Stimulant vs non-stimulant ADHD meds for adults

Do you find it hard to pay attention or find yourself being impulsive? If yes, you may have attention deficit hyperactivity disorder (ADHD). ADHD is a neurodevelopmental disorder that affects adults every day. It causes symptoms that include inattention, hyperactivity, and impulsivity. And 2 main classes of medications are used to treat adults with ADHD — stimulants and non-stimulants. 

In this article, we explore stimulant vs non-stimulant ADHD meds for adults, their effectiveness, potential side effects, and how to determine which may be right for you.

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6 key differences between stimulant vs non-stimulant ADHD medications for adults

Common stimulant medications for adults with ADHD include Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate). They’re very effective at reducing or eliminating ADHD symptoms. But they carry the risk of addiction and can sometimes be hard to find due to shortages. 

Common non-stimulant medications for adults with ADHD include Strattera (atomoxetine) and Intuniv (guanfacine) among others. They can also be effective for minimizing symptoms and are ideal if there’s a concern about addiction. They also tend to be easier to find and haven’t had the shortages Adderall and other stimulant medications have suffered from.

If you’re weighing your options between stimulants and non-stimulant ADHD medications, here are 6 key things to consider and to ask your provider about.

1. How stimulant vs non-stimulant ADHD meds work

• Stimulants increase dopamine and norepinephrine levels in the brain. Dopamine and norepinephrine are neurotransmitters that work in the brain. They work together to promote alertness, focus, thought, effort, and motivation. 
• Non-stimulants target different neurotransmitters or receptors, usually norepinephrine only or noradrenaline, and have an alternative mechanism of action.

2. How quickly stimulants vs non-stimulants work

• Stimulants provide rapid symptom relief, often within hours of the first dose.
• Non-stimulants typically take several weeks of consistent use to reach full effectiveness.

3. How long the effects of stimulant vs non-stimulant ADHD meds for adults last

• Stimulants are available in short-acting and extended-release forms to give you flexibility in treating your ADHD. Short-acting or immediate-release forms work quickly while extended-release forms offer a continuous effect over a longer timeframe.
• Non-stimulants generally provide a consistent and sustained effect throughout the day.

4. Suitability of stimulants vs non-stimulants

• Stimulants are commonly prescribed as the first-line treatment for ADHD because of their effectiveness in treating ADHD symptoms.
• Non-stimulants are preferred when stimulants aren’t well-tolerated, not as effective, and for people at a higher risk for addiction.

5. Potential side effects with stimulants vs non-stimulants for ADHD

• Stimulants can cause side effects, such as insomnia, appetite suppression, and increased heart rate.
• Non-stimulants’ side effects can include drowsiness, fatigue, dizziness, and dry mouth.

6. Risk of dependency

• Stimulants have a potential risk of misuse, dependency, and/or abuse.
• Non-stimulants have a lower risk of dependency.

Stimulant medications for adults with ADHD

Stimulant medications are the most commonly prescribed drugs for individuals with ADHD. These medications are very effective in managing ADHD symptoms and have been used successfully to treat adults in ADHD for years. They primarily function by increasing levels of the dopamine and norepinephrine neurotransmitters in the brain, which, in turn, helps enhance focus and reduce impulsivity.

Types of stimulant ADHD meds

There are 2 primary types of stimulant medications commonly used to treat ADHD.

Immediate-release stimulants

Immediate-release stimulant medications are known for their rapid onset of action, which makes them an ideal choice for individuals who require flexible control over their medication regimen. These medications offer fast relief of symptoms and are typically taken multiple times throughout the day. By taking immediate-release stimulants as needed, you can adjust your medication schedule to align with the activities and demands of your day.

Immediate-release stimulants are particularly helpful during situations where prompt symptom management is needed. For example, they might be taken before a challenging task or during periods when heightened focus and attention are critical.

Extended-release stimulants

Extended-release stimulant medications offer a different approach to managing ADHD symptoms. These medications are formulated to release their active ingredients gradually over an extended period, usually an entire day. As a result, they provide a more consistent and sustained effect compared to their immediate-release counterparts.

Extended-release stimulant medication is typically taken just once a day, making it a convenient option for individuals seeking long-lasting symptom control without needing to remember to take multiple doses throughout the day. This extended duration of action is advantageous for people who need symptom relief throughout the day and into the evening.

Common stimulant medications used for ADHD

Stimulant medications commonly prescribed for adults with ADHD fall into 2 main groups, methylphenidate-based medications and amphetamine-based medications.

Methylphenidate-based stimulant medications for ADHD

Methylphenidate-based medications are a class of stimulant drugs that work by increasing the levels of neurotransmitters in the brain, specifically dopamine and norepinephrine. They’re available under various brand names. Ritalin and Concerta are the most well-known drugs in this group.

