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ADHD Medication Options: Stimulants, Nonstimulants & 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.

7 Comments: ADHD Medication Options: Stimulants, Nonstimulants & More

  1. Been on Vyvanse for 7 years and in the last year i have noticed some changes. It is making me mentally spiral and generally feel dysphoria. I have been taking instant release dex instead to avoid these negative side effects. i have discussed with a fellow adhd’er and she noticed a similar change at the same time i did. when i am on it I have no natural confidence despite being very confident the days i don’t take… it on these days i have zero focus. Any theorys/ suggestions?

    i feel like the formula has changed honestly

  2. To the person who mentioned clonidine and Guanfacine, they are the usual alpha-agonists. Article mentions that category. Reread

  3. In the UK, we also have Xenidate, which is a methylphenidate medication. Xenidate XL is long release in 18/27/36/54mg doses

  4. My 12 year old son has been on various forms of stimulants for 6 years. His level of focus has barely improved. Worse, I am now far more concerned that his growing body is not getting the nutrition it needs during this critical part of his life. And this is something I know about. As an aside, my mother came from a poor farm family with 9 kids. With the exception of the two oldest, the other 7 were all put up for adoption. The youngest were all adopted immediately (at that time age 4 and under). The older children (age 7-14) took longer to adopt. The 3 youngest (boys) all grew up to be over 6′ tall. None of the others grew to be taller than 5’3. That was all due to diet and the availability of nutrition. Luckily my mother and a younger brother were the next to go and only had to wait a year to be adopted and both were adopted into families that were able to provide proper nutrition and educational support. The older 4 children were all dead by age 60. With the exception of one killed in military service, the younger ones (and her brother) have all lived to be over 85. So now here is my son, whose primary dosage has been Focilin and Focilin XR. He is 58″ tall which puts him on the smaller side (39th decile – normal). But he only weights 60 lbs putting him in 0.75 percentile for weight. His BMI is 12.5. That puts him so low on the BMI scale that it if anyone were to see him, you’d think he was anorexic. This is completely due to his medication. How able to focus will he be if his brain doesn’t get enough protein to form. These drugs are as much a part of the problem. Worse yet, they are only treating a symptom, not the root cause. He is also diagnosed with Aspergers. Against his physicians request and his mother’s, I have been able to get a court to allow him to be treated by a respected Children’s Hospital in our area on a new program that seeks to prove that the increases in spectrum disorders and ADHD are due to a microbiome imbalance. With any luck, he will be off these terrible prescriptions.

  5. You left out #10 – Tenex (gunafacine) another non-stimulant medication

    #11 – clonidine another non-stimulant used as an alternative /add on med

    It would have been useful to include those in this article. Makes it out of date.

  6. >>> I hope parents of children on ADHD stimulants read this, especially if they are punishing their child for stimulant-rebound meltdowns. <<<

    Vyvanse is “slow-on, slow-off,” with about a 2-hour ramp-up/ramp-down time. That means that you don’t get nearly the medication rebound that happens with other stimulants. Having experienced the rebound of short-acting stimulants myself, I am amazed that doctors still prescribe them. (It may be due to expense/insurance, but that needs to change.) Talk about “do no harm.” It is a horrible experience; you feel like dirt. (See below for a detailed description of my experience.) And it is happening to young kids who can’t describe their experience.

    I feel so sad for all the young kiddoes suffering daily rebounds, often at homework time, and the parents who are trying to manage the meltdowns.

    Vyvanse is the only medication that has been effective for my two daughters w/o significant side effects. I started taking it 3 years ago, and now both of my daughters as well as my sister do. She thanked me profusely for telling her about it – she had been taking Ritalin and didn’t like it so she had given up. She did have to go through a big rigmarole with her insurance, but they did approve it.

    I wish it had existed in 2014 when my younger daughter was diagnosed with ADHD at the end of 1st grade. Due to ineffectiveness and/or intolerable side effects of the medications we tried (several stimulants of each type, as well as each of the non-stimulant ADHD medications), we gave up on medication and she has gone untreated for nearly 4 years, poor thing (until just recently, when we tried Daytrana — ineffective, and now Vyvanse). However, she managed well (good grades, good behavior — but would fall apart after school) until this year – 5th grade was just more than she could handle untreated, and she was diagnosed with anxiety and depression.

    When we learned last year that my middle school daughter had stealth ADHD, I couldn’t believe that our then-psychiatrist gave her Ritalin with the instruction to go to the nurse’s office during her (very short) lunch. Needless to say, she didn’t go, and he wouldn’t prescribe Vyvanse. I figured it wasn’t used in kids.

    When we recently switched to a pediatric psychiatrist with a top-notch reputation, she prescribed Vyvanse for both girls without blinking an eye.

    I would say that Vyvanse has changed our lives. (I have no affiliation with any pharmaceutical company or anything else remotely related.)

    I hope my recounting of our experience helps someone else. Our lives would have been so much better had Vyvanse been available in 2012.

    ———

    Here’s an email I wrote to a parenting coach / child therapist who specializes in challenging children:

    “I now know how HORRIBLE [my daughter] felt during 1st grade, and thousands of other kids feel when they take short-, mid-acting stimulants and they wear off (right at homework time). It’s really rough and unlike any physical illness you might be familiar with. I felt sick, but not like a flu. Metaphorically, kind of like bad nausea if applied to the whole body and brain/mind. A state that a child’s brain really shouldn’t have to be in (but of course I recognize the need and advantage of stimulants) and that a child shouldn’t have to experience.

    “I wish I had a way to tell all the parents, so they could really sympathize with their children. I know that we found the horrible rebound behavior [my daughter] had, to be stressful for US, but didn’t REALLY get how horrible she must have felt.

    And her response:

    “Thanks for the info on the rebound.  I have witnessed and heard countless stories of the crash that occurs when kids’ meds wear off but didn’t know the chemical reason and so it is helpful to hear from an articulate adult on it so that I can share it with parens whose kids cannot explain it.”

  7. Are there any studies that look at the long-term health effects of taking either methylphenidate or dextro-amphetamine for an extended period? Changes in aging stress hormones or metabolism?

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