Non-Stimulant Management of ADHD

mother with five year old daughter piggy back behind her, both smiling

Non-stimulant medications have been used since 2003 to help treat symptoms of ADHD in children.

Atomoxetine (Straterra)

Atomoxetine (Strattera) is a non-stimulant approved by the FDA as a first-line treatment of ADHD. It is a selective norepinephrine reuptake inhibitor that regulates the availability of neurotransmitters in the brain to help with symptoms of ADHD. It can take up to 6 weeks after starting atomoxetine before reaching its maximum effectiveness. Possible side effects (in a very small number of cases): suicidal thoughts, upset stomach, decreased appetite, nausea or vomiting, tiredness, problems sleeping, and dizziness.

Long-Acting Guanfacine (Intuniv)

Long-Acting Guanfacine (Intuniv) is an alpha-agonist that is approved for treating high blood pressure and for children with ADHD who have tics, sleep problems, and/or aggression. Possible side effects: decreased appetite, sleepiness (improves with time), headaches, fatigue, stomachaches, nausea, dizziness, irritability, and decreased blood pressure. Time to reach maximum effectiveness is 3-4 weeks.

Long-Acting Clonidine (Kapvay)

Long-Acting Clonidine (Kapvay), like guanfacine, is also an alpha agonist that is a non-stimulant approved by FDA for the treatment of ADHD. Side effects similar to guanfacine.

Bupropion (Wellbutrin)

Bupropion (Wellbutrin) is an antidepressant, while not FDA-approved for ADHD, there are convincing preliminary data that it is effective in reducing ADHD symptoms in some children. Currently, it is used as an off-label, third-line agent for treating ADHD symptoms in children. Possible side effects: (very small number of cases) increased risk of seizures in some individuals with a history of seizure disorders, hence somewhat contraindicated in patients with epilepsy. Other side effects: decreased appetite, irritability, insomnia, and worsening of existing tics.

Dr. Eileen Shi

Board-Certified Las Vegas Pediatrician

Your pediatrician should always be your child’s advocate and believe your child always comes first. Little Roots Pediatrics families on their wellness journey with Concierge Pediatric care. We integrate evidence-based care with holistic health principles to provide the most up-to-date, direct-access pediatric care.