Hyper All The Time

There are two types of kids with ADHD, those who have some Hyperactivity and more Inattention and those who are always extremely Hyperactive with Attention out the window. In the first kind I prefer to use a single stimulant medication, i.e. either dextro-amphetamine (Dexedrine, Vyvanse Adderall) or methylphenidate preparation (Concerta, Medatate, Ritalin). These are kids who predominately need the medication to be functional at school or other structured activity and in general can be hyper and manageable at home. In the second kind, I prefer to use medications such as Clonidine (Kapvay) and Guanfacine (Tenex and Intuniv). I find that the hyperactivity needs to be contained first and with more of a 24/7 coverage. A stimulant can be used in conjunction. Strattera by itself or with Clonidine or Guanfacine is also very effective in extremely hyper motoric children.