ALTERNATIVES TO STIMULANT MEDICATIONS

What are the non-stimulant medications available in your clinic?

Atomoxetine (Strattera), Guanfacine (Intuniv), and Bupropion (Wellbutrin) are available in our clinic. They are not as effective as stimulant medications and are considered the second line of treatment. They may be considered if a child has too many side effects with stimulant medications, or if they have pre-existing medical conditions which make stimulant use unsuitable, such as epilepsy (repeated seizures) or heart conditions. The effects of non-stimulant medications build up over time, so it takes a few weeks before their benefits are observed.

Can you tell me more about Strattera?

Strattera is the brand name of the non-stimulant medication Atomoxetine. It belongs to a class of medications called Selective Norepinephrine Reuptake Inhibitors and it works by boosting the levels of brain messengers (mainly norepinephrine). Atomoxetine is helpful in children with ADHD and co-occurring tics and anxiety. Side effects may include nausea, loss of appetite, stomachache, tiredness and insomnia.

Can you tell me more about Guanfacine?

Guanfacine (Intuniv) belongs to a class of medications called Alpha Agonists. It works on the front part of the brain (i.e. the prefrontal cortex) and is used primarily for ADHD in children and teenagers. It is also effective in conditions like tics, aggression, insomnia, and hypertension. Side effects may include sleepiness, dizziness, low blood pressure and low heart rate.

Can you tell me more about Wellbutrin?

Bupropion (Wellbutrin) belongs to a class of antidepressants called Norepinephrine-Dopamine Reuptake Inhibitor. It is often used for the treatment of depression and has been found to be helpful in ADHD by boosting levels of dopamine and norepinephrine in the brain. Side effects may include nausea, loss of appetite and sleep difficulties. It is not suitable for people with epilepsy (repeated seizures) or eating disorders.

What about vitamins, minerals and fish oil?

Some studies have suggested that fish oil (Omega-3) is beneficial for ADHD. The Ministry of Health guidelines in Singapore also supports the use of Omega-3 supplements as an add-on to complement the medical and behavioral treatment of ADHD.
V-RIN (formerly known as Vayarin) is a specially formulated omega-3 supplement which targets the brain and ADHD symptoms. Its combines Phosphatidylserine (PS) and Omega-3, creating PS-Omega-3, which is delivered efficiently to the brain to provide nutrients and lipids which may be deficient in ADHD. If the child is unable to swallow pills, the V-RIN capsules can be opened up into beverage or yogurt for the child to take in powder form. V-RIN is available in our clinic.
Smaller studies have also suggested that Zinc, Iron, Magnesium, Vitamin D, and Vitamin B Complex may be beneficial for ADHD. While parents may consider these supplements, they are unlikely to notice a significant difference in their child’s ADHD symptoms.

What if my child is already diagnosed by a psychologist in another psychology practice? Do I still need a consultation with the psychiatrist before medications can be prescribed?

If your child has been diagnosed with ADHD by an educational psychologist or clinical psychologist from another centre, our psychiatrist will be able to provide medications. A full clinical consultation with our psychiatrist (medical doctor) is still necessary before medications can be prescribed. We will discuss the various treatment options and formulate an individualized treatment strategy to target the different aspects of ADHD to help your child fulfill his or her full potential.

What else can I do to help my kids?

Children with ADHD require structure and routines to keep organized and focused. Because the natural tendency of the ADHD brain is to drift and seek stimulation (internally or externally), systems such as to-do-lists, schedules, rewards and gamification of daily tasks will go a long way to improve their ability to start tasks and stay on track.
The basics are not to be neglected. A balanced diet is crucial for brain growth and development. Regular exercise and outdoor activities are great outlets to discharge pent-up energies and promote better sleep and concentration. In fact, exercise itself boosts many of the same brain messengers which stimulant medications do.
Quality family time is essential to cultivate healthy parent-child bonding. Don’t just focus and dwell on ADHD symptoms. Excessive criticisms are unhelpful and may strain your relationship, yet not achieve the intended effects.
Focus also on your child’s unique strengths and charm. A nurturing, loving and predictable home environment forms the most basic foundation of every child’s springboard to achieving their life goals.

How do I book an appointment?

To arrange an appointment with our psychiatrists, psychologists, or therapists, you can call or WhatsApp us at 8875 3108 (Novena Branch) or 9738 3595 (Farrer Park Branch). Alternatively, you can email us at appointment@privatespace.com.sg.

We are open 7 days a week, except on public holidays. If available, please bring your child’s school report books, as they may contain useful data for the assessment process.

Conclusion

We have come to the end of our 7-part Q&A series on ADHD in children and teenagers. You are welcome to read the earlier parts, where we covered different aspects of ADHD symptoms, prevalence, trajectory, assessment process, diagnostic implications, complications, and treatment options.
We hope the content has been useful as an initial guide. If you suspect ADHD in your child, don’t hesitate to reach out, and we will do our best to help.

Seek Help Today

Thank you for taking the time to read about ADHD. If you or someone you know is struggling with symptoms like those mentioned, don't hesitate to reach out to our expert clinicians. Understanding, support, and proper treatment can make a significant difference in managing ADHD and improving quality of life.

Your well-being matters, and we're here to help every step of the way.

Dr Victor Kwok
Senior Consultant Psychiatrist
Private Space Medical
Dr Tay Kai Hong
Senior Consultant Psychiatrist
Private Space Medical