ADHD Medication Options: Stimulants, Non-stimulants & More
Adderall. Vyvanse. Ritalin. Strattera. Concerta. The number of ADHD medication treatment options is staggering, and finding the right solution feels overwhelming at times. Here, an ADHD specialist explains the stimulants and nonstimulants for adults and children in terms we can all understand.
ADHD Medication Treatments: Which Are Best?
The number of medications available to treat attention deficit hyperactivity disorder (ADHD) is overwhelming at best, and the process for selecting the best ADHD medication for you or your child, or deciding to medicate at all, is incredibly personal.
The ADHD medications prescribed to both children (as young as age 6) and adults are broadly categorized as
- Stimulants – considered the first-line treatment for ADHD. Amphetamines fall under this category, along with methylphenidate, the most widely used treatment for ADHD, and their derivatives.1
- Nonstimulants – prescribed to patients who don’t tolerate or see benefits from stimulant medications (up to 30 percent of patients do not respond to stimulants2). Four non-stimulants are approved to treat ADHD: atomoxetine, guanfacine, viloxazine, and clonidine. Non-stimulants may also be prescribed for use alongside stimulants to treat symptoms that the latter does not alleviate.
[People Also Ask: How Should I Treat My Child’s ADHD?]
Selecting the “best” ADHD medication can be a lengthy trial-and-error process of dosage and timing that is often related to a patient’s history, genetics, experienced side effects, and unique metabolism. ADHD medication is also often accompanied by behavioral therapy and other non-pharmacological treatments.
The most popular ADHD medications among ADDitude readers include (in alphabetical order):
- Adderall XR (amphetamine)
- Concerta (methylphenidate)
- Dexedrine (amphetamine)
- Evekeo (amphetamine)
- Focalin XR (dexmethylphenidate)
- Quillivant XR (methylphenidate)
- Ritalin (methylphenidate)
- Strattera (atomoxetine hydrochloride)
- Vyvanse (lisdexamfetamine dimesylate)
- Azstarys (serdexmethylphenidate and dexmethylphenidate)
Many parents and adults with ADHD remain confused about the distinctions and similarities between these and other treatment choices for ADHD. Our ADHD medication chart offers a side-by-side comparison of the most popular stimulants and non-stimulants in the treatment of ADHD.
What Are the Newest ADHD Medications?
Qelbree is a non-stimulant approved for the treatment of ADHD in children and adults in 2021 and 2022, respectively.
Azstarys is a once-daily central nervous system (CNS) stimulant approved for the treatment of ADHD in patients ages six or older in 2021.
Jornay PM is taken in the evening; the medication begins working by the time the patient wakes and through the rest of the day.
Xelstrym was approved by the FDA in March 2022. It is a once-daily transdermal amphetamine patch used to treat ADHD in adults and children ages six and older.
How Do Stimulant Medications Treat ADHD?
ADHD is a neurological disorder resulting from the deficiency of a neurotransmitter, or a group of neurotransmitters, in specific areas of the brain. Neurotransmitters are chemicals that transmit signals between nerve cells by bridging the synapse (or gap) between them.3
One key neurotransmitter often deficient in individuals with ADHD is norepinephrine, along with its building blocks, dopa and dopamine. In theory, the primary stimulant medications used to treat ADHD stimulate specific cells within the brain to produce more of this deficient neurotransmitter. That’s why these medications are called stimulants — though it’s unknown exactly how they work to relieve ADHD symptoms.
The two main classes of stimulant medications, methylphenidate and dextro-amphetamine — both generic names — have been used since the 1930s.4 All brand-name stimulants are variations of these two medications. The ADHD medication Adderall, for instance, is a modification of dextro-amphetamine. Methylphenidate, on the other hand, comes in many forms (including a chewable tablet, a liquid, and a skin patch) with each variation having its own name.
How Do Nonstimulants Work to Treat ADHD?
Atomoxetine (brand name Strattera) and viloxazine (brand name Qelbree) are selective norepinephrine reuptake inhibitor (SNRI) that work, in theory, by increasing concentrations of norepinephrine and dopamine in the prefrontal cortex, which is believed to regulate behavior and thus helps with ADHD symptoms1.
Bupropion (Wellbutrin), while not approved for ADHD treatment, is an antidepressant that clinicians commonly prescribe off-label to treat ADHD.
How is ADHD Medication Dosed?
The FDA requires, among other provisions, that medication be labeled according to its5:
- Dosage Form/Route of Administration: Capsule, tablet, liquid, patch, etc. The patient information sheet inside the medication’s box or packaging states how much medication is in each unit of liquid; for example, 5mg per 5ml of liquid. Another methylphenidate product — Daytrana — is a patch that releases medication through the skin and into the bloodstream. Daytrana 30mg contains about 30mg of methylphenidate and releases about 3.3mg of it per hour.
