ADHD is a developmental condition that affects concentration and attention. Many different medications can reduce ADHD symptoms, and each has a range of benefits and side effects.
Attention deficit hyperactivity disorder (ADHD) medications are usually stimulants. Common options include Adderall XR, Vyvanse, and Concerta. However, people can also use nonstimulant drugs, such as Strattera or Intuniv XR. Medications can have short-, medium-, or long-acting effects.
The best medication for a person depends on many factors. These include the medication’s side effects, how long it lasts, and an individual’s personal preferences. A doctor can advise on which type is best, but it is useful to know the benefits and side effects of each type.
In this article, we will compare the different medications that people can take to manage ADHD symptoms.
Doctors prescribe two main types of drugs to treat the symptoms of ADHD:
Stimulants are more effective than nonstimulants in adults, adolescents, and children. However, they also carry a risk of misuse, and they can cause rebound symptoms.
For this reason, many people use nonstimulants instead. Additionally, long-acting versions of stimulants can also reduce the potential for misuse.
The following table lists the stimulant and nonstimulant drugs available to treat ADHD symptoms:
|Long-acting stimulants||amphetamine and dextroamphetamine (Adderall XR, Mydayis)|
|amphetamine (Adzenys ER, Adzenys XR-ODT, Dyanavel XR)|
|methylphenidate (Adhansia XR, Aptensio XR, Concerta, Cotempla XR-ODT, Daytrana, Jornay PM, QuilliChew ER, Quillivant XR, Relexxi, Ritalin LA, and generics)|
|dexmethylphenidate (Focalin XR)|
|dextroamphetamine (Dexedrine, Dexedrine Spansules, and Xelstrym)|
|serdexmethylphenidate and dexmethylphenidate (Azstarys)|
|Short- and intermediate-acting stimulants||dexmethylphenidate (Focalin)|
|methylphenidate (Ritalin, Ritalin SR, Methylin, and generics)|
|amphetamine and dextroamphetamine (Adderall)|
|amphetamine (Evekeo, Evekeo ODT)|
|dextroamphetamine (ProCentra, Zenzedi)|
|guanfacine (Intuniv XR)|
|clonidine ER (Kapvay)|
An antidepressant medication called bupropion (Wellbutrin) is sometimes prescribed as a non-stimulant treatment for ADHD. Because this medication is not FDA-approved to treat ADHD, this is considered an “off-label” use.
Doctors typically prescribe stimulants as a first-line treatment for children, adolescents, and adults with ADHD. Stimulants act on norepinephrine and dopamine, two brain chemicals that may play a role in ADHD.
Stimulants called amphetamines are more effective and produce fewer side effects in adults. The first choice for children and adolescents with ADHD is methylphenidate.
What are the side effects?
The most common side effects of stimulant medications for ADHD are:
- increased heart rate
- increased blood pressure
- reduced appetite
- difficulty sleeping
Serious heart-related complications are rare. Doctors should closely monitor people with heart problems who are taking stimulants.
Central nervous system stimulants have a high potential for misuse and dependence. Longer-acting formulations have a lower potential for misuse, so doctors more commonly prescribe these.
What are the drug interactions?
Stimulants can interact with several medications.
Monoamine oxidase inhibitors (MAOIs) are antidepressants that people should not take with stimulants. In fact, a person must stop taking any MAOI at least 14 days before starting any stimulant medication.
Other antidepressants that interact with stimulants include:
- selective serotonin reuptake inhibitors (SSRIs)
- serotonin-norepinephrine reuptake inhibitors (SNRIs)
- tricyclic antidepressants
The following sections look at types of stimulant medication for ADHD in more detail.
Many ADHD stimulant medications contain methylphenidate, an ingredient that works by increasing dopamine levels in the brain. Long-term studies have demonstrated that methylphenidate is safe and effective, so these medications are popular choices.
Methylphenidate is used in a range of different long-acting medications. Short-acting forms are also available.
Long-acting methylphenidate medications include:
- Adhansia XR
- Adzenys ER, Adzenys XR-ODT
- Aptensio XR
- Cotempla XR-ODT
- Dexedrine Spansules
- Dyanavel XR
- Jornay PM
- QuilliChew ER
- Quillivant XR
- Ritalin LA
- generic medications
Short-acting methylphenidate medications include:
- Evekeo, Evekeo ODT
- Ritalin SR
- generic medications
There are also several other forms of stimulant medications, such as Adderall and Vyvanse.
The following sections discuss long-acting stimulant drugs in more detail.
Concerta capsules use osmotic-controlled release oral delivery system (OROS) technology to release methylphenidate. The effect of methylphenidate is also long-acting — it releases 22% immediately and the remaining 78% gradually.
The OROS technology is only present in Concerta and not in generic formulations. When a person swallows Concerta, fluid from the stomach and intestines enters the tablet and pushes the medication out of the pill slowly throughout the day.
