Methylphenidate is the usual first-line ADHD medicine for UK children aged 5 and over; lisdexamfetamine, dexamfetamine, atomoxetine and guanfacine are the other licensed options. All must be started by a specialist.
The five medicines used
UK guidance names five medicines for children. The first three are stimulants: methylphenidate (brand names include Equasym, Medikinet and Concerta), lisdexamfetamine (Elvanse) and dexamfetamine (Amfexa). The other two are non-stimulants: atomoxetine (Strattera) and guanfacine (Intuniv). Stimulants work within hours and can be stopped and restarted; non-stimulants build up over weeks and must be taken every day, so they cannot be paused for weekends or school holidays.
The order they are tried
NICE sets out a ladder for children aged 5 and over. Methylphenidate is offered first. If a 6-week trial at an adequate dose has not helped enough, the specialist switches to lisdexamfetamine. Dexamfetamine is an option for children who respond to lisdexamfetamine but cannot tolerate its longer-lasting effect. Atomoxetine or guanfacine come next, used when a child cannot tolerate the stimulants or has not responded to separate trials of both. Modified-release (long-acting) versions are usually preferred because one morning dose lasts the school day.
Who can start and continue it
Medication is not the automatic first move. NICE recommends it only after support at home and school has been put in place and reviewed, and the decision is made with you and your child. Treatment must be initiated by a healthcare professional with ADHD expertise (a paediatrician or child psychiatrist), who checks height, weight, heart rate and blood pressure first. Once a child is settled on a dose, a GP can usually continue prescribing and monitoring under a shared care agreement. Medicines reduce symptoms; they are not a cure, and they work best alongside other support.
Where the law comes from
Related
This page is general information, not clinical or legal advice.