taught by a specialist psychologist or psychotherapist. Once learnt, these skills can be used for life. Behavioural techniques, such as learning organisational skills and how to manage the internal restlessness that often accompanies ADHD can be particularly effective for those with mild ADHD.

Benefits of behavioural therapy / psychotherapy:

  • Increased self esteem
  • Learning new coping mechanisms
  • Teaches skills that child can use for rest of their life
  • Teaches positives ways of behaving
  • Improve medication compliance

Parenting support

Parental interactions are of key importance for children with ADHD. The aim is to improve the quality of the interactions and reduce family stress, encourage positive behaviours and create a happier home life. Parenting support will also teach more effective ways of dealing with difficult behaviours, breaking any negative cycles that have arisen.

The type of support that is best for your family will depend on the challenges and stresses you are experiencing, so finding a solution that works for your family’s individual needs is key to making effective changes.

The benefits of treatment

The aim of treatment is to allow you child to reach their full potential and mature into a happier and more fulfilled individual. Many children and teens report a positive impact on their peer relationships, ability to concentrate at school and reduced strain within the family.

Benefits of effective treatment can include:

  • Improved peer relationships
  • Improved relationship with parents and siblings
  • Improved behaviours towards teachers
  • Improved Self esteem
  • Reduced physical aggression
  • Ability to complete homework
  • Improved ability with writing, writing, maths

Starting medication helped me enormously, I was able to concentrate better at school and have realised I am actually quite good at maths

Dominic, 14, Newcastle

Diagnosing ADHD allows focused and personalised treatment packages to be delivered both at home and at school, as opposed to a 'one size fits all' solution.
Dr Partha Banerjea
MBChB, MRCPsych

Consultant Child & Adolescent Psychiatrist
London

Dr Partha Banerjea is a very senior and experienced Consultant Child & Adolescent Psychiatrist. He is currently the Lead clinician for Southwark CAMHS, and has for the last 15 years managed a specialist outpatient adolescent service. This is a...

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