Attention deficit hyperactivity disorder (ADHD), also called attention deficit disorder (ADD), is most commonly seen in children but may continue into adulthood. Adult ADHD can cause difficulties with daily functioning in areas such as organizational skills, impulse control and task completion. This could result in problems at home and the workplace. According to the National Institute of Mental Health, there are a number of choices for the treatment of adult ADHD including both stimulant and non-stimulant ADHD medications.
Amphetamine Derivatives
Derivatives of amphetamine have been used for many years in the treatment of ADHD. ADHD appears to be a result of lack of the neurotransmitters dopamine and norepinephrine in areas of the brain responsible for impulse control, attention focus and emotions. Amphetamine and derivatives, including methamphetamine and dextroamphetamine, appear to work by increasing the activity of dopamine and norepinephrine. This may result in an increased ability to focus attention, control impulses and maintain emotional control.
Though often effective at appropriate dosage levels, all amphetamine derivatives pose a risk of abuse and psychological addiction. Because of this risk, they are highly controlled substances. Amphetamines carry side effects such as anxiety, increased heart rate and blood pressure, insomnia and loss of appetite. The use of controlled-release formulations might decrease the occurrence of some side effects along with the risk of abuse.
Methylphenidate
Methylphenidate is a non-amphetamine stimulant medication approved for the treatment of ADHD in adults. Unlike amphetamine, it appears to work mainly by increasing levels of dopamine in the brain and has little effect on norepinephrine. The National Library of Medicine states that methylphenidate may cause side effects similar to amphetamines such as nervousness, difficulty sleeping, increases in heart rate and loss of appetite. It also carries a risk of abuse and psychological addiction and is highly controlled. Methylphenidate is available in fast-release tablets, controlled-release tablets and capsules as well as a transdermal patch.
Atomoxetine
Atomoxetine is the first non-stimulant medication approved for the treatment of ADHD in both adults and children older than age 6. Atomoxetine is thought to work by inhibiting the uptake of norepinephrine in areas of the brain, which in turn results in increased activity of the neurotransmitter. The side effect profile of atomoxetine is different from stimulants in that it may cause dizziness, drowsiness, changes in sleep pattern, constipation, along with dry mouth and possible loss of sexual functioning. Atomoxetine is a prescription medication but it is not a controlled substance, as it has not been shown to pose a potential for abuse or addiction, making it a good alternative for a patient with a previous history of drug abuse.
Antidepressants
Some patients do not respond well to stimulant medications or atomoxetine. Others may be unable to tolerate side effects in which case the American Academy of Family Physicians suggests treatment with an antidepressant. Antidepressants which increase the activity norepinephrine in the brain, including imipramine, desipramine and venlafaxine, have been used along with buproprion, which increases the activity of dopamine in the brain. Antidepressants that increase the activity of serotonin do not appear to work for the treatment of ADHD. Antidepressants used for ADHD may cause side effects such as anxiety, dizziness, drowsiness, constipation, increased sweating and loss of sexual desire or functioning. Antidepressants can increase the risk of suicidal thoughts or behaviors, though this is a rare effect. With any medication, severe side effects that persist or become bothersome should be reported to a physician.
