Why medication at all?
According to current scientific research, the altered functioning of the brain responsible for the development of ADHD implies a complex disorder in the catecholamine balance of the brain. What does this mean? It can be concluded that in the case of a clearly proven attention deficit syndrome, the imbalance of the messenger substances can be held responsible for the behaviour that deviates from the norm.
While some messenger substances are sufficiently available, others are insufficiently available, this ultimately results in the different symptoms of ADS. Due to the many possible combinations (see above), catalogues of criteria for symptomatic analysis or similar can never really be considered a complete list. – The messenger substances are normally in balance, but this balance is disturbed in children with ADHD.
- The catecholamines (= messenger substances) are attributed a specific function: Noradrenaline – drive Serotonin – impulsiveness Dopamine – drive. The interaction of these messenger substances in turn leads to further effects: Norepinephrine and serotonin – development of anxiety Serotonin and dopamine – appetite, aggression, lust Norepinephrine and dopamine – motivation Serotonin, norepinephrine, dopamine – mood, emotionality, cognitive abilities. – Behavioural patterns allow conclusions to be drawn about the underlying imbalance. – This imbalance disturbs the transmission of information between the individual nerve cells in the area of individual brain areas. If this balance is disturbed, stimuli cannot be transmitted in the usual way.
What are the arguments for and against medication?
The effectiveness of these substances clearly speaks in favour of taking medication. The ability to concentrate is improved within a very short time and participation in school or work is made easier. Drug therapy is therefore the simplest and often most effective form of treatment for attention disorders.
In addition, a large number of studies with large numbers of test persons allow the benefits and risks of these drugs to be assessed. However, the common drugs often have side effects that could possibly be more serious than the current study situation suggests. Children in particular are therefore concerned about disrupting their development and causing long-term damage.
In addition, more and more new therapies promise similar success with fewer side effects. The current drugs are therefore becoming less and less important. However, they remain the best-researched form of therapy with undisputed effectiveness, and other substances and measures can also cause side effects that are not yet known. The most important thing in treatment is therefore to weigh up the benefits and risks of each form of therapy and to draw up the best plan for the patient individually.
Which drugs are used?
In principle, the same active ingredients can be used in ADHD as in typical ADHD. These substances increase the ability to concentrate through improved signal transmission in the brain and can therefore help with almost all attention disorders. The most commonly used substance for this purpose is methylphenidate, which is contained in drugs such as Ritalin® or Medikinet®.
If this does not show sufficient improvement, other drugs can be used, such as amphetamines with the same mechanism of action. Although these stimulants are very effective in treatment, they are psychotropic drugs and often have side effects. Other substances such as atomoxetine (in the drug Strattera®) attack at a different point in the signal transmission in the brain.
Their effect is usually somewhat weaker, but they have no addictive potential and there are fewer side effects. Other medications that were actually developed for other diseases, but in individual cases also help with ADHD, can also be prescribed at the discretion of the doctor. The different imbalances of the messenger substances claim different groups of drugs for themselves, which are intended to specifically address the imbalance and alleviate or reduce symptoms.
All the groups of drugs mentioned below belong to the so-called psychotropic drugs. This group of drugs generally includes all drugs that have a psychoactive effect and thus affect the activity of the CNS (= central nervous system). They act at the synapse / at the synaptic cleft, i.e. exactly where messenger substances are used to transmit stimuli from nerve cell to nerve cell.
You can find more information under Causes of ADS on the ADS – Main Page. The following groups of drugs are used in case of a messenger imbalance: With regard to antidepressants, a distinction is made between: Depending on the necessity and nature of the imbalance, the treating physician will prescribe medication from the appropriate group. In the case of ADS, stimulants are primarily used and are considered to be the drugs of first choice.
Within the framework of therapy for adults with ADS, the use of tricyclic antidepressants may also be advisable. – Stimulants, including for example drugs with the active ingredient methylphenidate (e.g. Ritalin®)
- MAO – Inhibitors
- NARI (Selective Norepinephrine Resumption Inhibitors)
- RIMA (Reversible Monoaminooxidase Inhibitors)
- SNRI (Serotonin – Norepinephrine – Resumption inhibitor)
- SSRI (selective serotonin reuptake inhibitor)
Herbal medicines are used for a wide variety of concentration problems to improve mental performance and psychological well-being. One example of this is the Chinese ginkgo active ingredient, which improves blood circulation in the brain.
Preparations containing caffeine and omega-3 fatty acid capsules can also improve attention in some patients. As a supplement, Bach Flowers improve mental health and thus also mental performance. THC, the active ingredient of the cannabis plant, can also be prescribed by a doctor, but is very rarely used and usually only in the hyperactive form of ADHD.
Unlike the typical ADHD, ADHD does not require sedation by the active ingredients. Popular substances such as valerian and the like are therefore usually not effective either. The effect of the herbal medicines is also controversial, insufficiently proven and side effects cannot be excluded.
In mild forms of ADHD or in cases of severe intolerance to psychostimulants, they can be an alternative, but should be taken with caution. The herbal medicines mentioned above are available without prescription and in pharmacies. Experienced pharmacists may also recommend other substances.
However, the quality of the substances should be taken into account, especially in the case of over-the-counter drugs, as more and more of these food supplements are now on the market, are also sold by supermarkets and the like, and are not subject to as strict testing as prescription drugs. When buying in a pharmacy, however, good quality can be assumed. As with herbal medicines, homeopathic approaches can be very effective, but they also have side effects. Since homeopathy as a holistic therapy concept promotes the entire psychological well-being, it can achieve great therapeutic success, especially in the case of ADHD with its accompanying psychological problems. Depending on the appearance, different substances can be considered, for example sulphur for high intelligence and curiosity or agaricus for typical dreaminess.