The value of biofeedback is unsubstantiated. Most studies have found minimal change in behavior and no sustained benefit. Methylphenidate, a dopamine agonist, is the drug of choice and has fewer adverse effects than dextroamphetamine. However, cognition is often impaired at higher doses. Response to medication often is individual, and dosage is prescribed depending on the severity of the behavior and the child's ability to tolerate the drug.
Many children have difficulty absorbing or tolerating methylphenidate sustained-release doses.
Too much of a stimulant across the day can result in rebound reactions as the drug dissipates. Drugs often are prescribed to help the child only in school. Long-term benefits of drugs alone have not been demonstrated conclusively. However, drugs have been shown to permit participation in activities previously inaccessible because of poor attention and impulsivity. Drugs often interrupt the cycle of inappropriate behavior, enhancing behavioral and academic interventions, motivation, and self-esteem.