What Types of Medication Treat ADHD?

ADHD medications fall into two categories: stimulants like Adderall (amphetamine/dextroamphetamine) and non-stimulants like Strattera (atomoxetine).

Attention deficit hyperactivity disorder (ADHD) medications help decrease the symptoms of ADHD. Standard treatment for ADHD typically includes behavior therapy and counseling, in addition to medications. There is no known cure for ADHD, but symptoms can be managed with treatment and a healthy lifestyle.

Drug treatments for ADHD in both adults and children fall into two main categories:

• stimulant and
• non-stimulant medications.

Stimulant medications include amphetamines and derivatives like Adderall (amphetamine/dextroamphetamine), while non-stimulant drug therapies may include various classes of drugs, including

• antidepressants,
• SNRIs (serotonin and norepinephrine reuptake inhibitors) and
• others.

Strattera (atomoxetine), for example, is a popular non-stimulant ADHD drug.

Attention deficit hyperactivity disorder is a neurodevelopmental disorder that affects brain development, and consequently, behavior. Though ADHD is usually first diagnosed in childhood, it may last into adulthood for some people, which can affect work and relationships. The primary symptoms of ADHD include:

• Hyperactivity
• Trouble paying attention
• Difficulty in controlling impulsive behaviors

The three basic types of ADHD are:

• Predominantly inattentive
• Predominantly hyperactive/impulsive
• Both above combined

Hyperactivity and lack of focus are normal in young children, but in children with ADHD, these traits persist or worsen. There is no single test to diagnose ADHD. Diagnosis is typically made after medical tests and evaluations by a pediatrician or a mental health specialist to rule out other conditions with similar symptoms.

The cause of ADHD is not clear, but research suggests genes play an important role in the disorder. Eating too much sugar, watching too much television, parenting techniques, or social factors such as poverty or family discord do not cause ADHD, though they may aggravate the symptoms. 

Other possible risk factors that scientists are studying include:

• Brain injury
• Premature birth and low birth weight
• Tobacco and/or alcohol use during pregnancy
• Exposure to other harmful substances during pregnancy

According to the American Psychiatric Association, 5% of children in the United States have ADHD, but some studies say the rates have risen to as high as 11%. Boys are more likely to be diagnosed with ADHD than girls. About half of children with ADHD continue to have the condition as adults.

The treatment for ADHD depends on:

• The patient’s age
• The type of ADHD
• The severity of the condition

The American Academy of Pediatrics (AAP) recommends behavior therapy for ADHD as the first-line treatment in children four to five years of age, before trying medications. Therapy also includes training for parents. 

For children six years or older, the recommended treatment is a combination of medications and behavior therapy, which includes classroom behavior management through caregivers in the school, in addition to parent training. 

Treatment for ADHD in adults includes medication, mental health counseling, and skills training. Following a healthy lifestyle with nutritious food, adequate sleep and exercise can help alleviate ADHD symptoms to a great extent.

An effective treatment strategy for ADHD includes

• continued monitoring and follow-up evaluations,
• making necessary changes along the way.

ADHD medications are available as tablets for swallowing or chewing, oral solution, and skin patches. The two main types of medications used for ADHD treatment include:

• Stimulants: Stimulants are the most widely used type of medications which have been found effective for managing ADHD symptoms in 70%-80% of children. Stimulants help with improving focus and ignoring distractions. Stimulants come in two forms:
  • Short-acting with duration of effects up to six hours
  • Intermediate and long-acting with duration of 12 to 24 hours
• Nonstimulants: Nonstimulants may be used if stimulants are not effective or cause unacceptable side effects. Nonstimulants include:
  • Selective norepinephrine reuptake inhibitors (SNRIs)
  • Alpha-2 agonists
  • Antidepressants (tricyclic and atypical)

Stimulants

Stimulants increase the level of two different hormones, dopamine and norepinephrine, in the brain. Dopamine and norepinephrine are chemical messengers (neurotransmitters) which regulate attention, thinking, pleasure and movement. 

Stimulants are primarily of two classes:

• Amphetamine and derivatives
• Amphetamine sulfate (Evekeo)
• Dextroamphetamine sulfate (Dexedrine)
• Dextroamphetamine/amphetamine (Adderall, Mydayis)
• Lisdexamfetamine ((Vyvanse, Vyvanse chewable tablet)

Methylphenidate and derivatives

• Methylphenidate hydrochloride
  • Tablets (Ritalin, Methylin, Metadate CD, Aptensio XR)
  • Oral dissolvable tablet (Cotempla XR-ODT)
  • Chewable tablet (Quillichew ER)
  • Oral solution (Quillivant XR)
  • Skin patch (Daytrana)
• Dexmethylphenidate hydrochloride (Focalin, Focalin XR)

Stimulants have a potential risk for abuse. Addiction and withdrawal symptoms are possible with amphetamine-based ADHD medications. Never share your medication with anyone and bring all unused pills to the pharmacy for disposal if your doctor directs you to stop taking stimulants.

Nonstimulants

Selective norepinephrine reuptake inhibitors (SNRIs)

Selective norepinephrine reuptake inhibitors increase the level of norepinephrine in the brain by preventing its breakdown. The SNRI approved by FDA for ADHD is:

• Atomoxetine hydrochloride (Strattera)
• Alpha-2 agonists

Alpha-2 agonists inhibit the release of norepinephrine in the brain which has a sedative effect and brings down blood pressure. FDA-approved alpha-2 agonists for ADHD include:

• Clonidine hydrochloride (Kapvay, Catapres, Catapres-TTS skin patch)
• Guanfacine hydrochloride (Intuniv) approved for children of age six to 17 as adjunctive therapy to stimulants

Antidepressants

Antidepressants are medications to treat depression which are used off-label to treat ADHD. Most antidepressants for ADHD are long-acting with duration of effects lasting up to 24 hours, typically taken once a day.

Tricyclic antidepressants

Tricyclic antidepressants increase the level of serotonin, a hormone that regulates mood, sleep and digestion. Tricyclic antidepressants used for ADHD include:

• Imipramine hydrochloride (Tofranil)
• Desipramine hydrochloride (Norpramin)
• Nortriptyline hydrochloride (Pamelor)
• Atypical antidepressants

Atypical antidepressants used for ADHD include:

• Bupropion hydrochloride (Wellbutrin SR Wellbutrin XL) which increases the levels of dopamine, serotonin and norepinephrine in the brain.
• Venlafaxine hydrochloride (Effexor, Effexor XR) which increases the levels of serotonin and norepinephrine.

Additional information

Warning: FDA warns that patients, particularly in the ages 18 to 24, who are prescribed atomoxetine or antidepressants must be monitored for suicidal thoughts, especially during the first few weeks.

• Please visit our medication section of each drug within its class for more detailed information.
• If your prescription medication isn’t on this list, remember to look on MedicineNet.com drug information or discuss with your healthcare provider and pharmacist.
• It is important to discuss all the drugs you take with your doctor and understand their effects, possible side effects and interaction with each other.
• Never stop taking your medication and never change your dose or frequency without consulting with your doctor.