Ukrainian Journal of Perinatology and Pediatrics. 2025.3(103): 45-55. doi: 10.15574/PP.2025.3(103).4555
Kyrylova L. G.¹, Miroshnikov O. O.¹, Haletska V. G.², Poskrypko Yu. A.^2
1SI «Ukrainian Center of Maternity and Childhood of NAMS of Ukraine”, Kyiv
²«Naturfarm» PJSC, Kyiv, Ukraine

For citation: Kyrylova LG, Miroshnikov OO, Haletska VG, Poskrypko YuA. (2025). A differentiated approach to drug treatment of attention deficit hyperactivity disorder in children. Ukrainian Journal of Perinatology and Pediatrics. 3(103): 45-55. doi: 10.15574/PP.2025.3(103).4555.
Article received: Jul 27, 2025. Accepted for publication: Sep 15, 2025.

Attention deficit hyperactivity disorder (ADHD) is a common and complex neurodevelopmental disorder characterized by persistent manifestations of hyperactivity, inattention, and impulsivity, which leads to negative consequences for the quality of life.
Aim – to conduct a review of current data of ADHD etiopathogenesis, variants of clinical manifestations, and to study a differentiated approach to the pharmacotherapy of ADHD in children, in particular the advantages of using the NIHT approach to the treatment of ADHD in children. Data on the prevalence, etiology, pathogenesis, variants of the clinical course of ADHD in children, current recommendations and manuals for the diagnosis and treatment of ADHD, in particular first-, second-, and third-line drug treatment, as well as a differentiated approach to the use of adjuvant drugs and alternative approaches to the treatment of ADHD were systematized and analyzed. The possibilities of NIHT approach (Non-Individualised Homeopathic Treatment) in the pharmacotherapy of ADHD in children are considered, particularly the use of the drug Kindinorm^® N.
Conclusions. A differentiated approach to the drug treatment of ADHD in children should take into account the variants of the clinical course of ADHD, the characteristics and severity of symptoms, the clinical response to the use of "protocol" drugs, their tolerability and compliance with the regimen, as well as the possibilities of the NIHT approach both in complex treatment and in monotherapy.
The authors declare no conflict of interest.
Keywords: attention deficit hyperactivity disorder, non-individualised homeopathic treatment, Kindinorm N, Alpekid Norma.

REFERENCES

1. Advokat C, Scheithauer M. (2013). Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Front. Neurosci. 7: 82. https://doi.org/10.3389/fnins.2013.00082; PMid:23754970 PMCid:PMC3666055

2. Ayano G, Demelash S, Gizachew Y, Tsegay L, Alati R. (2023). The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. J. Affect. Disord. 339: 860-866. https://doi.org/10.1016/j.jad.2023.07.071; PMid:37495084

3. Bolbot Y. (2020). Attention deficit/hyperactivity disorder in pediatric practice. Pediatrics. Eastern Europe. 3(8): 423-431. https://doi.org/10.34883/PI.2020.8.3.009

4. Boyarshinova KI, Kravchenko RI, Klepets YM, Lorberg B, Martsenkovsky IA et al. (2019). Attention deficit hyperactivity disorder in children and adolescents. Evidence-based clinical guideline. State Expert Center of the Ministry of Health of Ukraine: 66. URL: https://www.dec.gov.ua/wp-content/uploads/2019/11/2019_09_30_kn_rozladdu.pdf.

5. Bozinovic K, McLamb F, O'Connell K, Olander N, Feng Z et al. (2021). U.S. national, regional, and state-specific socioeconomic factors correlate with child and adolescent ADHD diagnoses pre-COVID-19 pandemic. Sci. Rep. 11(1): 22008. https://doi.org/10.1038/s41598-021-01233-2; PMid:34759326 PMCid:PMC8580963

6. CADDRA. (2020). Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines. 4.1 Ed. Toronto, ON: 112.

7. Coghill D, Banaschewski T, Cortese S, Asherson P, Brandeis D, Buitelaar J et al. (2023). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). Eur. Child. Adolesc. Psychiatry. 32(8): 1337-1361. https://doi.org/10.1007/s00787-021-01871-x; PMid:34677682 PMCid:PMC8532460

8. Dalrymple RA, McKenna Maxwell L, Russell S, Duthie J. (2020). NICE guideline review: Attention deficit hyperactivity disorder: diagnosis and management (NG87). Arch. Dis. Child. Educ. Pract. Ed. 105(5): 289-293. https://doi.org/10.1136/archdischild-2019-316928; PMid:31776172

9. Danielson ML, Holbrook JR, Bitsko RH, Newsome K, Charania SN et al. (2022). State-Level Estimates of the Prevalence of Parent-Reported ADHD Diagnosis and Treatment Among U.S. Children and Adolescents, 2016 to 2019. J. Atten. Disord. 26(13):1685-1697. https://doi.org/10.1177/10870547221099961; PMid:35603751 PMCid:PMC9489617

10. Dean L. (2015). Atomoxetine Therapy and CYP2D6 Genotype. In: Pratt VM, Scott SA, Pirmohamed M, Esquivel B, Kattman BL, Malheiro AJ, eds. Medical Genetics Summaries [Internet]. Bethesda (MD). PMID: 28520366. [Updated 2020 Jun 29].