- Dose Quantity/Strength: The specific amount of medication released into the blood over a given period of time. In other words, the number value for each product represents the total amount of the medication in the tablet/liquid/capsule/patch, not the amount in the blood at any one time. If methylphenidate, for example, is in the form of a four-hour tablet and it releases 5mg over that time, it is called methylphenidate 5mg. A capsule of Adderall, on the other hand, that releases 10mg immediately and 10mg four hours later is called Adderall XR 20.
- Release mechanism/Duration of Administration (released immediately or over an extended period of time): The length of time a medication will remain available and active. Stimulants release medications over many time frames, including an hour, four hours, or over eight or 12 hours. Here’s an example: The ADHD medication Ritalin is a tablet that is released immediately into the bloodstream and works for four hours, according to information provided by the drug’s manufacturer. Ritalin LA, on the other hand, is a capsule that releases over a longer period of time and works for eight hours, again, according to information provided by the drug’s manufacturer. Different names, even though both contain the same medicine — methylphenidate.
Even with the FDA’s guidelines, the average consumer may find labels on ADHD medications confusing. Take the ADHD medication Concerta. Designed to last 12 hours, Concerta has a “sponge” on the bottom of the capsule, medication on top, and a tiny hole above the medication. As the capsule passes through the gastrointestinal tract and absorbs moisture, the sponge expands and pushes the medication out of the hole.
The number value assigned to each dose is where the confusion tends to lie. Take Concerta 18mg. If the goal is to release 5mg consistently every four hours over a 12-hour period, then there needs to be 15mg in the capsule. However, it takes time for the sponge to become moist enough to start to expand. So an initial release of medication is needed until the sponge starts working. Researchers figured out that it should be 3mg. Thus, to release 5mg over 12 hours, one needs the initial 3mg, plus 5mg every four hours during the 12 hours. The total amount of medication is 18mg. That’s why the medication is called Concerta 18.
What Are The Side Effects of ADHD Medication?
Generally, stimulant medications have similar side effects that include1
- decreased appetite
- stomach pain
- sleep disturbances
Some side effects associated with non-stimulants include1:
- stomach pain
- decreased appetite
It is common for patients to experience side effects when trying and adjusting stimulant medications. Clinicians may start with small doses and increase dosing if the patient does not see benefits and if side effects are tolerable. Many side effects are also temporary until the patient adjusts. The American Academy of Pediatrics (AAP) notes that clinicians should titrate doses of ADHD medication to achieve maximum benefit with tolerable side effects.6
If adverse reactions persist, the clinician can make the switch to another stimulant, or to a non-stimulant.
ADHD Medications List: Stimulants
- Generic: tablet; immediate release; lasts about four hours; comes in 5mg, 10mg, 15mg*
- Aptensio XR: brand name; capsule; immediate and extended release; lasts 12 hours; comes in 10mg, 15mg, 20mg, 30mg, 40mg, 50mg, and 60mg*
- Concerta: brand name; tablet; lasts about 12 hours; comes in 18mg, 27mg, 36mg, 54mg dosages, generic equivalents available*
- Cotempla XR-ODT: brand name; extended release orally disintegrating table; comes in 8.6mg, 17.3mg, 25.9mg, and 34.6mg
- Daytrana: brand name; skin patch; lasts about eight hours; comes in 10mg, 15mg, 20mg, 30mg, generic equivalents available*
- Jornay PM: brand name; delayed release extended release capsule; comes in 20mg, 40mg, 60mg, 80mg, and 100mg
- Methylin: brand name; liquid; immediate release; lasts about four hours; 5mg/tsp and 10mg/tsp, generic equivalents available*
- QuilliChew ER: brand name; chewable tablet; extended release; lasts about eight hours; comes in 20mg, 30mg, and 40mg*
- Quillivant XR: brand name; liquid; extended release; lasts 12 hours; dosages range from 10mg/2 ml, 20mg/4ml, 30mg/6ml, 40mg/8ml, 50mg/10 ml, 60mg/12ml*
- Ritalin: brand name; tablet; immediate release; lasts about four hours; comes in 5mg, 10mg, generic equivalents available*
