A Complete Guide to ADHD Medications for Adults

What are the medication options for adult ADHD?

The most common type of medications used for ADHD are stimulants, but that’s not your only option. Other medication options include non-stimulants and antidepressants (despite the name, they’re not just for depression). Let’s take a look at your options and the pros and cons of each type. 

Stimulant medications for ADHD

The most common types of medications that are used for adult ADHD are called psychostimulants, or stimulants. Stimulants work by increasing levels of certain chemicals, like dopamine and norepinephrine, in your brain. Since dopamine levels are low in ADHD, many people find stimulants quite helpful. Stimulants help with problems like impulsivity, hyperactivity, and inattention. Stimulant medications usually are the most effective for adult ADHD, which is why they’re so commonly prescribed. Many people also prefer them because they work immediately and you can choose to take them as-needed rather than every day. 

What you should know about stimulants

There are several key points to keep in mind if you’re considering taking stimulant medication for ADHD.

• Stimulants are the most commonly used medication in the treatment of ADHD, and they are about 70%-80% effective for adults.

• You should always take your medication exactly as prescribed.

• Stimulants used for ADHD carry a risk for addiction, and they are a Schedule I drug. Although stimulant medications for ADHD have the potential to be abused, research hasn’t shown that it increases your risk for addiction if you have ADHD. 

• Recreational stimulants are not a substitute for prescribed stimulants; the formulations and effects on your brain are different. 

• Usually, stimulant medications are started at a low dose and increased as needed.

• The benefits of these medications usually go away when you stop taking them. They haven’t been found to have long-term benefits.

• You can choose to take them daily, only on workdays, or as needed. 

Common types of stimulants

The types of stimulants that are used for ADHD are amphetamines, methylphenidate, and their derivatives. Stimulants can be short-acting or long-acting. 

1. Short-acting stimulants: People may take short-acting medications several times a day. They start working in about 30 to 45 minutes and last between 3 to 6 hours. 

2. Long-acting stimulants: People take long-acting stimulants once a day. They contain the same active ingredients as their short-acting counterparts but have special coatings that slow down their absorption. Part of your dose will have an immediate effect while the remainder will continue to work for 8 to 16 hours.  

Many people prefer to take long-acting medications so that they don’t have to remember to take them as often throughout the day and because they are associated with fewer side effects. 

Here are some of the most common brands of medications and chemical make-up for the different types. Occasionally, your pharmacist may dispense a generic brand of ADHD medication, in that case you’ll see the chemical formulation is the same but the name may differ. 

Short-acting and long-acting amphetamines options

Here are the most commonly prescribed types of short- and long-acting amphetamines for ADHD: 

Short-acting Amphetamines

• Adderall (levoamphetamine-dextroamphetamine)

• Dexedrine(dextroamphetamine)

Long-acting Amphetamines

• Adderall XR (levoamphetamine and dextroamphetamine)

• Vyvanse (lisdexamfetamine)

• Dexedrine XR (dextroamphetamine)

Short-acting and long-acting methylphenidate options

Here are the most commonly prescribed types of short- and long-acting methylphenidate for ADHD: 

Short-acting Methylphenidates

• Ritalin (methylphenidate)

Long-acting Methylphenidates

• Ritalin LA/XR (methylphenidate)

• Concerta (methylphenidate)

These medications are most often taken as a pill, but some of them are available as patches or liquids.

Common side effects of stimulants in adults with ADHD

Some of the most common side effects of stimulant medication for adult ADHD include:

• Dry mouth

• Headache

• Lack of appetite

• Weight loss

• Trouble sleeping

• Upset stomach

• Higher blood pressure or heart rate

• Nervousness or anxiety

• Irritability (may only happen when the medication wears off)

Rare but more serious side effects include:

• Heart attack or stroke

• Seizures

• Abuse or addiction

• Mood swings or psychosis

• Skin discoloration

• Rare allergic reactions

• Serotonin syndrome (when combined with supplements like St. John’s wort)

Tell your prescribing doctor about any side effects you’re facing. They can tell you whether or not what you’re experiencing is normal, and can also change the dosage if it’s necessary.

Are stimulant ADHD drugs addictive?

