Adults with attention-deficit hyperactivity disorder (ADHD) experience a range of challenges, from difficulty focusing at work to persistent disorganization. While some manage without intervention, others find medication essential for improving daily function.
This article breaks down the most commonly prescribed ADHD medications for adults, explaining how they work, their potential side effects, and who should avoid them.
How ADHD Medication Works
ADHD medications primarily target neurotransmitters like dopamine and norepinephrine, chemicals in the brain crucial for attention, focus, and impulse control. The two main classes are stimulants and non-stimulants, each with unique properties.
Stimulants are often the first-line treatment. They increase dopamine and norepinephrine levels quickly, improving focus within 30–60 minutes. These come in short-acting (requiring multiple doses daily) and extended-release (ER) formulations for more sustained control.
Non-stimulants work differently, gradually increasing norepinephrine levels over time. They take 2–6 weeks to take effect but offer steadier, 24-hour coverage. They are often used when stimulants are ineffective or cause unwanted side effects.
Stimulant Medications: Amphetamines vs. Methylphenidate
Stimulants fall into two primary categories: amphetamine-based and methylphenidate-based. Some studies suggest amphetamines may have a stronger effect, but individual responses vary.
Here’s a breakdown of common ER stimulant options:
| Medication Name | Form | Duration |
|---|---|---|
| Adderall XR (amphetamine) | Capsules | Up to 12 hours |
| Vyvanse (lisdexamfetamine) | Capsules/Tablets | Up to 12 hours |
| Mydayis (amphetamine) | Capsules | Up to 16 hours |
| Concerta (methylphenidate) | Tablets | 10–12 hours |
| Ritalin LA (methylphenidate) | Capsules | 8 hours |
| Focalin XR (dexmethylphenidate) | Capsules | Up to 12 hours |
Important Note: Stimulants are Schedule II controlled substances with a potential for addiction and dependence.
Non-Stimulant Options for ADHD
Non-stimulants offer an alternative with lower misuse risk and fewer rebound effects (irritability or exhaustion when the medication wears off). However, they may be less effective for attention deficits and take longer to work.
Here are common non-stimulant medications:
| Medication Name | Form | Dosing Frequency |
|---|---|---|
| Strattera (atomoxetine) | Capsules | Once or twice daily |
| Intuniv (guanfacine ER) | Tablets | Once daily |
| Kapvay (clonidine ER) | Tablets | Once or twice daily |
| Qelbree (viloxazine ER) | Capsules | Once daily |
Potential Side Effects
Both stimulants and non-stimulants can cause side effects, though the severity varies.
Stimulant side effects include decreased appetite, insomnia, headaches, increased heart rate/blood pressure, nervousness, and gastrointestinal issues. Some people may experience jaw clenching or teeth grinding.
Non-stimulant side effects are generally milder, including nausea, stomach upset, sleep changes, dry mouth, dizziness, and fatigue.
If side effects are severe or interfere with daily life, consult your healthcare provider.
Who Should Avoid These Medications?
Certain medical conditions warrant caution or avoidance of ADHD medication:
- Severe insomnia or sleep disorders
- Heart conditions or uncontrolled high blood pressure
- Hyperthyroidism
- Glaucoma
- Severe anxiety, panic disorder, psychosis, or bipolar disorder
- History of substance use disorder
- Pregnancy or breastfeeding
Always disclose your medical history to your doctor before starting medication.
Talking to Your Doctor
When discussing ADHD treatment, be specific about how the condition affects your daily life. Instead of vague statements like “I’m distracted,” describe concrete examples: missed deadlines, difficulty completing tasks, or constant task-switching.
Ask your healthcare provider about:
- The best medication option for your health history
- Expected improvements and timelines
- Common side effects and how to manage them
- Monitoring plans for blood pressure, heart rate, mood, and sleep
Conclusion
Choosing the right ADHD medication involves careful consideration of individual needs, medical history, and potential side effects. Stimulants offer rapid improvement, while non-stimulants provide steadier coverage. Open communication with your healthcare provider is crucial for finding the most effective and safe treatment plan.
