To treat or Not to treat

Most of ADHD medications are highly effective. Methylphenidate (Ritalin) starts working in 15 to 30 minutes, but in 3 to 5 hours, it leaves the body in the urine. The effect is there only when the medicine is in the body. It is just like wearing glasses. During this period of time, the sufferers’ capability to think and do things is improved and if they learn some good habits and good learning skills, the skills will stay for a much longer time.

The medicine hence helps not only in school or work but of equal importance in emotional competence and character competence.
  • Emotional competence includes regulation of negative emotions and translating them into insight and, with guidance, to positive energy.
  • Character competence includes integrity, morality, honesty, etc.

The sufferers are able to improve in many areas of life:


School / Work: listen and learn better, improved in memory, easier to start doing work and maintain the standard consistently, less careless mistakes, better in handwriting, more planning, better organized in daily activities and organizing materials/ school bag.


Friends: more attentive to friends, less impulsive or abrasive, less addictive to please others, more able to say ‘No’ when appropriate, less annoying to them, less brush people off.


Family: Family members are also happier and relieved. In general, family members feel that they are not brushed off as often and communication among them are easier. Parents become more at ease to coach and guide their children and the relationship between them may be improved.


Sufferer:a decrease in accidental injuries owing to less impulsivity, and over time, more confident, better in own insight, better in verbal expression, better in setting priority, able to play better roles in life (as a student, as a son, as a sibling, and yourself, etc), more productive, better able to organize time, money and work, and happier.

As a ten year-old boy commented, the medicine helped him to become his own boss.

Cons – Side Effects

Side effects mostly occur early in treatment. The evaluation of the side effects* and the management should be discussed with your doctor.

  • Headache or stomachache or dizziness: usually mild; occur in the first week of treatment. Those taking atomoxetine may feel tired and or nauseous initially.
  • Appetite may be suppressed in some people. Adults who are overweight usually like it but parents may be concerned that the child does not eat enough. However, when the medication is out of the body, the child may feel very hungry and eat like a horse!
  • Delayed bedtime - some people may find it hard to fall asleep. This should be discussed with their doctor.
  • Rebound phenomenon: when the medicine is wearing off from the body, sufferers may feel more tired, cranky, yawning, more emotional, inattentive or agitated. This may last for half to one hour. During this period of time, it is better for them to take a bath, eat something, and relaxed.
  • Minor issues: thirstiness, sweatiness, dry eyes.
  • Rare adverse effect: hallucination. Be cautious if there is family history of schizophrenia, bipolar disorder, obsessive compulsive disorder, etc.

Signs and symptoms may become more apparent when a person also has underlying anxiety disorder, obsessive compulsive disorder, tics, etc. Be cautious if the person is on the autistic spectrum. For treatment resistant cases, another diagnosis or missing diagnosis should be considered.

"For those children who have additional medical conditions or reasons which make taking stimulant medication unadvisable or do not respond well to stimulant medication, second-line treatments, that is, non-stimulant medications may be prescribed (e.g. atomoxetine, tricyclic antidepressants, and bupropion).” ("ADHD – A Complete and Authoritative Guide” of the American Academy of Pediatrics”)

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