Attention-deficit hyperactivity disorder (ADHD) can affect how someone focuses, organizes, and manages emotions. While stimulant medications are the most common treatment, they don’t work for everyone. For some, non-stimulant ADHD medication is a better option.
This article explains how non-stimulant medications work, when they’re used, what kinds are available, and how they compare to stimulants.
Stimulant vs. Non-Stimulant Medications for ADHD
Stimulant medications are frequently prescribed for ADHD. They increase dopamine and norepinephrine, which are brain chemicals that are responsible for attention and impulse control. Since they affect the brain’s reward system, stimulants are considered controlled substances, meaning they’re regulated to prevent misuse.
Non-stimulant medications are not controlled substances. They work by increasing norepinephrine, similar to stimulants, but not all of them affect dopamine levels. Unlike stimulants, which often act within hours, non-stimulant medications sometimes take a few weeks to show results.
When Are Non-Stimulants Prescribed?
Non-stimulant ADHD medications are prescribed when stimulants cause problems or don’t work well. For example, some people have side effects like loss of appetite or insomnia. Others may have health conditions like high blood pressure that make stimulant use unsafe.
A doctor might also recommend non-stimulants when:
- Stimulants make anxiety or mood symptoms worse
- There’s a higher risk of medication misuse or dependence
- A person needs treatment that won’t interfere with nighttime work or sleep
- There are coexisting conditions like depression or anxiety
- Stimulant shortages make prescriptions harder to fill (in 2023, 38% of adults with ADHD reported difficulty getting their medication)
Sometimes, doctors will use stimulants and non-stimulants together to get better results.
Types of Non-Stimulant ADHD Medications
There are several types of non-stimulant medications for ADHD. Each one works a little differently, so it may take time to find the right fit.
Atomoxetine (Strattera)
Strattera is one of the best-known non-stimulant medications for ADHD. It’s approved for children six and older and is sometimes used in adults as well. This medication is a norepinephrine reuptake inhibitor (SNRI) that can help reduce impulsivity and improve focus.
Possible side effects include:
- Headache or nausea
- Trouble sleeping
- Dry mouth
- Stomach pain or loss of appetite
- Sweating or tiredness
Strattera usually takes a few weeks to start working, but many people like that it provides consistent focus without the ups and downs of stimulants.
Guanfacine (Intuniv)
Guanfacine ER (Intuniv) lowers adrenaline activity, which helps calm the nervous system. It can be taken on its own or alongside a stimulant and is approved for children age six and up. Usually taken once a day, this medication is helpful for emotional regulation, impulsivity, and hyperactivity.
Common side effects include:
- Drowsiness or dizziness
- Low blood pressure or slow heart rate
- Fatigue or irritability
- Constipation or dry mouth
Clonidine (Kapvay)
Clonidine ER (Kapvay) calms hyperactivity and impulsivity while improving attention. It can be taken once or twice daily and is sometimes used with a stimulant for more symptom control.
Possible side effects include:
- Drowsiness or fatigue
- Constipation or dry mouth
- Dizziness or lightheadedness
- Nightmares or irritability
Kapvay can be a good choice for children who struggle with sleep problems or anxiety along with ADHD.
Viloxazine (QelBree)
Viloxaine ER (Qelbree) is a newer non-stimulant medication that’s approved for children and adults over six years old. It helps increase norepinephrine levels and improve communication between brain cells involved in attention and emotional regulation.
Side effects might include:
- Sleepiness
- Nausea or upset stomach
- Headache or dry mouth
- Decreased appetite
- Trouble sleeping
Other Non-Stimulants for ADHD
Some medications that aren’t officially approved by the FDA for ADHD may still be used when other options don’t work. These include:
- Wellbutrin (bupropion) increases dopamine and norepinephrine and may help with both ADHD and depression.
- Effexor (venlafaxine) affects serotonin and norepinephrine and can improve focus and mood.
- Tricyclic antidepressants (TCAs) may help attention but are rarely used due to side effects.
- MAOIs and some blood pressure medications may help hyperactivity but are used only in special cases.
Are Non-Stimulants as Effective as Stimulants?
Stimulants are still the first choice for many people with ADHD, but that doesn’t mean non-stimulants don’t work. In fact, one review of 18 studies found that atomoxetine, guanfacine, and viloxazine were all more effective than placebo for managing ADHD symptoms. Another study showed that atomoxetine and methylphenidate (stimulant) improved attention and thinking skills in similar ways over the long term.
Non-stimulants tend to work more slowly, but they can provide steady improvement without as many peaks and crashes. Keep in mind, treatment usually works best when combined with other approaches, such as:
- Counseling, coaching, and mindfulness-based interventions
- Consistent routines and healthy habits
- Home and school structure
- Lifestyle support from friends, family, coworkers
Achieve Your Full Potential With Non-Stimulant ADHD Medications
ADHD treatment looks different for everyone. What works for one person may not work for another, and that’s okay.
At Pulse TMS, we focus on helping patients understand their options and find what truly works for them, not just what works on paper. Our goal is to make ADHD treatment supportive and personalized every step of the way.
Reach out today to learn more about non-stimulant ADHD treatment, and start building a plan that helps you feel more in control.
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