Today, we're tackling a big question. How young is too young to treat children with medication

for ADHD?

I'm Dr. Josh Fader, the editor-in-chief of the Carlis Child Psychiatry Report and co-author

of the Child Medication Fact Book for Psychiatric Practice,

Second Edition, 2023, and our other book, Prescribing Psychotropics.

In Amerig Government, a licensed clinical social worker in Southern California with a private practice

and an avid reader of the Carlet Psychiatry Report.

ADHD in preschoolers is a hot topic, and in our practice, we see the struggle parents face

when non-pharmacological strategies aren't enough.

Absolutely, Mera.

ADHD medications are FDA approved for marketing to kids as young as

three, but guidelines still recommend starting with non-pharmacological interventions. And when

that doesn't work, many parents and providers hesitate before turning to stimulants.

Right. And that caution makes a lot of sense. Current research also helps to paint

a better picture of these interactions. A recent meta-analysis that looked at nine clinical trials

with over 500 kids under seven showed that stimulants had a medium to large effect size on parent and teacher ADHD ratings,

but only a small effect on inattention.

Let's look at that distinction.

Hyperactivity and impulsivity seem to improve more than inattention.

But this is what concerns me.

The neuropsychological test showed no improvement with stimulants.

And that makes me wonder if the medication is just kind of masking outward behaviors

...