Selecting the most effective medication for an adult with attention deficit hyperactivity disorder (ADHD) can involve trial and error. The best medication for adult ADHD will depend on a person’s history, genetics, and response to the drug.

ADHD is one of the most common neurodevelopmental conditions in children, and it often continues into adulthood. Without treatment, the symptoms can make it difficult for a person to focus, stay organized, feel calm, and manage impulses.

Medications can help people manage these symptoms. This article explores adult ADHD and the best medications for treating the condition.

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The medications doctors prescribe for ADHD in children and adults are mostly the same. However, a child with ADHD may need different medications as they grow.

A doctor will consider how a person’s ADHD affects them in order to prescribe a medication tailored to their needs.

ADHD medications fall into two categories:

Stimulants

Also called psychostimulants, stimulants are the first line of treatment for ADHD. They work by slowing down the brain’s absorption of dopamine and norepinephrine, which are neurotransmitters (chemical messengers that transmit signals in the body).

Stimulants increase the availability of these chemicals in the brain, allowing more effective communication along brain pathways. These drugs have a rapid effect. They are controlled substances because they are habit-forming and have the potential for misuse.

Common stimulants for ADHD treatment include:

  • methylphenidate (Concerta, Ritalin, Metadate, Focalin)
  • amphetamine (Adderall, Adderall XR)
  • dextroamphetamine (Dexedrine, Desxtrostat)
  • lisdexamfetamine (Vyvanse)

Certain people should not take these medications, including those with:

In addition, a person who took monoamine oxidase inhibitors (MAOIs) in the last 14 days should not take stimulant drugs.

Nonstimulants

A doctor may prescribe nonstimulants if a person experiences an adverse reaction to stimulant drugs or does not respond to them. They may also recommend nonstimulants if the person has a history of drug misuse or certain heart conditions, such as severe hypertension or cardiovascular diseases.

Compared with stimulants, nonstimulants do not have a potential for misuse. However, they are not as effective as stimulants and have a slower onset.

Common nonstimulant medications for ADHD include:

  • atomoxetine (Strattera)
  • guanfacine (Intuniv)
  • clonidine (Kapvay)
  • bupropion (Wellbutrin), which doctors may prescribe off-label for adult ADHD
  • viloxazine (Qelbree)

Adderall is a combination of dextroamphetamine and amphetamine. This central nervous system (CNS) stimulant helps improve concentration and reduce impulsivity.

There are two types of Adderall: immediate release (IR) and extended-release (XR). The standard dose is 5 to 20 milligrams (mg).

A person may take Adderall IR one to three times per day, with or without food, while they only need to take Adderall XR once per day. The effect of Adderall IR lasts for about 4 to 6 hours, while Adderall XR may last up to 12 hours.

Adderall takes effect within 30 minutes to an hour. A person can feel its peak effect within 1 to 3 hours.

Concerta is another stimulant. A person typically needs to take this drug once per day, in the morning. It comes in the following strengths:

  • 18 mg
  • 27 mg
  • 36 mg
  • 54 mg

Concerta’s effects last up to 12 hours. It lasts longer than Adderall IR because the drug releases more slowly. It has an advanced formulation and works within an hour, with peak levels at 6 to 10 hours.

Dexedrine is a stimulant that contains dextroamphetamine as its active ingredient. It comes in short-acting and long-acting forms.

People taking short-acting Dexedrine may need to take a dose two to three times per day, 4 to 6 hours apart. A person may only need to take the long-acting form first thing in the morning.

Similar to Adderall, Dexedrine only takes about 30 minutes to take effect. The short-acting tablet may stay effective for 4 to 6 hours, while the Dexedrine spansule (long-acting capsule) may be effective for 8 to 12 hours.

Focalin is the brand name for dexmethylphenidate, another CNS stimulant. This drug comes in IR and XR forms.

A person may need to take two doses 4 hours apart for the IR form. Meanwhile, a person only needs to take one Focalin XR, typically first thing in the morning. The duration of the effects of Focalin IR and XR are similar to those of Adderall.

People who have trouble swallowing pills may open the capsule and sprinkle the contents into applesauce to make swallowing easier.

Ritalin has the same active ingredient as Concerta. The primary difference between the two medications is that Ritalin is a short-acting drug that immediately releases into the body. Even the long-acting formulation of Ritalin does not last as long as Concerta.

This drug may be helpful for individuals who need immediate symptom relief. For a person’s body to absorb the medication fully, they need to take Ritalin two to three times per day, preferably 30 to 45 minutes before meals.

