Rhonda Patt

Ask the Pediatrician: Can genetic testing pinpoint the best ADHD medication?


Q. I have a 9-year-old son with attention deficit hyperactivity disorder. Our child’s doctor has recommended genetic testing to figure out the right medication. The testing is expensive, and I can’t find a lot of information about it. Do most children need this testing?

A. ADHD is a common neurologic disorder of childhood, with about 10 percent of U.S. children diagnosed. Children with ADHD may have difficulty paying attention, careless or impulsive behavior and hyperactive behavior.

Clinicians diagnose ADHD based on symptoms and level of impairment. Information is gathered via questionnaires completed by the child’s parents and teachers. Psychological testing can provide objective data. Because there are no blood tests available to confirm an ADHD diagnosis, many people remain skeptical of the final diagnosis.

Optimal treatment of ADHD is multifaceted and involves modification of the environment, behavioral therapy for the child and medication if indicated. Most ADHD medications are stimulants and can have side effects such as decreased appetite, anxious feelings, headaches, abdominal pain, sleep problems and tic behaviors. Side effects are usually dose-related and will typically resolve by lowering the dose or type of medication.

Recently, over-the-counter testing has become available that claims to predict which ADHD medication will best suit a specific child. This testing uses a technology called pharmacogenetics, which looks for genetic markers that predict how a person will metabolize certain medications.

It is an up-and-coming field, but is still in the very early phases. It provides information about drug metabolism but is currently not clinically correlated with effectiveness or outcome.

Rhonda Patt is a pediatrician with Charlotte Pediatric Clinic. Email living@charlotteobserver.com; put “pediatrician” in the subject line.