• Ritalin (methylphenidate hydrochloride) is a short-acting methylphenidate-based medication that provides rapid symptom relief. It’s typically taken multiple times a day, which allows for flexibility in dosage adjustments to match your daily schedule and needs.
• Concerta (methylphenidate hydrochloride) is an extended-release methylphenidate medication. It offers a consistent and sustained effect throughout the day, requiring only a once-daily dose.

The difference between Ritalin vs Concerta is primarily their delivery systems. Because they’re so similar, talk to your healthcare provider who can better explain which will work best for you.

Amphetamine-based medications for ADHD

Amphetamine-based medications also enhance the levels of dopamine and norepinephrine in the brain. These medications are another commonly prescribed category of stimulants for ADHD. 2 well-known examples are Adderall and Vyvanse.

• Adderall (dextroamphetamine and l-amphetamine salts) is a blend of amphetamine salts and is available in immediate-release and extended-release forms — Adderall and Adderall XR. The immediate-release version provides rapid symptom relief but requires multiple doses throughout the day. The extended-release option, Adderall XR, offers prolonged symptom control.
• Vyvanse (lisdexamfetamine) is an extended-release amphetamine medication that provides a consistent and extended duration of symptom control. It’s typically taken once a day and has a lower potential for misuse due to its prodrug formulation, meaning it has to be metabolized by the body before it takes effect. 

The biggest differences between Adderall vs Vyvanse are the active ingredients, available forms, how long they last, and side effects. 

Common doses of ADHD stimulant meds for adults

The appropriate dosage of stimulant medications for ADHD isn’t one-size-fits-all. Your dosage is individualized and determined by your healthcare providers based on a variety of factors, such as your age, weight, and the specific medication being prescribed. Follow your healthcare provider’s recommendations for dosage and the right amount of ADHD medication to take.

How effective are stimulant ADHD medications?

Stimulant medications are proven effective in managing ADHD symptoms. Many individuals experience remarkable improvements in attention, focus, and impulse control when taking the properly prescribed stimulant medication and dose. These medications help bring about a sense of clarity and calmness, making it easier for individuals with ADHD to engage in tasks that require sustained attention.

Side effects of stimulant medications for ADHD

While stimulant medications can be highly effective in managing ADHD symptoms, they’re not without potential side effects. Common side effects associated with stimulant ADHD medications can include:

• Insomnia: Stimulant medication can disrupt sleep patterns, leading to difficulty falling asleep and/or staying asleep.
• Appetite suppression: Some individuals experience a decrease in appetite while taking stimulant medications, which can lead to weight loss.
• Increased heart rate and blood pressure: Stimulants can elevate heart rate and blood pressure, which may be problematic for individuals with cardiovascular issues.
• Nervousness or anxiety: Stimulants may cause feelings of nervousness or anxiety, especially at higher doses.

Potential risks of stimulant meds for ADHD for adults

There are potential risks associated with the use of stimulant medications, primarily related to the dangers of misuse, dependency, or abuse of controlled substances. These medications have the potential to be diverted for non-medical use due to their stimulating effects. Immediate-release stimulant medications also have a higher risk for abuse because the medication is absorbed faster.

It’s critical to use stimulant medications only under the guidance and supervision of a qualified healthcare provider who can closely monitor you and your medication.

Despite this possibility, stimulant medications, whether methylphenidate-based or amphetamine-based, are valuable ADHD tools in managing ADHD symptoms. They’re highly effective, providing individuals with improved attention, focus, and impulse control. However, it’s important to be aware of potential side effects and the risk of misuse. Using these medications as prescribed and under the supervision of a primary care physician or psychiatrist is essential for safe and effective treatment.

Non-stimulant medications for adults with ADHD

Non-stimulant medications used to treat ADHD work differently than stimulant meds. While stimulant medications provide rapid symptom relief, often within hours of taking the first dose, non-stimulant medications typically offer continuous relief over a longer timeframe.

How fast do non-stimulants meds for ADHD work?

Non-stimulant medications have a gradual onset of action, which means it may take some time for their therapeutic effects to be noticeable. In most cases, individuals who are prescribed non-stimulant medications for ADHD may need to use the medication consistently for several weeks before realizing their full benefits. 

Healthcare providers typically monitor the progress of patients using non-stimulant medications and may make adjustments to the dosage or treatment plan as needed. This monitoring ensures that the medication is tailored to the individual’s specific needs and that the desired outcome is achieved.

Common non-stimulant ADHD medications

Non-stimulant medications offer an alternative approach to managing ADHD symptoms, especially for individuals who don’t respond well to stimulants or have concerns about their potential side effects. 

Common non-stimulant medications used to treat adults with ADHD are included below.

Strattera (atomoxetine)

Atomoxetine is sold as a generic and under the brand name Strattera. It’s a non-stimulant medication that’s U.S. Food and Drug Administration (FDA)-approved for the treatment of ADHD in both children and adults. Unlike stimulants, atomoxetine doesn’t affect dopamine levels. Instead, it primarily targets norepinephrine neurotransmitters in the brain. This unique mechanism of action makes it a suitable choice for those who can’t tolerate stimulant medications or have a history of substance abuse. Read more about Statterra vs Adderall for a deeper comparison.