Similar to Biphentin, the medication will last for 10–12 hours. When the medication wears off, people can use a short-acting methylphenidate form if needed.
People should not cut or crush Concerta capsules. People who cannot swallow pills may have difficulty taking Concerta.
Methylphenidate ER is the generic version of Concerta. This product does not use the OROS technology for releasing the medication.
The major reason that people choose the generic form instead of Concerta is its lower cost. However, no clinical studies have confirmed that this generic option has the same effect as Concerta.
Some doctors have reported behavioral changes when people switch from Concerta to its generic equivalent. Caregivers, loved ones, pharmacists, and doctors should report any behavioral changes they observe.
Ritalin LA is an extended-release tablet that releases half of the medication at once and the other half slowly throughout the day.
Doctors can prescribe Ritalin LA to children, adolescents, and adults with ADHD. People should not crush, chew, or split this tablet.
Daytrana is a methylphenidate patch that a person places on their hip. Researchers have studied its effects in children ages 6–12 years and those ages 13–17 years.
A person applies this patch to their skin 2 hours before they need the effects of the medication. They should remove the patch after a maximum of 9 hours.
Dextro-methylphenidate is a variation of methylphenidate present in Focalin and Focalin XR. This variation of methylphenidate is more active than its typical counterpart.
Focalin XR is the long-acting formulation of Focalin.
A doctor can prescribe this medication for all age groups. People can open the capsules and combine the contents with food.
Dextro-amphetamine is the main active ingredient in Adderall XR, the long-acting formulation of Adderall. Doctors can prescribe this medication to children, adolescents, and adults with ADHD. As a long-acting medication, it provides symptom control for 10–12 hours.
Sometimes, doctors will need to prescribe a short-acting amphetamine drug to provide symptom control later in the afternoon.
Vyvanse contains lisdexamfetamine, an inactive form of amphetamine. When a person takes Vyvanse, their body converts the inactive medication into dextroamphetamine. Vyvanse has similar effects to Adderall XR.
Children can control their ADHD symptoms for 13 hours when taking Vyvanse. Adults who take Vyvanse can achieve 14 hours of symptom control.
Dexedrine and Dexedrine Spansules
Dexedrine and Dexedrine Spansules contain dextro-amphetamine.
The Dexedrine Spansules will last about 6–8 hours, while the tablets will only last 3–5 hours, so people tend to use it once the long-acting drug wears off later in the day.
Xelstrym is an amphetamine patch approved by the FDA in 2022 for the treatment of ADHD. It contains dextroamphetamine, the same active ingredient in Dexedrine and Dexedrine Spansules.
The patch is applied daily and should be left on for a maximum of 9 hours. A person should use one patch per day.
Mydayis is a newer formulation of dextroamphetamine and amphetamine. It is a capsule that is typically taken once a day when a person first wakes up.
This medication is designed to be longer-acting than other amphetamine formulations. One capsule may work for up to
Adzenys ER, Adzenys XR-ODT, and Dyanavel XR
These medications are long-acting forms of amphetamine that are approved for use in people over the age of 6. They are typically taken once a day, in the morning.
Adzenys XR-ODT is a quick-dissolve tablet that can be taken without water. Adzenys ER and Dyanavel XR are liquid formulations.
Quillivant XR and QuilliChew ER
Quillivant XR and QuilliChew ER contain methylphenidate in two forms. A small portion of the medication is in an immediate-release form, while the majority of the medication is a film-coated extended release form. This means that part of the medication can be absorbed immediately while the rest is absorbed over up to
Quillivant is a powder that is dissolved in water and swallowed, while QuilliChew is a chewable tablet.
Adhansia XR and Aptensio XR
Adhansia XR and Aptensio XR both contain “
Like other extended-release forms of methylphenidate, they typically begin to work within 1 hour. Adhansia may remain active for up to
Aptensio capsules can be opened up and sprinkled over applesauce or yogurt, but the beads must not be chewed.
Cotempla XR-ODT is a tablet that dissolves quickly in the mouth, so it can be taken easily without water. Approved by the FDA in
Part of the medication is active immediately, while the extended-release medication contained in Cotempla can continue to act for up to
Jornay PM is the first “
FDA-approved in 2022, Relexxi is a methylphenidate extended-release tablet. It must be swallowed whole. It is approved for children over the age of 6, adolescents, and adults.
In clinical trials, the most common side effect of Relexxi in children and adolescents was upper abdominal pain. Commonly-reported side effects in adults include loss of appetite, headache, and dry mouth.
Azstarys is a once-daily medication containing serdexmethylphenidate and dexmethylphenidate. It is the first medication to contain these two ingredients.
The capsules can be swallowed whole, or emptied into a glass of water or small portion of applesauce.
The following sections discuss some short- and intermediate-acting stimulant drugs in more detail.
