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Medications for Attention Deficit Hyperactivity Disorder (ADHD)

This page is meant to give you a general idea about the medications listed here. Only the most general side effects are included. Ask your doctor if you need to take any special precautions with your prescription. Use each of these medications as recommended by your doctor. Follow the instructions that have been provided to you. Talk to your doctor if you have further questions about its use or side effects.

Medications for ADHD can help control hyperactive and impulsive behavior. They may also increase attention span.

Prescription Medications

Food and Drug Administration Warning

The US Food and Drug Administration (FDA) requires some stimulant medication to have a warning label. The label must note that some of these medications have a slight increase in the risk of certain side effects. There have been reports of sudden death in those with underlying serious heart problems. There are also reports of stroke and heart attack in adults with certain risk factors. There is a slight increased risk for psychiatric side effects. This can include hallucinations, paranoia, and mania, even in those without previous problems.

*Recent research has not found a clear link between stimulants and sudden death, heart attack, and stroke.

These stimulants must carry this warning:

  • Amphetamine
  • Methylphenidate
  • Methamphetamine
  • Detroamphetamine
  • Dexmethylphenidate
  • Methylphenidate
  • Lisdexamfetamine
  • Atomoxetine

The American Heart Association suggests that children have an ECG before starting stimulant medication. This test may help find unknown heart issues.

Talk to your doctor about these warnings before you take the medication.

Stimulants

Common names include:

  • Methylphenidate
  • Dextroamphetamine
  • Amphetamine
  • Methylphenidate patch
  • Lisdexamfetamine—this medication can be used to treat children aged 6-12 years and adults
  • Dexmethylphenidate

Stimulants are the most common treatment for ADHD. These medications work by changing the action of a brain chemical called dopamine. It can stimulate parts of the brain that are less active in children with ADHD. This creates a calming effect that makes it easier to focus. These medications also have the risk to become addictive. Your child’s doctor will start with the lowest effective dose. The response will be closely monitored. The doctor may also stop treatment at some points to see if treatment needs to continue.

Common side effects of stimulants include:

  • Insomnia
  • Stomach ache
  • Headache
  • Reduced appetite
  • Irritability
  • Rage
  • Confusion
  • Shakiness
  • Hallucinations
  • Seizures
  • Possible decrease in growth rate

Antidepressants

There are a number of antidepressant medications. New options appear often. Common names include:

  • Bupropion
  • Fluoxetine
  • Sertraline
  • Doxepin
  • Protriptyline
  • Amitriptyline
  • Imipramine
  • Desipramine

These medications affect two brain chemicals norepinephrine or serotonin. Most effect both chemicals. Some may only act on one. All are used to treat depression.

Common side effects include:

  • Dry mouth
  • Lightheadedness
  • Sedation
  • Insomnia
  • Sweating
  • Nausea
  • Weight gain
  • Constipation
  • Urine retention (loss of ability to urinate)
  • Blurred vision
  • Mental changes

Side effects of bupropion include:

  • Weight loss
  • Agitation
  • Anxiety
  • Seizures
  • Dry mouth
  • Insomnia

Antipsychotics

Antipsychotics may be used. It is often chosen to treat children and young adults who have aggressive behavior. Examples of antipsychotics include:

  • Risperidone
  • Quetiapine

Common side effects include:

  • Sedation
  • Constipation
  • Urine retention
  • Dry mouth
  • Blurred vision
  • Mental changes
  • Muscle spasms
  • Restlessness
  • Sexual problems
  • Abnormal heartbeat
  • Weight gain

Atomoxetine

Atomoxetine is not a stimulant. It works by changing how a brain chemical called norepinephrine works.

Note: There have been a small number of reports of severe liver injury associated with atomoxetine. The damage was reversed after the medication is stopped. Atomoxetine is stopped if there are signs of liver disease such as jaundice, yellowing of skin.