Stimulant medications that are used to treat ADHD can lead to addiction if they are abused. Taking more doses than prescribed, ingesting a higher dose than recommended, and mixing them with other stimulants and recreational drugs are all risk factors for abuse and addiction. In general, there is no evidence suggesting that using stimulant medications as prescribed for ADHD increases your risk of developing substance use disorder. 

In fact, some studies have shown that taking ADHD medication (if you have been diagnosed with ADHD) actually lessens your risk of developing substance use disorder. This is probably because your symptoms are better managed, so you’re less likely to try to self-medicate.

However, if you have had an addiction to stimulant drugs in the past, or know that you’re at high risk for substance use disorder, it’s best to tell your provider about this. Signs of addiction include taking more than recommended, feeling dependent, experiencing adverse side-effects but not stopping, and drug-seeking behavior. Abusing stimulants can have serious side-effects so speak to your doctor about your options if you feel at risk. 

Are ADHD stimulant medications right for me?

Stimulant ADHD medications are generally safe and well-tolerated by most people. However, some people may need to be cautious when taking these medications. Tell your healthcare provider if you:

• Have pre-existing heart problems

• Have a history of anxiety, psychosis, Tourette’s syndrome, or tic disorder 

• Have glaucoma or are at high risk of glaucoma

• Take a type of antidepressant called monoamine oxidase inhibitors (MAOIs)

• Supplement with St. John’s Wort 

Your doctor will weigh the benefits of stimulant medication against its risks in your case if these things apply to you.

Non-stimulant ADHD medication

Although stimulants are the most common and effective medication for adult ADHD, many people choose non-stimulant options for a variety of reasons. Non-stimulant options can be very effective and may have additional benefits, such as reducing depression and controlling blood pressure. 

What to know about non-stimulant medications for adult ADHD

• Non-stimulants are a broad category of medications that can include any medication for ADHD that isn’t a stimulant. In this category, we’ve included four non-stimulant medications that have been FDA-approved to treat ADHD in children.

• Non-stimulants can be a great option for people who aren’t eligible to take stimulant medications.

• Non-stimulant medications are not used as first-line treatment because stimulants have been shown to be more effective.

• Non-stimulants are not classified as Schedule I drugs and are typically not habit-forming.

• You usually have to take non-stimulants regularly over a period of time to gain the benefits

Non-stimulant medication options for ADHD

There are four types of non-stimulant medications specifically used for ADHD. These are:

1. Selective norepinephrine reuptake inhibitors (SNRIs) for ADHD

   Strattera (atomoxetine):  Strattera is an SNRI, meaning it increases levels of norepinephrine in the brain which can help with attention and decrease impulsivity. It is the first non-stimulant medication that the FDA approved for the treatment of ADHD in adults. 

2. Blood pressure medications for ADHD

   Intuniv (Guanfacine): This blood pressure medication, known as Alpha-2 adrenergic agonist, is approved for the treatment of ADHD in its long-acting form. It has been found to be significantly helpful in reducing hyperactivity and impulsive symptoms. It is not as helpful for inattention. 

In some instances, your doctor may prescribe one of these medications along with stimulant medication to help control blood pressure and/or improve sleep. Many people take their beta-blockers at night before bed to help them sleep better and then enjoy the benefits of symptom reduction without side effects the following day. 

Common side effects of SNRI medication for ADHD

The most common side effects of SNRIs for adult ADHD:

• Constipation and upset stomach

• Dry mouth

• headache

• Insomnia

• Decreased libido or sexual side effects

• Fatigue or feeling sluggish

• Increased heart rate and blood pressure

Rare, but serious, side effects of SNRIs include:

• Liver problems; jaundice, yellowing skin, dark urine, or unexplained flu-like symptoms

• Rare allergic reactions

• Increased risk of heart attack or stroke

• Increased suicidal thoughts

Common side effects of blood pressure medication for ADHD

Some of the common side effects of blood pressure medications include:

• Decreased blood pressure

• Drowsiness

• Dry mouth

• Constipation

• Nausea

• Fatigue

This isn’t a complete list of the possible side effects. Tell your healthcare provider about any symptoms that you experience after starting any medication and be sure to always disclose any medications and supplements you may be taking along with prescribed medications. 

Are ADHD non-stimulant medications right for me?

