Understanding ADHD, and Why Stimulants are Its Best Treatment

 The body loses 0.5% of dopamine neurons a year from berth to death. They start and drive movement.  The amount of movement drops every year. Go to a free play playground and look at 3 year olds and 10 year olds. If you put a normal 5 year old in a 12 year old class, you will think, ADHD. That means teachers are best source of information for making the diagnosis. They have a class full of kids to compare a child. The Diagnosis of ADHD is made if the child sticks out from his same age peers. It does not respond to good classroom discipline, and will affect function. That means, the child may have to be moved out of class. The child is disrupting the learning of tohers, and consumming an unfair amount of staff attention. 

What are stimulants stimulating? They are stimulating the frontal lobes. They inhibit many parts of the brain, including the dopamine system. One old fashioned alternative was the infliction of pain, in corporal punishment. Fear helped kids control themselves in class in the past. Most parents do not want to raise their kids in fear. The other problem with corporal punishment is that it may be rewarding to a child with ADHD. They are bored. They enjoy adult attention. They are sensation seekers. Corporal punishment provide all those rewarding properties. If it worsens the child, it should be stopped. Medications should be considered. 

Stimulants are twice as effective as other medications like atomoxetine, antidepressants and blood pressure medications. They work in an hour, peak at 2 hours (both benefits and side effects), and last 4 hours (all original stimulants), 8 hours (Adderall), or allegedly 12 hours (Vyvanse, Adderall XR). They each help 70% of patients. Put the 30% of non-responders on the alternative drug, and half will improve. Try combinations on the remaining treatment resistant patients. They must be matched for strength before drawing conclusions about effectiveness. For example 10 mg of methylphenidate has the strength of 5 mg of amphetimine. Adjust the doses before comparing their effects. The dose is by the weight. An effective dose will stop working even if adjusting for weight, after several month or a year. An alternative to repeated increases in doses per weight is to stop the stimulanst for 2 weeks on a school break, and restart at the same dose.