This guidance updates and replaces NICE technology appraisal 13 (published in October 2000).

If a child or adolescent needs treatment with medication for ADHD, methylphenidate, atomoxetine and dexamfetamine are all recommended as possible choices. When deciding which to use, doctors should consider the following:

  • whether the child or adolescent has other conditions such as epilepsy
  • the side effects of each medicine
  • factors that might make it difficult for the person to take the medicine at the right time (for example, if it is difficult to take a dose during school hours)
  •  the possibility that the medicine might be misused, or passed on to another person for misuse
  • the individual preference of the child or adolescent and/or their family or carer.

Where more than one of the medicines is considered to be appropriate for a child or adolescent, their doctor should choose the cheapest one.

Treatment with methylphenidate, atomoxetine or dexamfetamine should only be started after a specialist who is an expert in ADHD has thoroughly assessed the child or adolescent and confirmed the diagnosis. Once treatment has been started it can be continued and monitored by a GP.