Non-stimulant medications are great alternatives that provide significant symptom relief for many people. You may choose to switch between stimulant medications and non-stimulant medications at different times in your life. You may want to consider non-stimulant medications if you:

• Experience significant or unwanted side-effects from stimulant medications

• Have high blood pressure or are at risk

• Want a break from stimulants

Antidepressants for Adult ADHD

Sometimes, antidepressant medications are used to help treat ADHD in adults. Antidepressants have a number of different benefits such as raising levels of brain chemicals involved with mood and attention. Through these effects, antidepressants can help with problems like inattention, aggression, and impulsivity.

ADHD and depression have a large overlap. Studies show that up to 53% of adults with ADHD also experience depression. Antidepressants may be a particularly helpful treatment if you have both of these conditions because they directly treat the symptoms of both.

What to know about antidepressants for ADHD:

• Although some types of antidepressants have been found to help with the behaviors that come along with ADHD (like impulsivity), none of them have been found to be as helpful as psychostimulants or Strattera. They are usually used as a second- or third-line treatment or in people with mild symptoms of ADHD and depression

• Selective serotonin reuptake inhibitors, SSRIs, are the most commonly prescribed antidepressants for depression but aren’t typically used for ADHD

• Some people take both antidepressants (for depression) and stimulant medications (for ADHD). Your doctor will discuss your best options with you if you have depression and ADHD.

Antidepressant Medication Options for ADHD

No antidepressant is FDA-approved for the treatment of ADHD, but doctors typically prescribe one of the following:

• Wellbutrin/Zyban (bupropion): Bupropion is an atypical antidepressant that acts as a norepinephrine–dopamine reuptake inhibitor. That means it helps increase levels of both dopamine and norepinephrine in the brain which can help with inattention, hyperactivity, and other symptoms of ADHD. It takes between 3 to 7 days to begin working and has milder effects on symptoms of ADHD compared to stimulants.

• Effexor (venlafaxine): Venlafaxine is a serotonin and norepinephrine reuptake inhibitor (SNRI), meaning it raises levels of serotonin and norepinephrine in the brain. It is also used to treat nerve pain from diabetes, fibromyalgia, and chronic musculoskeletal pain. More studies are needed to determine its effectiveness for adult ADHD, but it may be beneficial to some people. 

There is also evidence that monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs) may be helpful with ADHD, but their risks and side effects generally outweigh their benefits. 

Common side effects of antidepressants for ADHD

Some common side effects of bupropion:

• anxiety

• dry mouth

• hyperventilation

• irregular heartbeats

• irritability

• restlessness

• shaking

• trouble sleeping

Some common side effects of venlafaxine:

• dry mouth

• sleepiness

• loss of appetite

• erectile dysfunction

• abnormal ejaculation

• loss of libido (sex drive) in men and women

• weakness

• dizziness

• nausea

• constipation

• sweating

• trouble sleeping)

Are antidepressants for ADHD right for me?

Antidepressants can be a great option for people who want a non-stimulant medication and have depressive symptoms with their ADHD. Given that they take longer to work, need to be taken every day, and are not quite as powerful as other options, they are certainly not for everyone. Talk to your doctor if you would like to try an antidepressant for your ADHD to determine whether it would be a good option for you and your needs. 

Do I need to take medication for adult ADHD?

Before deciding which ADHD medication to take, you need to decide whether or not you want to take medication at all. This is a personal decision that should be made between you and your healthcare provider. Around 70%-80% of adults with ADHD see improvement with medications. 

Be honest with all of your care providers about your symptoms and how ADHD affects your daily life. They can help you make the right decision about whether or not to take medication, and prescribe you the medication that’s right for you. You also don’t need to take medication forever or even every day; there are many options to suit your lifestyle.

How to get medication for ADHD

The only way to get medications for ADHD is by getting a diagnosis and prescription through a healthcare provider.  If you want to talk to a professional about which ADHD meds are best for you, Frida can help. Take our ADHD self-assessment and learn more about how the experts at Frida can guide you through a diagnosis and get you a treatment plan with medications delivered right to your door. 

Many people with ADHD try out different medications over time to determine what is best for them. It’s also possible that your needs will change over time depending on various factors such as significant life changes like a new job or becoming a parent. Just know that it is completely normal to try different medications and stop and restart as needed. You should always do what's best for you and your needs in consultation with your healthcare provider.