ADHD Medications List
Based on "Essential Psychopharmacology"
written by Stephen M. Stahl, MD, PhD
Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by excessive motor activity, difficulty paying attention, and impulsive behavior (acting before you think).
PsychoStimulants
The two classes of psychostimulants indicated for the treatment of ADHD are:
- Methylphenidate
- Amphetamines
Stimulants function by increasing the amount of dopamine and noradrenaline in the brain and stimulating the central nervous system.
Stimulants are the most potent, and also the most effective class of ADHD medications. Stimulant drugs are considered a first line therapy for controlling ADHD symptoms, unless there are contraindications that preclude their use. Methylphenidate and amphetamines are equally effective, with efficacy rates ranging from 70% to 90%3, 4.
Stimulants are available in many different formulations including short-acting, intermediate-acting, and long-acting preparations.
| Generic name | Brand name |
|---|---|
| Amphetamine | Dyanavel XR, Adzenys XR, Evekeo |
| Amphetamine/ dextroamphetamine salts | Adderall, Adderall XR |
| Dexmethylphenidate | Focalin, Focalin XR, Dexedrine, Dextrostat, ProCentra, Zenzedi |
| Lisdexamfetamine | Vyvanse |
| Methamphetamine | Desoxyn |
| Methylphenidate | Ritalin, Ritalin SR, Ritalin LA, Methylin, Methylin ER, Quillichew ER, Quillivant XR, Aptensio XR, Concerta ER, Metadate CD |
| Methylphenidate transdermal | Daytrana |
Non-Stimulants
Non-stimulant medications approved for the treatment of ADHD have different mode of action compared to psychostimulants and are considered non-addictive with more favorable side effect profiles.
On the other hand, non-stimulants are generally less effective than stimulants in the treatment of ADHD. The non-stimulants are usually considered second- and third-line medications.
Atomoxetine is a selective norepinephrine reuptake inhibitor with a unique mechanism of action. Atomoxetine is thought to have minimal abuse potential and significantly less withdrawal symptoms than psychostimulants. The main drawback is that atomoxetine doesn't directly influence dopamine and it may take several weeks before the drug elicits a therapeutic effect.
Two antihypertensive drugs (alpha-2 noradrenergic agonists) are approved by the FDA to treat ADHD. These drugs reduce activity in the central nervous system but are considered less effective than stimulants2. Clonidine and guanfacine are considered relatively safe over the long-term.
| Generic name | Brand name |
|---|---|
| Selective Norepinephrine Reuptake Inhibitor | |
| Atomoxetine | Strattera |
| Alpha-2 Noradrenergic Agonists | |
| Clonidine extended-release | Kapvay |
| Guanfacine extended-release | Intuniv |
"Off-label" Medications
There are several medications used to treat attention-deficit hyperactivity disorder "off-label". While they are not approved for this disease, these medications can improve productivity, concentration, and overall cognitive function. Additionally, many are used as an augmentation strategy to treat patients that have comorbid depression or other disorders.
| Generic name | Brand name |
|---|---|
| Short-acting forms Alpha-2 Noradrenergic Agonists | |
| Clonidine | Catapres |
| Guanfacine | Tenex |
| Antipsychotics | |
| Aripiprazole | Abilify |
| Olanzapine | Zyprexa |
| Quetiapine | Seroque |
| Risperidone | Risperdal |
| Ziprasidone | Geodon |
| Wakefulness-promoting (eugeroic) drugs | |
| Armodafinil | Nuvigil |
| Modafinil | Nuvigil |
| Antidepressants | |
| Desipramine | Norpramin |
| Imipramine | Tofranil |
| Bupropion | Wellbutrin SR, Wellbutrin XL |
ADHD medications under investigation
| Generic name, Class | Brand name |
|---|---|
| Vortioxetine5 (serotonin modulator and stimulator) |
Brintellix, Trintellix |
| Centanafadine (serotonin-norepinephrine-dopamine reuptake inhibitor) |
|
| Dasotraline (serotonin-norepinephrine-dopamine reuptake inhibitor ) |
|
| Metadoxine6 |
Resources
- 1. New FDA Approved Drugs CenterWatch
- 2. Williams AE, Giust JM, Kronenberger WG, Dunn DW. Epilepsy and attention-deficit hyperactivity disorder: links, risks, and challenges. Neuropsychiatr Dis Treat. 2016 Feb 9;12:287-96. PubMed
- 3. Biederman J, Quinn D, Weiss M, et al. Efficacy and safety of Ritalin LA, a new, once daily, extended-release dosage form of methylphenidate, in children with attention deficit hyperactivity disorder. Paediatr Drugs. 2003;5(12):833-41. PubMed
- 4. Spencer TJ, Wilens TE, Biederman J, Weisler RH, Read SC, Pratt R. Efficacy and safety of mixed amphetamine salts extended release (Adderall XR) in the management of attention-deficit/hyperactivity disorder in adolescent patients. Clin Ther. 2006 Feb;28(2):266-79. PubMed
- 5. Asherson P, Bushe C, Saylor K, et al. Efficacy of atomoxetine in adults with attention deficit hyperactivity disorder: an integrated analysis of the complete database of multicenter placebo-controlled trials. J Psychopharmacol. 2014 Sep;28(9):837-46. PubMed
- 6. Manor I, Rubin J, Daniely Y, Adler LA. Attention benefits after a single dose of metadoxine extended release in adults with predominantly inattentive ADHD. Postgrad Med. 2014 Sep;126(5):7-16. PubMed
Last updated: September 20, 2018
Published:
March 04, 2017