11. De Felice A, Ricceri L, Venerosi A, Chiarotti F, Calamandrei G. (2015). Multifactorial Origin of Neurodevelopmental Disorders: Approaches to Understanding Complex Etiologies. Toxics. 3(1): 89-129. https://doi.org/10.3390/toxics3010089; PMid:29056653 PMCid:PMC5634696

12. Drevitska OO, Dziuba SO, Dziuba LO, Izmalkova KB. (2014). Kindinorm H in the treatment of borderline mental disorders in children. Children's doctor. 1(30): 31-34.

13. Eaton C, Yong K, Walter V, Mbizvo GK, Rhodes S, Chin RFM. (2022). Stimulant and non-stimulant drug therapy for people with attention deficit hyperactivity disorder and epilepsy. Cochrane Database of Systematic Reviews. Iss. 7. Art. No.: CD013136. https://doi.org/10.1002/14651858.CD013136.pub2; PMid:35844168 PMCid:PMC9289704

14. Eom TH, Kim YH. (2024). Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates. Clin. Exp. Pediatr. 67(1): 26-34. https://doi.org/10.3345/cep.2021.01466; PMid:37321571 PMCid:PMC10764666

15. Faraone SV, Larsson H. (2019). Genetics of attention deficit hyperactivity disorder. Mol. Psychiatry. 24(4): 562-575. https://doi.org/10.1038/s41380-018-0070-0; PMid:29892054 PMCid:PMC6477889

16. Ferrin M, Hage A, Swanson J, Wong KHTW, Dittmann RW et al. (2025). Medication adherence and persistence in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and qualitative update. Eur. Child Adolesc. Psychiatry. 34(3): 867-882. https://doi.org/10.1007/s00787-024-02538-z; PMid:39105823

17. First MB. (2013). Diagnostic and statistical manual of mental disorders. 5th ed. J. Nerv. Ment. Dis. 201(9): 727-729. https://doi.org/10.1097/NMD.0b013e3182a2168a; PMid:23995026

18. Hayman V, Fernandez TV. (2018). Genetic Insights Into ADHD Biology. Front. Psychiatry. 9: 251. https://doi.org/10.3389/fpsyt.2018.00251; PMid:29930523 PMCid:PMC5999780

19. Health Technology Review. (2024). Attention-Deficit / Hyperactivity Disorder Medications for Adults. Canadian J. Health Techn. 4(11): 25 PMID: 39693465. URL: https://www.cda-amc.ca/sites/default/files/pdf/htis/2024/RC1556-ADHD_Medications_for_Adults.pdf; https://doi.org/10.51731/cjht.2024.1035

20. Hultzsch W. (2007). Clinical treatment effects and tolerability of Zappelin compared to Ritalin. Kinder- und Jugendarzt. 56(6): 1-4.

21. ICB and ELFT. (2022). Shared Care Guideline for the Use of Methylphenidate, Dexamfetamine, Lisdexamfetamine dimesylate & Atomoxetine for the Management of Attention-deficit Hyperactivity Disorder (ADHD) in Adult Patients (age 18-64 years). NHS: 27. URL: https://www.elft.nhs.uk/sites/default/files/2023-11/Adult%20ADHD%20SCG%20Luton%20Bedfordshire%207.0.pdf (Last Review Date: Sep 2025).

22. ICD-11. (2022). International Classification of Diseases for Mortality and Morbidity Statistics, 11th Revision. v2025-01. 6A05. Attention deficit hyperactivity disorder. URL: https://www.findacode.com/icd-11/block-821852937.html.

23. Kemper AR, Maslow GR, Hill S, Namdari B, Allen LaPointe NM et al. (2018). Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents [Internet]. Rockville (MD). Report No.: 18-EHC005-EF. PMID: 29558081. https://doi.org/10.23970/AHRQEPCCER203

24. Lange KW, Reichl S, Lange KM, Tucha L, Tucha O. (2010). The history of attention deficit hyperactivity disorder. Atten Defic Hyperact Disord. 2(4): 241-255. https://doi.org/10.1007/s12402-010-0045-8; PMid:21258430 PMCid:PMC3000907

25. Leslie LK. (2002). The role of primary care physicians in attention-deficit/hyperactivity disorder. Pediatr. Ann. 31(8): 475-484. https://doi.org/10.3928/0090-4481-20020801-07; PMid:12174762 PMCid:PMC1647398

26. Lopez FA, Leroux JR. (2013). Long-acting stimulants for treatment of attention-deficit/hyperactivity disorder: a focus on extended-release formulations and the prodrug lisdexamfetamine dimesylate to address continuing clinical challenges. Atten. Defic. Hyperact. Disord. 5(3): 249-265. https://doi.org/10.1007/s12402-013-0106-x; PMid:23564273 PMCid:PMC3751218

27. Martsenkovskiy IA, Tkachova OV. (2007). Hyperkinetic disorder in preschool and primary school children (principles of diagnosis and therapy). Pediatrics, Obstetrics and Gynecology. 3: 40-47.

