In many cases the child s growth necessitates higher dosages for increased body weight. In other cases the reason is non-compliance on the part of the child, parents, or both. There are alternatives to Ritalin and stimulant tx of ADHD but most alternatives have risks and side effects of their own. TCAs are showing some promise due to their action on the noradrenergic system. The biggest barrier is that four children died on Desipramine in 1988.
Many subjects do as well as stimulant medicated subjects.
Recent studies have also shown that Clonodine was effective in reducing hyperactivity in 7 out of 10 children so diagnosed. The problem is that clonodin actually inhibits norepinephrine adding to the confusion of trying to map out the disorder. CLON has a favorable side-effect profile inducing sedation at night. There were 4 deaths among that group. Also it is important to really determine whether the child is hyperactive since no norms for childhood activity exist.