Many different types of treatment have been proposed and tried for ADD and ADHD. When you do a Google Search for ADHD, ADD, and related fields, many of the websites that come up are selling a specific megavitamin, mineral supplement or other treatment or cure for ADHD. How is a Mom or Dad to know what is the best and safest treatment for their child?
In searching for a treatment for this condition--or any other condition, you need to keep in mind a very important concept. This concept is THE PLACEBO EFFECT. This effect will often lead you down the wrong path when you are trying to determine what is helping and what is not.
The PLACEBO EFFECT is the result of the extremely strong power that suggestion has over an individual. If the parent and/or the child believe strongly that they are getting a treatment that is going to help them, up to 30% will be improved, regardless of what the treatment is. Even the Doctor will often be fooled by the Placebo Effect. Many of the mainline medical treatments from past years were recommended because the Doctor was fooled by the Placebo Effect. When the condition was later studied scientifically, it was found that the original treatment was of absolutely no value, in and of itself.
Treatments Commonly Used for ADHD
1. COUNSELING:
a. Counseling is often beneficial if the patient has a lot of "baggage", such as abuse issues, abandonment or separation issues, PTSD(post traumatic stress disorder, etc.
b. Group sessions are often helpful for Social Skills Training or Anger Control, which can accompany ADHD.
c. Counseling parents individually, or in groups, teaches new, effective ways to deal with and discipline the child with ADHD.
d. Counseling has not been shown to be helpful for the ADHD core problems--hyperactivity, impulsiveness, and inattention. Studies are still in progress and many new techniques are being tried.
2. DIET: Many different diets have been proposed and used for ADHD.
a. SUGAR. Excessive sugar is, of course, not healthy for children or adults. Many people, including teachers and doctors, feel that sugar causes children to be more hyperactive. After eating a candy bar or a large dessert, they seem to be more wound up--more hyper. When carefully studied ( so that neither the Doctor, parent, child or teacher knows when the child is getting sugar or a substitute) there was no increased or decreased hyperactivity associated with sugar. If the parent or teacher know the child is getting sugar, they often rate the child as more hyperactive.
b. HEALTHY DIET. Eating low fat, low sugar diet is overall healthier, but, according to the studies, does not directly help hyperactivity.
c. DYES. Eliminating yellow and red dyes from the diet has been thought to reduce many of the symptoms of ADHD. Careful studies, however, have not been able to show any measurable effect on ADHD.
3. VITAMINS, MEGA-VITAMINS, OR MINERAL SUPPLEMENTS
a. Many are advertised and highly recommended as treatment or even cure for ADHD. These may or may not help, but none are based on scientific study so far.
b. Some Vitamin or Mineral may someday be proven to be helpful. It would be wonderful if one or more of these someday prove to be helpful, as they have less side effects than currently used drugs. If you have found that something is working really well for you or your child, continue to use it. The vitamins and minerals, in standard doses, seem to be safe. Some of the herbal stimulants can have significant side effects and interactions with other medication, so be careful of these. It would be a good idea to check with your Doctor before taking these.
4. TRAINING OR RETRAINING SPECIFIC MUSCLE GROUPS OR BRAIN WAVES
a. EYE EXERCISES (OPTOMETRIC VISION TRAINING)--Proponents assert that the behavior problems of ADHD are due to faulty eye movement and sensitivities. Some programs also use various colored lenses for the child to read through. Studies are in progress to determine if these procedures are helpful. One use for optometric vision training may be to reduce the misdiagnosis of ADHD--when poor binocular coordination mimics inattention.
b. INNER EAR TREATMENT--Treat with anti-motion sickness drugs. I have not been able to find any evidence that this is helpful.
c. CANDIDA (YEAST)--The "yeast connection" has been blamed for many diseases, including ADHD. So far, no scientific proof that this is actually connected.
d. EEG BIOFEEDBACK--Some very promising research indicates that neurofeedback treatment for ADHD can change brain wave activity. Beta waves can be increased only if they are low, theta waves can be reduced and failures of alpha blocking during tasks can be reduced. There is a lot of active research ongoing.
e. APPLIED KINESIOLOGY--Realigning bones in the skull. I can find no scientific proof that this is helpful.
f. RETRAINING LARGE MOTOR MUSCLES--Belief that many hyperactive kids went straight from lying down and scooting to walking--completely skipped the crawling stage. They recommend--whatever age the child--that the child needs to practice crawling, and this will somehow help the hyperactivity. Schools are available that practice this. Absolutely no scientific proof exists for this treatment program.
g. FOOD ALLERGIES--Group of allergists who practice the "Wrinkle Technique" believe that food allergies are responsible for many of the cases of ADHD. There are many anecdotal claims that this treatment helps, but I have not been able to find any scientific proof.
5. MEDICATION--The only category of treatment which is actually proven to help the core symptoms of ADD/ADHD--hyperactivity, impulsiveness, and inattention.
a. STIMULANTS--These are first line and offer the most powerful treatment for the core symptoms mentioned above.
1) Ritalin and Ritalin Derivatives
Ritalin LA, Concerta, Focalin XR, Metadate CD
2) Amphetamine Salts
Adderall XR, Dexadrine(rarely used now)
b. NON-STIMULANTS--These are not as potent as the stimulants, in general. An exception is Strattera (see below)
1) Strattera--Can be very helpful for inattentive symptoms--lack of focus and trouble paying attention. Usually not helpful for hyperactivity and impulsiveness.
2) Modafinil = Provigil-- 2nd line drug for attention only; not effective for hyperactivity or impulsiveness. Minimal studies so far on this drug, but look for more to be coming. Sometimes helpful as an add-on.
c. OTHER DRUGS
1) Alpha-Blockers (High Blood Pressure Medicine)--sometimes helpful as an add-on.
a) Clonidine--sometimes helps sleep and impulsive behavior
b) Tenex
2) Antidepressants--Most are of little or no value for the core symptoms. 3rd or 4th line at best.
a) Welbutrin--occ helpful
b) SSRI's(Prozac, Zoloft, Paxil), Tricylics, MAO inhibitors rarely effective, unless the patient is also depressed.
Conclusion
This summary of the available treatments, will help you be a more educated consumer. You still do not have enough specific information about how well the drugs work, side effects, whether they cause addiction, long-term effects, etc.
Remember that over 50 % of the time ADD/ADHD is accompanied by another problem (co-morbid condition). Some of these conditions include major depression, bipolar depression, anxiety, panic attacks, substance abuse, learning disorder, and Tourette's. Often the patient does not get optimal improvement until both the ADHD and the co-existing condition is treated.
If you have any comments of ideas of things that would really help you, email me at:
DrJerry@ADHDStrategies.com
I want to help you "be the best person you can be"
Dr. Jerry Is Online
Jerry Rodgers, M.D.
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