28. Maidannik VG, Mityuryaeva IA, Molochek NV, Pokhodilo OV. (2018). New approaches to the treatment of tic disorders against the background of autonomic dysfunctions in children. Int. J. of Pediatrics, Obstetrics and Gynecology. 3(12): 69-75.

29. Mathie RT, Fok YYY, Viksveen P, To AKL, Davidson JRT. (2019). Systematic Review and Meta-Analysis of Randomised, Other-than-Placebo Controlled, Trials of Non-Individualised Homeopathic Treatment. Homeopathy. 108(2): 88-101. https://doi.org/10.1055/s-0038-1677481; PMid:30699444

30. Mathie RT, Ramparsad N, Legg LA, Clausen J, Moss S et al. (2017). A. Randomised, double-blind, placebo-controlled trials of non-individualised homeopathic treatment: systematic review and meta-analysis. Syst. Rev. 6(1): 63. https://doi.org/10.1186/s13643-017-0445-3; PMid:28340607 PMCid:PMC5366148

31. May T, Birch E, Chaves K, Cranswick N, Culnane E et al. (2023). The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder. Aust. N. Z. J. Psychiatry. 57(8): 1101-1116. https://doi.org/10.1177/00048674231166329; PMid:37254562 PMCid:PMC10363932

32. Mokia-Serbina SO, Chechel VV. (2013). Cognitive disorders and their correction in preschool children who had iron deficiency at an early age. Sovremennaya pediatriya. 6: 101-104.

33. Nigg JT. (2018). Toward an Emerging Paradigm for Understanding Attention-Deficit/Hyperactivity Disorder and Other Neurodevelopmental, Mental, and Behavioral Disorders: Environmental Risks and Epigenetic Associations. JAMA Pediatr. 172(7): 619-621. https://doi.org/10.1001/jamapediatrics.2018.0920; PMid:29799950 PMCid:PMC6511283

34. Peterson BS, Trampush J, Maglione M, Bolshakova M, Rozelle M et al. (2024). Treatments for ADHD in Children and Adolescents: A Systematic Review. Pediatrics. 153(4): e2024065787. https://doi.org/10.1542/peds.2024-065787; PMid:38523592

35. Rowland AS, Skipper BJ, Umbach DM, Rabiner DL, Campbell RA et al. (2015). The Prevalence of ADHD in a Population-Based Sample. J. Atten. Disord. 19(9): 741-754. https://doi.org/10.1177/1087054713513799; PMid:24336124 PMCid:PMC4058092

36. Sharkie I, Bonnar S, Seth S. (2006). Shared Care Protocol for Prescription of Medication in Attention Deficit Hyperactivity Disorder (ADHD): 12. URL: https://www.nhstaysideadtc.scot.nhs.uk/approved/shared/recommd/ADHD.pdf.

37. Shen F, Zhou H. (2024). Advances in the etiology and neuroimaging of children with attention deficit hyperactivity disorder. Front. Pediatr. 12: 1400468. https://doi.org/10.3389/fped.2024.1400468; PMid:38915870 PMCid:PMC11194347

38. Thomas R, Sanders S, Doust J, Beller E, Glasziou P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 135(4): e994-1001. https://doi.org/10.1542/peds.2014-3482; PMid:25733754

39. Tokko T, Miskinyte G, Eensoo D, Harro J. (2022). Driving risks of young drivers with symptoms of attention deficit hyperactivity disorder: association with the dopamine transporter gene VNTR polymorphism. Nord. J. Psychiatry. 76(8): 575-583. https://doi.org/10.1080/08039488.2022.2032330; PMid:35130472

40. Treuer T, Gau SS, Mendez L, Montgomery W, Monk JA, Altin M et al. (2013). A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability. J. Child Adolesc. Psychopharmacol. 23(3): 179-193. https://doi.org/10.1089/cap.2012.0093; PMid:23560600 PMCid:PMC3696926

41. Wolraich ML, McKeown RE, Visser SN, Bard D, Cuffe S et al. (2015). The prevalence of ADHD: its diagnosis and treatment in four school districts across two states. J. Atten. Disord. 18(7): 563-575. https://doi.org/10.1177/1087054712453169; PMid:22956714

42. Wolraich ML, Hagan JF Jr, Allan C, Chan E, Davison D et al. (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 144(4): e20192528. doi: 10.1542/peds.2019-2528. Erratum in: Pediatrics. 2020; 145(3): e20193997. https://doi.org/10.1542/peds.2019-3997; PMid:32111626

43. Zeyrek I, Tabara MF, Çakan M. (2024). Exploring the Relationship of Smartphone Addiction on Attention Deficit, Hyperactivity Symptoms, and Sleep Quality Among University Students: A Cross-Sectional Study. Brain Behav. 14(11): e70137. https://doi.org/10.1002/brb3.70137; PMid:39576227 PMCid:PMC11583478