Non-Stimulant ADHD Medication

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While stimulants are typically the first choice of medication used to treat attention-deficit/hyperactivity disorder (ADHD), there are several non-stimulant medications that may be prescribed. Non-stimulants may be prescribed if you do not respond to stimulants, if side effects of stimulants are too great, if you have a history of certain heart conditions, or if you have a history of drug abuse or bipolar disorder.

Options include Strattera, tricyclic antidepressants, Effexor, Wellbutrin, and some high blood pressure medicines. Of these, Strattera has been studied most extensively for use in the treatment of ADHD in adults and children. It appears to have fewer side effects than tricyclic antidepressants, and to be more effective than Wellbutrin.


Strattera (atomoxetine) is the first non-stimulant medication to be approved by the Food and Drug Administration (FDA) for the treatment of ADHD in adults and children over the age of 6. Atomoxetine is in the class of medications known as selective norepinephrine reuptake inhibitors. Studies have found that this drug improves symptoms of ADHD and reduces oppositional and defiant behavior and anxiety.

Strattera differs from stimulant medications in several ways. It does not seem to have a potential for abuse and thus is not classified as a controlled substance. It also appears to have a longer onset of action as compared to stimulants, which work on the day they are taken, meaning that the therapeutic effect of stimulants may be more quickly noticeable than Strattera.

It can take at least six weeks for Strattera to reach a maximal therapeutic effect. Once maximal effects are reached, however, they last 24 hours and may also have carry-over effects to the next day. Strattera must be taken every day, whereas doses of stimulants may be skipped—over the weekend, for example.

Side effects of atomoxetine may include stomachaches, weight loss due to decreased appetite, nausea, vomiting, dizziness, fatigue, dry mouth, increased heart rate and blood pressure, agitation, and irritability.

Tricyclic Antidepressants

The tricyclic antidepressants most frequently used in the treatment of ADHD include Norpramin (desipramine), Tofranil (imipramine), Elavil (amitriptyline), and Pamelor (nortriptyline). These antidepressants are typically tried when you haven't shown a good response to stimulants.

They may also be prescribed if you have symptoms of depression or anxiety in addition to ADHD. Tricyclic antidepressants, like stimulants, are thought to increase the amount of norepinephrine in the brain. Unlike stimulants, it may take several days or even weeks to see the therapeutic benefits of the tricyclic antidepressants, but once this level is reached, benefits last throughout the day.

Tricyclic antidepressants need to be taken daily. Missing a dose or stopping the medicine abruptly may cause aches and flu-like symptoms, so if you're going to go off the medication, you should be tapered off gradually over a period of time.

Common side effects of tricyclic antidepressants may include drowsiness, dry mouth, constipation, blurred vision, stomachaches, headaches, vivid dreams, and insomnia. More serious side effects may include problems with heartbeat or heart rhythm. If there is a family history of heart problems or you have any heart problems, these medications should be used with caution and close medical monitoring.

Tricyclic antidepressants may also increase the risk of seizures in patients with a history of seizure disorder. As with all medications, the use of tricyclic antidepressants requires close monitoring and consultation with the prescribing doctor.


Wellbutrin (bupropion) is a different type of antidepressant that has been found to reduce symptoms of ADHD and depression in many patients. Side effects may include irritability, weight loss due to decreased appetite, insomnia, and a worsening of existing tics. Wellbutrin may make some individuals more prone to seizures.


Effexor (venlafaxine) is sometimes used to treat ADHD. It helps with concentration and mood. Side effects can include tremor, sleep issues, dry mouth, sexual problems in adults, nausea, and anxiety.

Anti-Hypertensive Drugs

In addition to the above drugs, Catapres (clonidine) and Tenex (guanfacine) are sometimes used to help manage ADHD symptoms. Both these medicines were originally used to treat high blood pressure, but they have also been found to be helpful in reducing hyperactivity and impulsive symptoms.

These medicines do not appear to be as effective in improving symptoms of inattention. They are usually only used to treat ADHD when a person can't tolerate or doesn't respond to Strattera or stimulants.

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