People with ADHD have actual changes in their brain, particularly in an area called the prefrontal cortex. They can also have changes in some of the signaling molecules in the brain (called neurotransmitters) and their receptors. Specifically, the neurotransmitters norepinephrineand dopamine might not be present in the right amounts.
If symptoms are significantly impacting a person’s life, a healthcare provider might recommend medications. These medications work to balance the neurotransmitters in the brain and reduce symptoms.
Scientists have developed many different versions of these medications to help treat ADHD. This article will discuss these types in terms of some of their differences and their underlying similarities.
Types of ADHD Medications
Medications used to treat ADHD can be separated into these two broad categories—stimulants and non-stimulants:
Stimulants: These are a group of related medications that increase the amount of dopamine and norepinephrine that’s available in the brain. Stimulants can increase a person’s energy, alertness, and attention.
Non-stimulants: These are newer types of drugs that have been used to treat ADHD. They tend not to work as quickly as stimulant medications for ADHD, and they may not be as effective for many people.
For some people, using both a stimulant and a non-stimulant is most effective.
Stimulants for ADHD
Stimulants for ADHD fall into two main categories: those derived from the drug amphetamine and those derived from the drug methylphenidate. No evidence has shown that either is superior. These drugs have similar effects on a chemical level.
Over the years, scientists have developed many different formulations of these stimulants to treat ADHD. This often makes a bigger difference than the actual drug used.
Most products are available as pills to be swallowed, but some chewable tablets and liquids are also available. Unless indicated, the following products are available as pills or capsules.
Many people prefer extended-release formulations of stimulants compared to immediate-release versions. That’s partly because of the convenience of dosing: The extended-release formulations last longer, and they don’t have to be taken as frequently. Extended-release formulations also are less likely to be abused.
Amphetamine-Based Products
The following are long-acting amphetamine-based stimulants:
Adderall XR; Mydayis (amphetamine/dextroamphetamine) Dexedrine (dextroamphetamine) Vyvanse (lisdexamfetamine): Available as a pill or chewable capsule Adzenys (amphetamine): Available as a pill or chewable capsule Dyanavel XR (amphetamine): Available as a liquid
Below are some shorter-acting amphetamine-based stimulants:
Evekeo (amphetamine sulfate) Zenzedi (dextroamphetamine sulfate) Adderall (amphetamine/dextroamphetamine) ProCentra (dextroamphetamine sulfate): Available as a liquid
A very closely related drug, Desoxyn (methamphetamine hydrochloride), is another short-acting product. Its active ingredient is methamphetamine, which is sometimes made and sold illegally in the United States. Desoxyn is prescribed less frequently than these other stimulants.
Methylphenidate-Based Products
The following are some long-acting versions:
Adhansia XR; Aptensio XR; Concerta; Contempla XR; Jornay PM; Ritalin LA; Metadate (methylphenidate) Azstarys (serdexmethylphenidate/dexmethylphenidate) Focalin XR (dexmethylphenidate) Quillivant XR (methylphenidate): Available as a liquid QuilliChew ER (methylphenidate): Available as a chewable tablet Daytrana (methylphenidate): Available as patches
Below are some shorter-acting methylphenidate products:
Focalin (dexmethylphenidate) Ritalin (methylphenidate) Methylphenidate: Available as a chewable tablet Methylin solution: Available as a liquid
Non-Stimulants for ADHD
The following are the four non-stimulant medications that the Food and Drug Administration (FDA) has approved to treat ADHD:
Strattera (atomoxetine) Qelbree (viloxazine) Kapvay; Catapres (clonidine ER) Intuniv; Tenex (guanfacine ER)
Atomoxetine is the oldest non-stimulant medication specifically approved for ADHD. Viloxazine is the newest FDA-approved non-stimulant medication for ADHD, but it works in the same way as atomoxetine. Both are serotonin norepinephrine reuptake inhibitors (SNRIs).
Clonidine and guanfacine are also medications that have been used for many years, but for other health conditions, such as high blood pressure. These work in very similar ways, and they carry similar side effects. Both are alpha-2 adrenergic receptor agonists, which also affect norepinephrine.
Antidepressants for ADHD
Some clinicians have also used certain antidepressants to help treat ADHD, even though they haven’t technically been FDA approved. These drugs are also non-stimulants. And even though they have not been studied fully enough to get FDA approval, some studies have shown them helpful for people with ADHD.
Like other types of non-stimulants, they might make sense for people with certain medical conditions. Or they may be an option if other treatments have not worked for you. Sometimes they make sense to use in addition to FDA-approved ADHD treatments.
Some of the most commonly prescribed antidepressants in this context are:
Wellbutrin; Wellbutrin XL; Wellbutrin SR (bupropion) Norpramin (desipramine) Aventyl; Pamelor (nortriptyline) Tofranil (imipramine)
ADHD Medications and Side Effects
Side Effects of Stimulants
Stimulant medications for ADHD are very similar in terms of their potential side effects. The risk of side effects increases at higher doses of medication. Some possible side effects include:
Mild belly pain Headache Irritability or anxiousness Sleep problems Reduced appetite (and sometimes weight loss or poor weight gain in a child)
Side Effects of Non-Stimulants
Strattera (atomoxetine) and Qelbree (viloxazine) are in the same drug class and share some similar potential side effects. Some of these are:
SleepinessReduced appetiteUpset stomach
Catapres and Kapvay (both clonidine) and Tenex and Intuniv (both guanfacine) also share some similar side effects. Some key ones are:
SleepinessDecreased blood pressure causing dizzinessDry mouthIrritability
Some of these symptoms tend to be less severe in Tenex and Intuniv than the others.
Are Stimulants Addictive?
Many people worry that stimulants might have an addictive effect. However, when taken as prescribed, the risk of that is low.
These drugs are very similar to illegal street drugs, like methamphetamine, that people use to get high. However, those drugs are taken at much higher amounts than those prescribed by a clinician.
Some people do abuse medications used for ADHD, taking more than prescribed or tampering with the pills to get high. But people who take these drugs the right way don’t have these issues.
What Is an ADHD Medication Vacation?
Some people stop taking their ADHD medication for a while, especially stimulant medications. This is called a “medication vacation.” For example, parents might decide to stop giving ADHD medication to their child over summer break.
People do this for different reasons. Maybe a child isn’t gaining enough weight. Or sometimes parents don’t think it is necessary during the summer, when a child doesn’t need to focus as they would in school. Sometimes you just might want to see how a person responds to being off their medication.
Medication vacations can be helpful for some people. However, it’s best to plan them with your healthcare provider. Your doctor might suggest a lowered dosage or switching to a different ADHD medication instead.
Summary
Medications used to treat ADHD can be separated into two broad categories: stimulants and non-stimulants. Stimulant medications such as Adderall and Ritalin are well-established treatments for ADHD, and most people find them safe and effective. However, non-stimulant medications, such as Strattera, are another option. As with all medications, ADHD medications have potential side effects. Always consult your doctor about side effects and potential drug interactions.
A Word From Verywell
If you or your child is struggling with ADHD, you may be unsure how to handle it. If you are ready to try medication, the sheer number can be overwhelming.
You may find it reassuring to know that most stimulant medications for ADHD are very similar. You can always switch to a different formulation if you need to.
And if you are worried about stimulant medications, non-stimulants are another option. ADHD coaching and/or psychotherapy (talk therapy) can help many people as well. It’s OK to try different treatments and find what works for you.
Longer-acting medications also tend to be more expensive, as may non-tablets (such as liquids and chewable pills). If cost is a concern with your current medication, ask your healthcare provider about your other options.
