Patient's question:
Doctor, hello, my sister is already 12 years old. Because of illness in childhood, she has intellectual problems, cannot speak clearly, does not know when she is full when eating, cannot concentrate, is very active, and has poor memory, cannot remember anything. I would like to ask, is there any medicine or method that can treat it? Thank you.Doctor's answer:
Medications can improve attention deficits, reduce activity levels, and to some extent enhance academic performance, while also improving the relationship between patients and their families in the short term.(1) Central Nervous System Stimulants – First-line treatment medications, currently primarily pemoline and its controlled-release tablets in China.
Pemoline, marketed as Ritalin. Low doses help improve attention, while high doses can alleviate symptoms of hyperactivity and impulsivity, reducing behavioral issues.
Central Nervous System Stimulants are limited to use in patients aged 6 and older. Due to their central stimulant effects, they should not be used in the evening. Side effects include decreased appetite, insomnia, headaches, irritability, and restlessness, though it is not yet certain whether they affect growth and development. Central Nervous System Stimulants may trigger or worsen tics in patients, and those with comorbid tic disorders are not recommended to use them. Long-term use also requires consideration of the risk of substance abuse.
(2) Selective Norepinephrine Reuptake Inhibitors – Representative medication: Atomoxetine. Atomoxetine has efficacy comparable to pemoline, with fewer side effects and good tolerance, and has been listed as a first-line treatment for ADHD. Features: Once-daily dosing with a 24-hour duration of action; long-term use without addiction; the drug takes longer to take effect than central nervous system stimulants, with noticeable improvements typically occurring 1–2 weeks after starting treatment, making it unsuitable for patients requiring acute treatment. The most common side effects are gastrointestinal reactions, and the medication should be taken after meals.