- Ritalin LA: brand name; capsule; lasts about eight hours; comes in 10mg, 20mg, 30mg, 40mg, generic equivalents available*
- Focalin: brand name; tablet; lasts four hours; immediate release; comes in 2.5mg, 5mg, 10mg, generic equivalents available*
- Focalin XR: brand name; capsule; lasts eight hours; immediate release followed by second delayed release; comes in 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, generic equivalents available*
Serdexmethylphenidate and Dexmethylphenidate
- Azstarys: brand name; capsule; lasts 13 hours; co-formulated with immediate release; comes in 26.1mg/5.2mg, 39.2mg/7.8mg, and 52.3mg/10.4mg*
Dextro-Amphetamine/Modified Amphetamine Mixture
- Generic; tablet; immediate release; lasts four hours; comes in 5mg and 10mg*
- Adderall: brand name; tablet; immediate release; lasts four hours; comes in 5mg, 7.5mg, 10mg, 12.5mg, 15mg, 20mg, 30mg, generic equivalents available*
- Adderall XR: brand name; capsule; immediate and delayed release; lasts eight hours; comes in 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, generic equivalents available*
- Adzenys ER: brand name; extended release oral suspension; 3.1mg/2.5mL, 6.3mg/5mL, 9.4mg/7.5mL, 12.5mg/10mL, 15.7mg/12.5mL, 18.8mg/15mL
- Adzenys XR-ODT: brand name; orally-disintegrating tablet; immediate and delayed release; lasts up to 12 hours; comes in 3.1mg, 6.3mg, 9.4mg, 12.5mg, 15.7mg, and 18.8mg*
- Dexedrine Spansule: brand name; capsule; immediate release followed by gradual release; lasts eight hours; comes in 15mg, generic equivalent available*
- Dyanavel XR: brand name; liquid; tablet, extended release; lasts 13 hours; comes in 2.5mg/1mL, 5mg/2mL, 7.5mg/3mL, 10mg/4mL, 12.5mg/5mL, 15mg/mL, 17.5mg/7mL, 20mg/8mL*
- Evekeo: brand name; tablet; immediate release; lasts four fours; comes in 5mg and 10mg
- Evekeo ODT: brand name; orally disintegrating tablet, immediate release, comes in 5mg, 10mg, 15mg, 20mg
- Mydayis: brand name; long-acting capsule; comes in 12.5mg, 25mg, 37.5 mg, and 50mg
- ProCentra: brand name; liquid; immediate release; lasts four hours; comes in 5mg/5mL*
- Vyvanse: brand name; capsule and chewable tablet; lasts 10 to 12 hours; comes in 20mg, 30mg, 40mg, 50mg, 60mg, and 70mg (capsule only)*
- Xelstrym: brand name; transdermal patch; comes in 5mg, 9mg, 13.5mg and 18mg
- Zenzedi: brand name; immediate release tablet; comes in 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg, and 30mg, generic equivalents available in 5mg and 10mg
ADHD Medications: Non-Stimulants
- Strattera: brand name; capsule; long-acting; 24-hour duration; 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg, generic equivalents available*
- Kapvay: brand name; extended release tablets; 24-hour duration; 0.1mg and 0.2mg, generic equivalents available in o.1mg*
- Intuniv: brand name; extended-release tablets 1mg, 2mg, 3mg, 4mg; 24-hour duration, generic equivalents available*
- Qelbree: brand name; 100mg or 200mg once daily.
*The medication’s estimated duration of action is based on information provided by the drug’s manufacturer. For any individual patient, this medication’s effects may last longer or shorter than indicated.
How to Treat ADHD in Children: Next Questions
- What ADHD medications are used to treat children?
- Are ADHD meds safe for my child?
- What are common side effects associated with ADHD medication?
- What natural treatments help kids with ADHD?
- How can I find an ADHD specialist near me?
ADHD Medication: Next Steps
- Read: Your ADHD Treatment Options — Medication, Diet, Therapy & More
- Review: The Ultimate ADHD Medication List
- Find: ADHD Specialists and Clinics Near You
- Research: User Reviews of Popular ADHD Medications
- Free Tracking Chart: How Do We Know the Medication Is Working?
- ADDitude Guide: 13 Questions to Ask Before Starting a Stimulant
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View Article Sources
1 Briars, L., & Todd, T. (2016). A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 21(3), 192–206. https://doi.org/10.5863/1551-6776-21.3.192
2 Mohammadi, M. R., & Akhondzadeh, S. (2007). Pharmacotherapy of attention-deficit/hyperactivity disorder: nonstimulant medication approaches. Expert review of neurotherapeutics, 7(2), 195–201. https://doi.org/10.1586/1473718.104.22.168
6Wolraich ML, Hagan JF, Allan C, et al; Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2019;144(4):e20192528; https://doi.org/10.1542/peds.2019-2528