Pharmacotherapy of ADHD in young children

Attention-deficit hyperactivity disorder (ADHD) is a disorder common throughout childhood, with recognizable symptoms as early as preschool in many cases. ADHD is often treated in young children by simply implementing strategies proven efficacious and safe in older children and adolescents, as limited data is available in children younger than age six. Research has been extended into this age group by the Preschool ADHD Treatment Study (PATS) and other recent trials, providing clinically relevant data on differences in tolerability and efficacy of ADHD pharmacotherapies, primarily methylphenidate. No published data is yet available on the use of atomoxetine in children under age six. Growth is an area of particular interest and concern in the pediatric population, with data demonstrating variability in the long-term rates of growth in height as well as weight. While pharmacotherapy holds the potential for significant benefit in young children with ADHD, concerns with variation in response and tolerability highlight the need for careful evaluation, close monitoring, and an ongoing risk/benefit analysis throughout the implementation and use of medication.