Intuniv (guanfacine)

Guanfacine is sold as a generic and as the brand name Intuniv. It’s another non-stimulant medication prescribed for adults with ADHD. It belongs to a class of drugs called alpha-2 adrenergic agonists. Intuniv acts by affecting certain receptors in the brain, specifically noradrenaline, which creates a calming effect. It’s often used as an adjunct treatment or when stimulants aren’t effective alone. It can help reduce hyperactivity and impulsivity and improve focus.

Kapvay (clonidine)

Clonidine is available as a generic and as the brand name Kapvay. It’s also classified as an alpha-2 adrenergic agonist and is used to manage ADHD symptoms. Like guanfacine, clonidine has a calming effect and can help individuals with ADHD by reducing impulsive behaviors and hyperactivity. It may be prescribed as part of a comprehensive treatment plan for ADHD.

Dosages for common non-stimulant ADHD meds for adults

Your healthcare provider will decide the appropriate dosage of non-stimulant medications for ADHD for you. Dosages are individualized and depend on several factors, including your age, weight, severity of symptoms, and how you respond to a medication. It’s critical to follow your healthcare provider’s instructions and not adjust your dosage on your own.

How effective are non-stimulant ADHD medications?

Non-stimulant medications can be effective in managing ADHD symptoms, particularly in cases where stimulants aren’t suitable or haven’t provided symptom relief. They work by targeting different neurotransmitters in the brain, such as norepinephrine or receptors responsible for regulating attention and impulse control.

Side effects of non-stimulant meds for adults

While non-stimulant medications offer advantages in terms of reduced risk of dependence or abuse compared to stimulants, they can still have side effects. Common side effects of non-stimulant ADHD medications include the following.

• Drowsiness: Some individuals experience drowsiness, especially when starting the medication. Your provider may recommend that you take your medications at bedtime.
• Fatigue: A feeling of tiredness or fatigue can occur. Fatigue tends to diminish as your body adjusts to a non-stimulant medication for ADHD.
• Dizziness: Some individuals experience dizziness, particularly when standing up quickly. Rise slowly from a seated or lying position to minimize your risk.
• Dry mouth: Dry mouth can also be a side effect of non-stimulant medications. Staying well-hydrated and using sugar-free lozenges or gum can help.

Potential risks of non-stimulant ADHD medications

While non-stimulant medications have a lower potential for dependence or abuse compared to stimulants, they still should be used as prescribed and your use closely monitored by a healthcare professional. It’s essential to tell your provider about any side effects or concerns you have to ensure your medication is safe and effective for you.

Non-stimulant ADHD medications, such as atomoxetine, guanfacine, and clonidine offer valuable alternatives for individuals with ADHD, particularly those who don’t respond well to stimulants or have specific concerns. These medications can be effective in managing ADHD symptoms, but like all medications, they come with potential side effects that should be discussed with a healthcare provider. Ultimately, the choice of medication and dosage should be tailored to your unique needs, symptoms,   and circumstances.

Stimulant or non-stimulant ADHD medication: which is right for you?

Selecting the best ADHD medication for you is a decision to make in consultation with a qualified healthcare provider. Remember that finding the right ADHD medication may take time, and it’s important to be patient and persistent. 

Here’s a step-by-step guide to help you determine whether stimulant or non-stimulant ADHD medication is right for you.

• Consultation: Schedule an appointment to talk to a healthcare provider who specializes in ADHD treatment. Be prepared to discuss your medical history, current symptoms, and any concerns or preferences you have regarding medication.
• Evaluation: Your healthcare provider will conduct a comprehensive evaluation, which may include psychological assessments and interviews to assess the severity of your symptoms and rule out other underlying conditions.
• Trial period: Based on their evaluation, your healthcare provider may recommend an initial medication. If stimulants are chosen, you’ll typically start with a low dose and gradually adjust until you reach an optimal dose for you. For non-stimulants, consistent use over several weeks may be needed.
• Monitoring: Your healthcare provider will closely monitor your progress, including assessing the medication’s effectiveness and any side effects you may experience.
• Open communication: Maintain open communication with your healthcare provider. If you have concerns or experience side effects, don’t hesitate to talk to your provider about them. Adjustments to your treatment plan can often address these issues.
• Lifestyle considerations: In addition to medication, consider implementing lifestyle changes, such as therapy and medication treatment, time management strategies, exercise, and a balanced diet, to complement your treatment.
• Regular follow-ups: Schedule regular follow-up appointments with your healthcare provider to evaluate the ongoing effectiveness of your medication and make any necessary adjustments.

Get an appointment for ADHD treatment today

If you suspect you have ADHD or have been diagnosed with the condition and want professional guidance, schedule a consultation with a certified healthcare provider who specializes in ADHD on Klarity. Find an ADHD provider and have an appointment in as little as 24 hours and decide together whether stimulant vs non-stimulant medication is right for you.