Vyvanse is an amphetamine-based drug. Experts believe it helps with ADHD symptoms by restoring the balance of chemicals in the brain.

Healthcare professionals prescribe this stimulant medication to individuals with ADHD and binge eating disorder.

It comes in capsule and chewable tablet forms. The typical starting dose for this drug is 30 mg, with a maximum dose of 70 mg.

Strattera is the first nonstimulant medication approved by the Food and Drug Administration (FDA) to treat ADHD. It is a selective norepinephrine reuptake inhibitor (SNRI).

A person usually takes Strattera once or twice per day, with or without food. It has an excellent safety profile and the reported side effects, which include sleepiness and lack of appetite, are generally mild.

Learn about more types of ADHD medications.

Doctors may sometimes prescribe drugs off-label. This means that the FDA does not approve these medications for use in ADHD.

Antidepressants

Antidepressants such as tricyclic antidepressants, MAOIs, bupropion, and venlafaxine increase the levels of norepinephrine in the brain. This action has a positive effect on reducing ADHD symptoms.

Many doctors also prescribe antidepressants to treat ADHD that occurs with anxiety and depression.

Bupropion

Bupropion (Wellbutrin) is a norepinephrine-dopamine reuptake inhibitor antidepressant. It has approval for treating depression and seasonal affective disorder and helping with smoking cessation.

Adults typically take a 100-mg dose three times per day. Alternatively, they may take the sustained-release formulation in a 150-mg dose once or twice per day. The maximum dose is 450 mg.

Venlafaxine

Venlafaxine (Effexor) is another antidepressant doctors may prescribe off-label for ADHD. It is a serotonin-norepinephrine reuptake inhibitor. Doctors also prescribe this drug to manage conditions such as:

Blood pressure medications

Guanfacine (Intuniv) and clonidine (Kapvay) are two blood pressure medications in the class of alpha-2 agonists.

Their exact mechanisms are unknown, but experts believe they mimic norepinephrine and affect the receptors in the prefrontal cortex, leading to a reduction of inattention, impulsivity, and distractibility in those with ADHD.

The FDA has approved these drugs to treat ADHD, but only in children and adolescents, not adults. However, since both these drugs have approval for treating hypertension in adults, many doctors feel comfortable prescribing them off-label to adults with ADHD.

Neither medication is recommended for children and adolescents with severe depression, as they may worsen depressive symptoms. Common side effects of these drugs include:

Wake-promoting agents

Modafinil (Provigil) is an FDA-approved drug for narcolepsy. It activates different attention and arousal systems in the brain to increase frontal cortical activity. In a controlled study, almost half of adults responded positively to the medication.

As well as medication, behavioral therapy may be an effective treatment for symptoms of ADHD. Behavioral therapies can complement medication in helping people manage behavioral, social, and emotional concerns.

ADHD often occurs alongside other conditions that behavioral therapy may help with. For example, half of people with ADHD also have anxiety disorders, while 1 in 13 has coexisting bipolar disorder.

Below are a few examples of other treatment options that may help with adult ADHD:

  • Cognitive behavioral therapy (CBT): CBT can help people identify problematic thoughts and behaviors and implement strategies to help them cope, self-regulate, and adjust thinking patterns and behaviors.
  • Coaching: People with ADHD may work with coaches who can offer them guidance and feedback as they handle daily life challenges. A coach can help a person build practical skills such as planning, setting goals, time management, and organization.
  • Social skills training: This training aims to help a person improve their interpersonal skills. Activities may focus on communication, managing emotions, judgment, and problem-solving.
  • Marital counseling and family therapy: Counseling can help family members and couples communicate better and help them understand the underlying causes behind a person’s symptoms, behaviors, or habits.

Learn more about types of therapy and coping skills and strategies for adults with ADHD.

It is best to reach out to a doctor if a person with ADHD is experiencing any of the following:

  • new or worsening symptoms
  • medications no longer working
  • intolerable side effects from medication

If there are issues with a medication, a doctor may change the drug’s dosage or prescribe a different one. A person should never adjust the timing and dosage of their medications without speaking with a doctor.

ADHD is a condition that can affect a person’s ability to manage their behavior, attention, and concentration. Several types of medications are available for ADHD. The best medication for a person will depend on their symptoms, health status, and how they respond to different drugs.

It is best for people to work closely with a doctor to identify the best medication for them. Other treatments, such as behavioral therapy, are also available that can help a person reduce the effects of ADHD symptoms on their life.