Common side effects include:

  • Decreased appetite
  • Nausea
  • Vomiting
  • Fatigue
  • Weight loss
  • Slowed growth rate
  • Mild increase in blood pressure and heart rate

Modafinil

Modafinil may be somewhat helpful in patients with ADHD.

Common side effects include:

  • Insomnia
  • Abdominal pain
  • Decreased appetite
  • Cough
  • Fever
  • Runny nose
  • Headache

Clonidine

Clonidine acts in the brain to stimulate certain areas, but not others. It is similar to how stimulants work. Morning dosing increase the calming effect. Bedtime doses lessen it. Clonidine is also available in a patch. This allows a steady dose for a week at a time.

Clonidine is fairly safe. People with certain heart and circulation issues may have a higher risk of complications.

Possible side effects include:

  • Dry mouth
  • Sleepiness
  • Lightheadedness
  • Constipation
  • Stomach upset
  • Mental changes

Guanfacine

Guanfacine seems to help manage impulse and attention problems.

Guanfacine can be a long acting formula. It only has to be taken once a day, usually at bedtime. The medication should not be taken with a meal that is high in fat. The tablets need to be swallowed whole, not chewed, broken, or crushed.

It may take two weeks before results can be seen. Never take guanfacine with other medications that have the same drugs.

Possible side effects include:

  • Headache
  • Lightheadedness, sleepiness, blurred vision, change in the ability to think clearly
  • Constipation
  • Dry mouth
  • Sexual problems

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

When to Contact Your Doctor    TOP

Contact your doctor or mental health professional if:

  • Expected results of treatment are not happening
  • Unexpected results occur
  • Drug side effects are bothering you
  • You want to change the medication

References:

Attention-deficit hyperactivity disorder (ADHD) in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 27, 2016. Accessed October 4, 2017.
Attention-deficit hyperactivity disorder (ADHD) in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated December 27, 2016. Accessed October 4, 2017.
Antidepressant medication overview. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated September 30, 2016. Accessed October 4, 2017.
Biederman J, Faraone SV. Attention-deficit hyperactivity disorder. Lancet. 2005;366(9481):237-248.
FDA drug safety communication: safety review update of medications used to treat attention-deficit/hyperactivity disorder (ADHD) in children and young adults. US Food & Drug Administration website. Available at: https://www.fda.gov/Drugs/DrugSafety/ucm277770.htm. Updated August 4, 2017. Accessed October 4, 2017.
Lindsay SE, Gudelsky GA, Heaton PC. Use of modafinil for the treatment of attention deficit/hyperactivity disorder. Ann Pharmacother. 2006;40(10):1829-1833.
Medications for attention-deficit hyperactivity disorder (ADHD) in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated June 21, 2016. Accessed October 4, 2017.
Rappley MD. Attention deficit-hyperactivity disorder. N Engl J Med. 2005;352(2):165-173.
Seida JC, Schouten JR, Mousavi SS, et al. First- and second-generation antipsychotics for children and young adults [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Feb. (Comparative Effectiveness Reviews, No. 39.) Available at: https://www.ncbi.nlm.nih.gov/books/NBK84643.
4/30/2008 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Vetter V, Elia J, Erickson C, et al. Cardiovascular monitoring of children and adolescents with heart disease receiving stimulant drugs. Circulation. 2008;117(18):2407-2423.
2/18/2011 DynaMed Systematic Literature Surveillance http://www.dynamed...: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.
12/30/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Habel LA, Cooper WO, Sox CM, et al. ADHD medications and risk of serious cardiovascular events in young and middle-aged adults. JAMA. 2011;306(24):2673-2683.
2/15/2013 DynaMed Systematic Literature Surveillance http://www.dynamed...: Westover AN, Halm EA. Do prescription stimulants increase the risk of adverse cardiovascular events? A systematic review. BMC Cardiovasc Disord. 2012;12:41.
Last reviewed March 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 4/2/2018

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