During the first one or two visits to a new doctor, a hyperactive child may behave quietly and politely. Knowing what's expected, he may turn into a "model" child. Be prepared to describe, accurately and objectively, your child's behavior at home and in his social activities. If your child is having trouble at school, ask his teacher to speak with the doctor or send a written report. It may take several office visits before the hyperactive behavior becomes apparent. Don't worry. A child specialist can usually make an accurate diagnosis.
When treating a hyperactive child, your goal is to help him do the best he can, at home, at school, and with friends. Always remind yourself that your child is struggling mightily to overcome a nervous system handicap. Explain, if you must, but do not feel ashamed or guilty when your child misbehaves.
Parents of hyperactive children deserve an enormous amount of credit. It takes a lot of patience-and stamina-to love and support a hyperactive child through all the trials and frustrations that come with the condition. Parents of a hyperactive child are always concerned and watchful, always "on the alert." Consequently, it's easy to feel tired, overwhelmed, and frustrated at times. It is vitally important for parents of a hyperactive child to be good to themselves, to take appropriate breaks, to search out, and accept, help and support for themselves as well as for their child.
Before any treatment, a physical examination should be done to rule out other causes for your child's behavior, such as chronic middle ear infection, sinusitis, visual or hearing problems, or other neurological problems.
Methylphenidate (Ritalin) is the most commonly prescribed medication for hyperactivity. This is a stimulant that has the paradoxical effect of calming the nervous system and enhancing the ability of a hyperactive child to pay attention. Ritalin can be taken when needed, so that a child need not take it, for example, on weekends or during vacations, when all that extra energy can find an outlet. Be sure, however, that you check with your doctor before taking your child off this medication. Potential side effects of Ritalin include insomnia, decreased appetite, weight loss, slowed growth, increased heart rate and blood pressure, and an initial period of increased tearfulness and irritability.
Pemoline (Cylert) is a central nervous system stimulant that is often prescribed for hyperactivity. This medication enhances nerve impulse transmission in the brain. It can cause insomnia and so should be given at least six hours before bedtime. It is not recommended for children under six years of age.
Dextroamphetamine (Dexedrine) is another medication sometimes prescribed for hyperactivity. This drug is also a stimulant, but has the same paradoxical calming effect as Ritalin, as well as similar side effects.
Tricyclic antidepressant drugs, such as desipramine or nortriptyline (Pamelor) are less frequently prescribed. They are used mainly when an underlying depression is suspected.
Thiordazine (Mellaril) is a major tranquilizer that may be resorted to if a child is extremely aggressive, and then only in the most difficult situations.