Non-Stimulant ADHD Medication
Typically, the first type of medication doctors will prescribe for patients with ADHD is a stimulant drug such as methylphenidate (Ritalin) or dextroamphetamine (Adderall). However, these are only effective for around 70 to 80% of patients and can cause some unpleasant side effects.
Fortunately, there are several other drugs which may help relieve ADHD symptoms. These are known as non-stimulant ADHD medications.
This article will discuss what you'll need to know before making a decision about taking a non-stimulant medication.
What Is Non-Stimulant ADHD Medication?
ADHD is typically treated with stimulant drugs. These drugs work by increasing levels of the neurotransmitters dopamine and norepinephrine in the brain. These two neurotransmitters are often poorly regulated in people with ADHD, which leads to symptoms such as hyperactivity, inattentiveness and impulsive behavior.
Although stimulant ADHD medications work well for most people, they are not effective for everybody. Furthermore, they can cause a number of side effects and also carry a high risk of abuse.
Non-stimulant ADHD medications are a good alternative for people who cannot take stimulant medications. They may work well for people for whom stimulants are ineffective or those who cannot tolerate the adverse effects.
What Is the Difference Between Stimulant and Non-Stimulant ADHD Medication?
Stimulant ADHD medication works by increasing levels of dopamine and norepinephrine in the brain. Non-stimulant ADHD medication works in a similar way, although it may affect different neurotransmitters depending on the type. Although there are some similarities between stimulant and non-stimulant ADHD medications, there are also some important differences to take into account.
One of the major problems with stimulant ADHD drugs is that they can cause a number of unwanted side effects. These include:
- Reduced appetite
- Sleep disturbance
- Headaches
- Abdominal discomfort
- Tiredness or fatigue
When taken for long periods, stimulant drugs may interfere with a child’s growth meaning that young patients on these drugs should be monitored closely.
Stimulants also have a high potential for abuse, which is why they are classed as controlled substances. This means that they are subject to many different prescribing regulations that can make life more complicated for patients and physicians alike.
Non-stimulant ADHD drugs, on the other hand, are not likely to be abused and are therefore much easier to prescribe. They also cause fewer side effects and may work for people who are not helped by stimulants.
Although non-stimulant ADHD drugs work more slowly than stimulants, their effects may last longer, thus reducing the number of tablets that need to be taken each day.
Types of Non-Stimulant ADHD Medication
There are several different types of non-stimulant ADHD medication, and they all work in slightly different ways. Some of the most common non-stimulant ADHD drugs are atomoxetine (Strattera), clonidine (Kapvay) and guanfacine (Intuniv).
Atomoxetine
Atomoxetine belongs to a class of drugs known as "specific norepinephrine reuptake inhibitors." This means that it increases norepinephrine levels in the brain. It can help with symptoms such as poor concentration and impulsivity, and studies show that it may be as effective as methylphenidate in some patients.
Atomoxetine is generally well-tolerated and has a relatively low risk of side effects compared with stimulant ADHD medication.
Clonidine
Clonidine belongs to a class of drugs called "centrally acting alpha-agonist hypotensive agents." It is sometimes used to treat high blood pressure, but can also help people with ADHD by influencing the brain areas associated with attention and impulsivity.
Guanfacine
Guanfacine is in the same drug class as clonidine and it works in a very similar way. It may help with symptoms such as lack of focus, impulsivity and hyperactivity.
While atomoxetine can be taken by people of all ages, clonidine and guanfacine are usually only recommended for children ages 6 to 17.
Other Non-Stimulant ADHD Medications
A number of other medications can be used to manage the symptoms of ADHD. One example is anti-depressants, including tricyclic antidepressants (e.g. imipramine) and serotonin and norepinephrine reuptake inhibitors, or SNRIs (e.g. venlafaxine). These may be especially helpful for ADHD symptoms accompanied by anxiety or depression.
Other drugs such as bupropion, buspirone and beta blockers may also help with some ADHD symptoms. However, there is limited evidence to support their use and they are not prescribed frequently.
Non-Stimulant ADHD Medication Side Effects
Since non-stimulant ADHD medications all work in slightly different ways, they can also cause a variety of side effects.
Some of the most common atomoxetine side effects include:
- Reduced appetite
- Digestive issues
- Dizziness
- Drowsiness
- Headaches
- Irritability
- Low sex drive
- Changes in heart rate and blood pressure
It is also thought that atomoxetine may affect growth in children and this should be monitored closely.
Some of the most common clonidine and guanfacine side effects include:
- Dry mouth
- Tiredness
- Headache
- Irritability
- Abdominal pain
- Digestive issues
- Sexual dysfunction
- Changes in blood pressure
Other non-stimulant ADHD drugs are also associated with their own side effects. When you or your child start taking any new medication, watch out for any unusual changes and report them to your physician immediately.
Treating ADHD with Non-Stimulant Medication
Although both stimulant and non-stimulant medications can be effective, they are not usually recommended as the sole treatment for ADHD. These drugs are thought to be most effective when combined with therapies such as behavioral therapy, training for parents or carers and educational interventions.
These therapies can help people with ADHD learn coping mechanisms and social skills as well as how to manage the core symptoms of hyperactivity, inattentiveness and impulsivity. Although a combination of medication and therapy is often recommended for adults and children over 6 years of age, children under 6 should be treated with therapy first and medication should only be added later if necessary.
Because non-stimulant ADHD medication can take longer to start working than stimulant medication, you may need to wait up to a week for these drugs to reach their full effect. In the meantime, be patient and keep an eye out for any side effects.
In addition to medication and therapy, lifestyle changes may also help some patients with ADHD. These include dietary modifications, exercise and practices such as meditation. Talk to your health care provider for further information.