by Alan Brandis, Ph.D.

There are several categories of treatment for reducing attention-deficit symptoms and related issues of performance and behavior. This is not intended to be an exhaustive list, but it highlights the most common approaches.

Chemical Approaches: Traditionally, the stimulant medications have been used, stemming from the “Dark Ages” (1980’s and before) when ADD was still called “Minimal Brain Dysfunction.” The names of these medicines are Ritalin, Adderall, Dexedrine, Metadate, Concerta, Focalin, and others. They are available in “regular” and time-release versions. They work by increasing activity in the prefrontal cortex, the part of the brain that controls voluntary attention, planning, and connecting behavior with consequences. Unfortunately, these medicines also increase activity in other parts of the brain, and because of this they can (but certainly do not always) cause “side effects” such as loss of appetite as well as increased anxiety or anger.

A note about “bad experiences” with medications (not just the stimulants, but also antidepressants and others). We often hear parents and patients describe their bad medication experiences. Almost always, these have occurred because of inadequate diagnosis (that’s why we use several tests to make sure of what we are treating), failure to properly adjust dosages, and/or lack of physician-parent-patient communication to “fine-tune” the treatment.

Most of the psychoactive medications have main effects as well as other, subtle effects that are important to consider. Often, a patient may have two conditions that require treatment, but only one is being treated. Unfortunately, physicians often have only a few minutes to spend with each patient so the subtle issues never get brought up. We strongly recommend continuing to see your psychologist or counselor until everyone involved feels that the medication or other regimen is working well. This will help ensure that all of the approaches are working in concert and will help minimize the chance of a bad experience.

There are now a number of alternative ways to alter brain chemistry, which might work for you or your child and could reasonably be tried before resorting to a prescription. Of course, any herbal remedy that changes brain function is still a “drug,” and it is an illusion to believe that an herbal product is somehow not “using a drug.” That said, there are a number of herbal/vitamin/amino acid substances and combinations available at nutrition stores and on the Internet.

Some people claim that powerful antioxidants help with focus and attention. Examples are Pycnogenol, derived from the bark of a tree that grows in France, or extracts of grape seeds or pine bark. These are 25-50 times more powerful than vitamin E. Some vitamins and amino acids (dietary precursors of brain chemicals) seem to help with attention and focus issues, especially if there is an unknown deficiency of that vitamin or brain chemical which the supplement is correcting. Some people have had success using l-tyrosine, the amino acid that the body uses to make dopamine.