Attention deficit hyperactivity disorder, or ADHD, is usually treated with medication. Sometimes medication is combined with behavioral interventions. Several medications have been shown to be effective in the treatment of ADHD. The top medications for treating ADHD include the stimulant methylphenidate, other stimulants, some nonstimulant medications and certain antidepressants. The top ADHD medications all are prescription drugs and should only taken under a physician's supervision due to any potential for abuse and their potential side effects.
Methylphenidate is a stimulant that has been most effective in treating ADHD. Two of the most commonly prescribed forms of methylphenidate include Ritalin and Concerta. Concerta is an extended-release form, which means the drug is released in the system slowly over time, allowing for fewer doses; Ritalin is an immediate-release form and may require more than 1 dose daily. A patch form, Daytrana, allows for better absorption into the system. Methylphenidate has fewer side effects than other stimulant drugs, decreases hyperactivity and impulsivity and increases the ability to focus.
If methylphenidate does not work, typically the second choice of stimulant drugs to treat ADHD is dextroamphetamine and amphetamine (Adderall). Research has indicated that Adderall may be more effective for older children than methylphenidate. Adderall is also an extended-release drug, so fewer doses are needed each day. Adderall has been shown to decrease hyperactivity and increase the ability to focus in children with ADHD. All of the stimulant medications affect the neurotransmitters dopamine and norepinephrine, but the exact way they treat the symptoms of ADHD is not well understood.
Non-Stimulant ADHD Medications
Atomextine (Strattera) is a nonstimulant drug that was originally designed to treat depression; it was ineffective for that but was found to effectively treat ADHD symptoms in some people. This drug acts on the neurotransmitter norepinephrine, but the actual mechanism of how it treats ADHD is unknown. Two other nonstimulant drugs, guanfacine hydrochloride (Intuniv) and clonidine (Kapvay) were originally used to treat high blood pressure but were also found effective in treating ADHD. These nonstimulant drugs do not cause the decreased appetite, agitation or sleeplessness often associated with stimulant medications, but it may be several weeks before they begin to exert their effects, whereas stimulant medications work quickly.
Several antidepressant medications have been used to treat ADHD, including amitriptyline (Elavil), bupropion (Wellbutrin) and venlafaxine (Effexor); however, these drugs are not specifically approved by the Food and Drug Administration to treat ADHD. These medications can be particularly effective for people who have both ADHD and depression and may be used in conjunction with stimulants and nonstimulant medications. Antidepressant medications are often not effective in treating symptoms of inattention in people with ADHD and therefore are not the first-line treatment choices for individuals just diagnosed with ADHD.
- The Prescriber's Guide, Fourth Edition; Stephen M. Stahl
- Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD; J. Gordon Millichap
- Journal of Child Psychology and Psychiatry: Practitioner Review: Current Best Practice in the Management of Adverse Events during Treatment With ADHD Medications in Children and Adolescents