Nonstimulant Treatments for Adult ADHD
Although ADHD is typically diagnosed in childhood, many people still experience symptoms as an adult. Stimulant medications, such as methylphenidate (Ritalin), are usually the first line of treatment for adults with ADHD. However, in some cases, nonstimulant treatments for ADHD can be considered.
Stimulants work by increasing dopamine and norepinephrine in your brain, which help with your thinking and attention span. They can be very effective for treating ADHD, but your doctor may choose to prescribe a nonstimulant medication instead if:
- You can’t tolerate the side effects: This is the most common reason for stopping stimulants. Common side effects include trouble sleeping, loss of appetite, and jitteriness.
- Stimulants aren’t helping your symptoms: Some nonstimulants can be added to your current treatment plan, or you may be switched solely to a nonstimulant medication to see whether you have a better response.
- You have certain preexisting psychiatric conditions: Stimulant medications may worsen conditions, such as bipolar disorder and anxiety.
- You’ve experienced drug misuse: Stimulants are controlled substances and have the potential to be misused. Nonstimulant medications can’t be misused in this way.
Nonstimulant medications take time to reach their full effect, often weeks. They are usually taken once a day, and they work for a longer period. This is different than stimulants, which may kick in quickly but wear off faster.
The Food and Drug Administration (FDA) has approved four nonstimulant medications specifically for ADHD. These include:
- Atomoxetine (Strattera)
- Viloxazine (Qelbree)
- Extended-release guanfacine (Intuniv)
- Extended-release clonidine (Kapvay)
Atomoxetine is the most commonly used nonstimulant approved for children and adults. Atomoxetine increases the amount of norepinephrine and can improve ADHD symptoms.
Viloxazine works similarly, and it’s approved only for children ages 6–17 but may be prescribed off labe for adults. “Off label” means the drug has been approved for a different type of condition, but your doctor may recommend it to treat your symptoms.
Guanfacine and clonidine are medications used to treat high blood pressure. However, they can also help with ADHD symptoms. The extended-release versions are FDA-approved for children ages 6–17. Doctors may still prescribe them for adults according to their specific needs. Clonidine (Catapres) and guanfacine (Tenex), the immediate-release formulations of these drugs, may be used as well.
Some antidepressants that affect the amount of norepinephrine in your brain may also be used off label for treating ADHD. For example, bupropion (Wellbutrin) and tricyclic antidepressants, such as nortriptyline (Pamelor), may help reduce symptoms like hyperactivity and impulsivity. These medications may be a good choice for adults who have both ADHD and depression, or anxiety.
Medication alone isn’t expected to cure ADHD. Adults with ADHD may benefit from extra support, such as incorporating cognitive behavioral therapy (CBT). Some programs have even been developed specifically for adults with ADHD. CBT can address mental processes that people with ADHD struggle with including focus, attention, and memory.
CBT can also teach adults how to implement helpful lifestyle behaviors, such as using a planner or establishing routines for each day.
Living with ADHD can be challenging. However, there are many options for treatment. If you’re having difficulty, let your doctor know you want to explore additional treatment options. With professional help, you can find the solutions that work best for you.