Non-Stimulant Management of ADHD

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.