The short-release version of Adderall comes in tablet form and is immediately released into the body. Doctors commonly prescribe this drug to people with ADHD.
Evekeo and Evekeo ODT
Evekeo is an amphetamine medication. It is available in a tablet form that can be swallowed or crushed, as well as a quick-dissolve tablet that easily dissolves in the mouth (Evekeo ODT).
Evekeo can be prescribed for use in children ages 3-17.
Ritalin, Ritalin SR, and generics
Methylphenidate is available in short-acting formulations, including Ritalin, Ritalin SR, and their generic equivalents. They release methylphenidate immediately, but the effect does not last long, so people must take multiple doses per day.
Methylin is another short-acting methylphenidate medication. It is available as a liquid and a chewable tablet.
For children and adolescents over the age of 6, Methylin is typically taken twice a day before breakfast and lunch. Adults may take Methylin 2 or 3 times daily, usually before meals.
Focalin contains dextro-methylphenidate and is the short-acting version of Focalin XR.
A person can open these capsules and sprinkle them into food. Doctors can prescribe Focalin and Focalin XR to all age groups.
Procentra and Zenzedi
Procentra and Zenzedi are medications containing dextroamphetamine. Procentra is a liquid, while Zenzedi is the brand name for a newer tablet form.
Zenzedi can be prescribed for children as young as
Nonstimulant medications act on a set of different pathways that offer another treatment option. Doctors may prescribe nonstimulant medications in combination with stimulants or alone.
Some people cannot tolerate the side effects of stimulant medications and can only take nonstimulants.
When people use nonstimulant medications, they may only notice that their symptoms start to improve after about 6–8 weeks. As a result, this treatment is not appropriate for people who require urgent symptom control.
There are several nonstimulant drugs available for ADHD:
- Intuniv XR
Because stimulants can make anxiety worse, Strattera may be beneficial for people with ADHD who also have anxiety. Doctors can prescribe it for children, adolescents, and adults. People may take both stimulant medications and Strattera if necessary.
The most notable side effects of Strattera include nausea and stomach upset. People should not open Strattera capsules because the medication may irritate the eyes — instead, they must swallow Strattera capsules whole, which can be challenging for some people.
Quelbree is a newer medication that works in a similar way to Strattera. Both medications are designed to increase the amount of a neurotransmitter called norepinephrine in your brain.
This medication can be prescribed for children ages 6-17 and adults. Some possible side effects include sleep problems, fatigue, loss of appetite, and nausea or vomiting.
Because Qelbree can interact with certain other drugs, it is important to talk with a doctor or pharmacist if you are taking any other medications.
For those who have difficulty swallowing pills, Qelbree capsules can be opened up and sprinkled over applesauce.
Doctors recommend Intuniv XR to treat ADHD symptoms in children ages 6–12 years.
The major benefit of this medication is that its effect can last into the evening and early morning. Children with other conditions, such as anxiety, aggression, and tics, can use Intuniv XR.
People should not chew, crush, or break the tablets. They must consume them whole.
People taking Intuniv XR must let their doctor or pharmacist know if they are taking any medications for their heartbeat. People should exercise caution when taking such drugs to prevent the heart rate from getting too low. Doctors and pharmacists should remind caregivers not to abruptly stop administering Intuniv XR to their children because blood pressure and pulse may increase.
Intuniv XR can interfere with many drugs, including ketoconazole and valproic acid. To avoid problematic interactions, people taking Intuniv XR should let their doctors and pharmacists know which medications they are taking. They should also avoid eating grapefruit or drinking grapefruit juice when taking Intuniv XR.
This medication is an alpha-2 agonist and can also be used to treat high blood pressure. Doctors prescribe it for children with ADHD ages 6–17 years.
It is usually taken twice per day. People should not crush, chew, or break the tablets.
Some research has shown that combining medication and psychosocial interventions is an effective strategy for managing ADHD symptoms.
There are five main types of interventions:
- behavioral interventions
- social interventions
- educational and vocational accommodations
Psychoeducation is effective for children over 8 years of age. This intervention educates children and their caregivers on ADHD and its impacts.
Healthcare professionals design behavioral interventions such as coaching and lifestyle changes for people of all age groups with ADHD. They use rewards and consequences with the aim of improving behavior.
Social interventions can help people improve their social skills and manage their anger.
Older children and adults can benefit from self-talk, behavioral therapy, and family therapy. A psychotherapist may use play and expressive arts therapy as well as supportive counseling.
Educational and vocational institutes include special education programs and workplace interventions to provide additional help for people with ADHD.
Long-acting stimulant formulations are the first choice of treatments for people with ADHD. They allow people to benefit from the effect of the medication throughout the school or work day.
Doctors also prefer longer-acting medications due to the lower risk of misuse.
Healthcare professionals can recommend a combination of medication and psychosocial interventions to improve the lives of people with ADHD.