Episode Four: ADHD Medication – Treatment, Trials, and Tailoring

In the final episode of our three-part ADHD series, Dr. Gretchen Hoyle walks us through the complex and highly individualized process of ADHD medication management in children. While stimulants are often the first line of treatment, she explains how other medications—like alpha-2 agonists originally designed for hypertension—are often used in combination to balance efficacy with side effects such as elevated blood pressure.

M. Butterman

4/23/20251 min read

🎧 Episode Four: ADHD Medication – Treatment, Trials, and Tailoring

Guest: Dr. Gretchen Hoyle, Pediatrician

In the final installment of our three-part ADHD series, we explore the real-world challenges and decision-making processes behind ADHD medication management in children. Dr. Gretchen Hoyle returns to guide us through:


🧠 Topics Covered

  • Medication combinations and why stimulants are often paired with alpha-2 agonists

  • How insurance formularies influence medication choices more than many parents realize

  • Age-specific prescribing, including alternatives for children who can't swallow pills

  • Navigating medication shortages and supply chain disruptions

  • The role of trial and error in ADHD medication—and how to manage it

  • Introducing genetic testing tools like GeneSight to guide personalized treatment

  • Managing co-occurring conditions such as anxiety and depression alongside ADHD

  • Importance of close monitoring, including questionnaires and side effect screening

  • Why collaborative care between families and physicians leads to the best outcomes

🧪 Mentioned in This Episode

  • GeneSight® – A pharmacogenomic test that analyzes how genes may affect medication response

  • Vanderbilt ADHD Diagnostic Rating Scales – Used to monitor symptoms and side effects

  • Alpha-2 agonists – Medications like guanfacine and clonidine, often used in combination with stimulants

📝 Key Takeaways

  • ADHD treatment is not one-size-fits-all; medication choice depends on medical, practical, and systemic factors

  • Parents play a critical role in observing and reporting how medications are affecting their child

  • While most children respond well to first-line medications, new tools like genetic testing can provide valuable insights—especially in complex cases

  • Regular follow-ups, screening tools, and open communication are essential to long-term success

📌 Resources

🔜 Next Up on Nimble Youth

We're launching a new series on Anxiety in Children:

  • Part 1: Anxiety in younger children

  • Part 2: The unique experience of teenage girls

  • Part 3: Addressing the growing crisis among adolescent boys

Don't miss it—subscribe wherever you get your podcasts!


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