Non-stimulant ADHD medication: amantadine (Symmetrel) use in children

I'd like to share anectdotal reports of my use of amantadine in children. Amantadine is a medication that is not used much in child psychiatry. It was originally developed for the treatment of flu symptoms. It was later found to be helpful in Parkinson's. I ran across an article about using it for the treatment of ADHD in the late 80"s. I have always kept it "in my back pocket" in case I needed an alternative to traditional ADHD medication when there was a history of tics, bipolar or an intolerance to stimulants. I have had some very good results in the treatment of ADHD with amantadine with very few side effects. The most common side effects are a decrease in appetite, weight loss and upset stomach. Dizziness can also occur.

It can be a a good option that shouldn't be overlooked.

Amantadine comes in liquid and 100mg capsules. The maximal dose is 100mg three times a day.

ADHD medications with Bipolar children

There is much co-morbidity (co-existance) of ADHD in bipolar children. The concern, however, is that stimulants sometimes cause an upset to the delicate balance of mood. It is not uncommon to see more anger issues, depression and even psychosis when stimulants are added. It is important therefore to be careful when using stimulant medication with bipolar children. Strattera (atomoxetine) is in the same camp since it exerts antidepressant effects and can cause manic activation in bipolar children.

Safer medications to consider in children with bipolar to address attention issues include tenex, provigil (though I have seen it increase anger on occasion), amantadine, buspar and to some extent wellbutrin (though it can cause manic activation it seems less likely compared to other antidepressants).