Stimulant medications, which include amphetamines and methylphenidate, are often used to treat ADHD. These medications are schedule II controlled substances that are highly addictive, habit-forming, and widely abused; therefore, I do not prescribe them. Fortunately, there are other treatments available. A review of those therapies is provided below, along with results from a study that compared the efficacy of different ADHD meds.
- Atomoxetine (Strattera®) - atomoxetine is a norepinephrine reuptake inhibitor approved to treat ADHD in children and adults. It has been around for a long time and has proven effective in trials. The main side effects are nausea (26%), dry mouth (20%), and decreased appetite (16%). It can raise heart rate and blood pressure in some patients, so people with hypertension should monitor their blood pressure during therapy. It has a cheap generic. See atomoxetine review for more.
- Clonidine - clonidine is a blood pressure medication that has been around for a long time. It works by decreasing sympathetic outflow from the central nervous system. It is FDA-approved for ADHD in children (6 - 17 years) but not in adults. Given that it has proven effective in children and used safely in adults for many years, a trial of clonidine is appropriate for adult ADHD. The main side effects are somnolence and dry mouth. It can lower blood pressure, so patients should monitor their blood pressure when starting it. It has a cheap generic. See clonidine review for more.
- Bupropion (Wellbutrin®) - buproprion is an antidepressant that is widely prescribed. It works by blocking the reuptake of norepinephrine and dopamine in the central nervous system. Bupropion is not FDA-approved for ADHD, but a handful of small studies have found it to be effective in children and adults. Given its efficacy in small trials and long safety record, a trial of bupropion is appropriate in adults and adolescents with ADHD. The drug also has a cheap generic. See bupropion review for more.