Is my son taking the correct treatment for attention deficit hyperactivity disorder (ADHD)?

Q: My 15 years old son is taking Addwize 10 mg twice daily, Diva OD 500 mg and Asprito 10 mg daily for attention-deficit hyperactivity disorder (ADHD) for the last one and a half years. He has a problem of memory loss, excessive sweating on the palms and some neurological disorder revealed during the EEG. His learning ability is also less. His condition hasn’t improved much and he has now been prescribed Attentrol 10 mg daily for a month and then twice daily in place of Addwize 10 mg. What are the adverse effects of withdrawing Addwize? Are there any side effects of Attentrol? Will my son improve with these? Should he continue the medicines? Please suggest.

A:Addwize is the brand name, the name of the medicine is methylphenidate. It should be given only for four weeks in ADHD and continued ONLY if there is significant improvement. If there was no improvement, then I do not know why it was continued for 18 months. Similarly, the beneficial effects of Attentrol (atomoxetine), if any, should appear in 6 to 10 weeks at the most. Asprito (aripiprazole) is actually meant for schizophrenia. Similarly Diva OD (divalproex) is actually meant for epilepsy. These drugs are sometimes tried though they are not licensed for the treatment of ADHD. The results are variable and different individuals respond differently. In clinical trials, atomoxetine reduced the hyperactivity any where from 25 to 33 per cent. In some exceptional cases it went down by 45%. Naturally, all these medicines do have side effects and one has to weigh benefits v/s risks. Aripiprazole, when used in schizophrenia, carries the risk of developing suicidal ideation. Methylphenidate (Addwize) has similar side effects including hallucinations and seizures. Attentrol (atomoxetine) carries the risk of suicidal tendency, peripheral coldness, growth retardation etc. Treatment of ADHD should not exclusively depend on drugs but on a holistic approach including psychotherapy.