ADHD Treatments: Drugs

Written by the Healthline Editorial Team | Published on December 1, 2014
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP on December 1, 2014

Drugs to Treat ADHD

A variety of medications can be used to treat ADHD.  According to the Centers for Disease Control and Prevention (CDC), data collected in 2011 indicated that 6.1 percent of children in the U.S. were taking ADHD medication.

Medication is often an important and difficult reality for parents of children with ADHD. Central nervous system stimulants like Adderall and Ritalin are the most commonly prescribed drugs. Your doctor may recommend other types as well.

Be sure to research drug information thoroughly, and then discuss with your doctor or a healthcare professional.

Central Nervous System Stimulants

Central nervous system (CNS) stimulants are the most common type of medication prescribed for ADHD. They have the longest track record of treating ADHD and have the most research to verify their effectiveness.

Researchers are not sure exactly how CNS stimulants ease the symptoms of ADHD. It’s believed that these drugs work by increasing dopamine levels in the brain. Dopamine is a brain chemical associated with:

  • motivation
  • pleasure
  • attention
  • movement

For many people with ADHD, stimulants can increase their ability to concentrate and focus. These drugs can also ease hyperactive and impulsive behaviors. CNS stimulants for ADHD come in both short- and long-acting forms.

Short-acting stimulants peak after several hours and must be taken two to three times a day. These usually come in pill or capsule form. Long-acting, or extended-release, stimulants last for eight to 12 hours and are usually taken just once a day. Extended-release stimulants contain the same drugs as short-acting forms; the difference is the way in which the drug is delivered into the body. Extended-release stimulants are usually taken in the form of a pill or capsule as well. However, an extended-release methylphenidate patch was recently put on the market as an alternative to pills.

CNS Stimulants for ADHD

CNS stimulants used to treat ADHD include the following.

  • Amphetamine-based stimulants (Adderall, Dexedrine, Dextrostat). These medicines are made up of either dextroamphetamine or a combination of dextroamphetamine and levoamphetamine.
  • Dextromethamphetamine (Desoxyn)
  • Dextromethylphenidate (Focalin)
  • Methylphenidate (Concerta, Daytrana, Metadate, Ritalin)

CNS stimulants are highly addictive. They should only be used under the supervision of a doctor. The medications can cause some adverse side effects, including decreased appetite, weight loss, trouble sleeping, irritability when the medication wears off, and, in rare cases, development of facial tics or heart conditions.

Although stimulants are commonly prescribed for the treatment of ADHD, recent research has discovered that there may be harmful effects on the heart health of children taking them. This is especially true in children with pre-existing conditions, such as diabetes, high blood pressure, or heart-rhythm abnormalities.

A task force of the American Heart Association (AHA) and American College of Cardiology (ACC) recently revised their recommendations on stimulants. The task force added a provision stating that doctors should carefully monitor the heart health of children who require stimulant medication to treat ADHD.

The U.S. Food and Drug Administration (FDA) has also added warnings to the labels of stimulants to warn patients about an increased risk of heart and psychiatric problems.

Non-Stimulant Medication

Non-stimulant drugs are often considered when stimulants have not worked or have caused intolerable side effects.

Atomoxetine (Strattera)

Atomoxetine is one of only two non-stimulant drugs approved by the FDA for ADHD treatment. As with CNS stimulants, researchers are not sure exactly why atomoxetine works. Atomoxetine, like stimulants, affects levels of neurotransmitters in the brain. However, atomoxetine boosts levels of the chemical norepinephrine. Atomoxetine is longer acting than stimulants. Its effects can last more than 24 hours.

Atomoxetine may be a good option for ADHD patients who are also experiencing symptoms of anxiety or depression because it also has some antidepressant properties. However, atomoxetine doesn’t appear to be as effective as stimulant medications for treating symptoms of hyperactivity.

Side effects of atomoxetine may include:

  • nausea
  • sedation
  • reduced appetite
  • weight loss

Guanfacine (Intuniv)

Guanfacine (Intuniv) is a non-stimulant approved by the FDA in 2009 for treating ADHD. In 2011, it was also approved for use alongside CNS drugs in treating ADHD in children. Guanfacine is primarily a blood pressure medication. But it has also been shown in clinical trials to effectively treat symptoms of hyperactivity, impulsivity, and aggression. It’s less helpful when it comes to attention problems. Other blood pressure drugs are sometimes prescribed off-label (medication prescribed for an unapproved indication, age group, dose, or method of administration) to treat ADHD.

Antidepressants

Although the FDA has not approved antidepressants for the treatment of ADHD, doctors will sometimes prescribe these medications to patients who don’t respond well to stimulants or to atomoxetine.

Atypical Antipsychotics

Certain second-generation antipsychotics are also sometimes prescribed off-label to treat ADHD in patients who don’t respond well to stimulants or atomoxetine. These drugs target multiple neurotransmitters in the brain.

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