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Thursday 15 December 2011


Medications to Treat ADHD
There are a number of different ADHD drugs used to treat the condition. Find out the specifics about ADHD drugs, including effectiveness and side effects.
By Diana Rodriguez
Medically reviewed by Sam Goldstein, PhD

    ADHD is a behavioral disorder affecting millions of children and adults. However, ADHD can be successfully managed with a combination of therapy and ADHD drugs. There are several types of ADHD drugs that are useful, and several medications within each type. There are standards of treatment that often provide the greatest success, but they don't work for everyone.

ADHD Drugs: Medication Classes Prescribed

The types of ADHD drugs used most often are stimulants, non-stimulant drugs including antidepressants, and high blood pressure medications.

The first line of treatment and the most commonly prescribed ADHD drugs are typically the stimulants, because they often work the best.

F. Allen Walker, MD, a psychiatrist who has ADHD and who runs his own practice specializing in ADHD in Louisville, Ky., feels the stimulant class of ADHD drugs is superior to other classes in treating ADHD.

"When treating patients, if you combine therapy and education with medication and you take the time to individualize the medication and dosage, that is the most effective way to treat ADHD," says Dr. Walker.

Stimulants primarily focus on increasing the neurotransmitter dopamine in the brain, particularly in the prefrontal cortex.

"The theory is people with ADHD have a brain that's a little bit thirsty for dopamine," says Walker, and increasing dopamine levels allows an ADHD brain to function better.

Non-stimulant drugs can also be used to treat ADHD. Non-stimulant medications such as various antidepressants affect not only dopamine, but also other neurotransmitters such as norepinephrine and serotonin. Antidepressants are sometimes used in patients who are not able to tolerate stimulant medications.

High blood pressure medications can help manage associated ADHD symptoms like irritability, impulsivity, restlessness, and tics, though they aren't very successful in managing inattention.

The Most Common ADHD Drugs

Here is a list of the most commonly prescribed ADHD drugs and information about each one:

    Ritalin, Mehylin, Metadate, Concerta, Daytrana (methylphenidate). This stimulant can effectively manage all of the primary symptoms of ADHD — impulsivity, hyperactivity, and inattention. Studies show that methylphenidate offers the most significant and quick reduction of ADHD symptoms and doesn't increase tics. Potential side effects include depression, dizziness, headaches, appetite loss, insomnia, and nausea. Studies have shown that Ritalin might have a negative impact on the healthy development of the brain in children and teenagers. Concerta is an extended-release form of methylphenidate. Daytrana contains the same medication in a patch that is applied to the skin daily.
    Adderall (dextroamphetamine and amphetamine). This stimulant can effectively manage all of the primary symptoms of ADHD, with all the potential side effects of Ritalin. Studies have shown a rare side effect of heart attacks, which can be fatal, particularly if mixed with alcohol use.
    Dexedrine (dextroamphetamine). This stimulant can effectively manage all of the primary symptoms of ADHD, with all the potential side effects of other stimulants. Studies show some evidence that dextroamphetamine may increase tics after long periods of time when given in greater-than-normal doses and should not be administered at such levels.
    Vyvanse (lisdexamfetamine dimesylate).This stimulant is known as a prodrug, meaning it is inactive until metabolized in the body. Vyvanse may prevent the potential for drug abuse that has been reported with Adderall.
    Focalin (dexmethylphenidate). This stimulant comes in a capsule, which can be opened and sprinkled on foods for those who have trouble swallowing pills. Though it is known to have fewer side effects than Ritalin, this medicine may stop working earlier than needed in some individuals.
    Strattera (atomoxetine). This non-stimulant drug offers the benefit of 24-hour effects, which is longer than stimulants. It can also help battle depression and is a good choice for people dealing with ADHD and depression or anxiety, but it's not as effective against symptoms of hyperactivity as stimulant drugs. Side effects can include fatigue, irritability, stomachache, headache, nausea, and vomiting. Studies show that atomoxetine is as effective as stimulants with some additional benefits and at a lower cost than some other drugs. Atomoxetine also doesn't have the risk of abuse and dependence that stimulant drugs do. However, it's been found to potentially increase the risk of suicide.
    Aplezin, Wellbutrin, Zyban (buproprion). This antidepressant affects the chemicals dopamine and norepinephrine in the brain and can be a very effective treatment in people who have both ADHD and depression. Buproprion can effectively manage symptoms of hyperactivity and inattention in people who don't find relief from stimulants or who can't tolerate their side effects. However, antidepressants have not been found to be effective at managing impulsivity. Side effects can include blurry vision, drowsiness, dryness of the mouth, and constipation. Studies have shown that some antidepressants can increase the risk of suicide. Antidepressants are not approved by the U.S. Food and Drug Administration (FDA) for the treatment of ADHD.
    Intuniv, Tenex (guanfacine). Intuniv, a long-acting form of the blood pressure medication Tenex, was approved for the treatment of ADHD by the FDA in September 2009. This once-a-day treatment for kids ages 6 to 17 is a non-stimulant medication thought to engage receptors in the area of the brain linked to ADHD. In 2011, the FDA said that Intuniv could be used along with a stimulant to help children who are not responding well to a stimulant alone. Guanfacine can strengthen memory, reduce distraction, and improve attention and impulse control. Side effects can include tiredness, abdominal pain, dizziness, a drop in blood pressure, dry mouth, and constipation.
    Catapres (clonidine). This high blood pressure medication can manage ADHD symptoms of aggressive behavior, impulsions, hyperactivity, and tics, but it's not very effective against inattention. Side effects can include drowsiness, dryness of the mouth, blurry vision, heart problems, and constipation. Studies have shown that this high blood pressure medication is becoming more popular and is a safe and successful treatment for ADHD in addition to or instead of stimulant medications, but it is not FDA-approved for this use.

With patience and a knowledgeable medical professional, you can find the right medication at the right dose to help manage ADHD symptoms.

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