From the Guidelines
For a 10-year-old with ADHD who needs medication that doesn't suppress appetite, Strattera (atomoxetine) is often a good option, as it has been shown to have lower effects on decreased appetite and fewer growth/height problems compared to stimulants 1. This non-stimulant medication works by increasing norepinephrine levels in the brain to improve attention and reduce impulsivity without typically affecting appetite. Some key points to consider when using atomoxetine include:
- The dosage usually starts at 0.5 mg/kg/day and may gradually increase to 1.2-1.4 mg/kg/day, taken once daily in the morning 1.
- Guanfacine (Intuniv) and clonidine (Kapvay) are other non-stimulant alternatives that work by affecting certain brain receptors to improve focus and behavior without generally causing appetite suppression 1.
- These medications typically take 2-4 weeks to reach full effectiveness, unlike stimulants which work immediately 1.
- Side effects of these non-stimulants may include initial drowsiness, dizziness, or mild stomach discomfort 1. It's essential to work closely with your child's doctor to find the right medication and dosage, as individual responses vary. Regular monitoring of height, weight, blood pressure, and overall well-being is crucial during treatment, and factors such as severity of symptoms, presence of comorbidities, and patients' preferences should be considered when selecting a medication 1.
From the Research
Alternative ADHD Medications
For a 10-year-old child, alternative Attention Deficit Hyperactivity Disorder (ADHD) medications that do not suppress appetite include:
- Atomoxetine (Strattera) 2, 3, 4, 5, a non-stimulant drug that has been shown to be effective in treating ADHD with minimal side effects, including decreased appetite, which is generally noted to be transient.
- Tricyclic antidepressants (TCAs) 4, 5, which have been studied as a second-line treatment for ADHD, although they may produce side effects such as sedation, dry mouth, and constipation.
- Bupropion 4, which has been shown to be superior to placebo in the treatment of ADHD and has a more favorable side-effect profile than TCAs.
- Alpha-2-adrenergic agonists, such as clonidine and guanfacine 4, 5, 6, which have been used as alternative agents in ADHD, although the controlled data are more limited.
Key Considerations
When considering alternative ADHD medications, it is essential to weigh the potential benefits and risks, including:
- Efficacy: The medication's ability to improve ADHD symptoms.
- Safety: The potential for side effects, such as decreased appetite, and the risk of serious adverse events.
- Tolerability: The likelihood of discontinuation due to adverse events.
- Acceptability: The medication's overall acceptability, including its impact on daily life and potential for long-term use.
Medication Options
The following medications have been shown to be effective in treating ADHD: