The effects of psychostimulant medications are usually noticeable within 30–60 minutes once an appropriate dose for that individual has been found. However, determining the proper dosage and medication schedule for each individual often takes a few weeks. Nonstimulant medications often require several weeks before their full effects can be observed.

Not necessarily. Many adolescents and adults continue to respond well to the same doses of psychostimulant medication. However, many others will require higher doses. Some children may respond well initially to a low dose of medication and then require a modest dose increase after a few weeks or months once a “honeymoon period” has passed.

Not necessarily. These medications can be stopped at any time. However, ADHD is a chronic condition. Its severity and developmental course are quite variable in duration and severity. Up to 60 percent of children with ADHD continue to exhibit problematic symptoms into adolescence and adulthood. For these individuals, continuing effective treatment modalities, including medication, can be helpful.

This should be decided with the prescribing medical professional and the therapeutic team. Children can often benefit from medication outside of school because it can help them succeed in social settings, peer relations, home environment and with homework. Medication can be of help to children who participate in organized sports and activities that require sustained attention, such as musical programs, debate or public speaking activities.

In general, two or three different stimulant medications should be tried before determining that this group of medications is not helpful. Similarly, several different antidepressant medications can also be tried. Most individuals will respond positively to one of these medication regimens. Some individuals, because of the severity of their disability or the presence of other conditions, will not respond. And some individuals will exhibit adverse side effects. In such cases, the entire treatment team—family, physician, mental health professional and educators—must work together to develop an effective intervention plan. Other medications such as clonidine may be helpful, and occasionally, combinations of medication may be needed. When all medication appears to be ineffective, consideration needs to be given to whether the diagnosis of ADHD is accurate, whether other conditions are affecting functioning, whether appropriate criteria for improvement have been established, and whether objective and accurate feedback is being provided regarding the effectiveness of medication.

No. Multiple studies that have followed children with ADHD for 10 years or more support the conclusion that the clinical use of stimulant medications does not increase the risk of later substance abuse. In fact, many studies have shown that individuals with ADHD who are not effectively treated with medication during childhood and adolescence have an increased risk of developing significant alcohol or drug abuse problems later in life. When treated, the risk of later drug or alcohol problems is the same as individuals who do not have ADHD.

Although there is potential for abuse when misused, psychostimulant medications do not cause addictions to develop in those being treated appropriately. Unfortunately, research does show that children who demonstrate conduct disorders (delinquent behaviors) by age 10 and are smoking cigarettes by age 12 are at higher risk for substance abuse in the teenage years, possibly persisting into mid-life. Therefore, it is important to recognize this subgroup early and get them involved in an effective multimodal therapeutic program.