5 Nonstimulant ADHD Medications: Strattera, Intuniv, and More

Attention-deficit hyperactivity disorder (ADHD) is a complex condition to treat. The good news is that there are several treatment options to choose from. But narrowing down which options are best suited for you and your symptoms can be a challenge.

Parent Training in Behavior Management (PTBM) is one important step in treating ADHD in children. This is where parents learn skills and strategies to help their kids thrive with ADHD. Getting extra support in the classroom is often recommended. Stimulant and nonstimulant medications can also be used in combination with PTBM, typically in kids ages 6 and older.

Stimulant medications are first-choice medications for children, adolescents, and adults with ADHD. But healthcare professionals can prescribe nonstimulant medications when stimulant medications haven’t worked or cause intolerable side effects.

1. Strattera

Strattera (atomoxetine) is one of the most common nonstimulant ADHD medications. It’s also typically considered the most effective. Strattera comes as an oral capsule that can be taken with or without food. This medication is available only as a generic product, atomoxetine. But it’s still widely known by its former brand name.

Strattera belongs to a class of medications known as selective norepinephrine reuptake inhibitors (NRIs). NRIs work by increasing the activity of a neurotransmitter (brain chemical) called norepinephrine. The specific way it works isn’t fully known, but Strattera helped address symptoms of inattentiveness and hyperactivity in its initial clinical studies.

The recommended Strattera dosage for children ages 6 to 17 depends on their body weight. If your child weighs 154 lbs (70 kg) or less, they’ll likely start by receiving a smaller, weight-based dose. But if they weigh more than 154 lbs, they’ll follow the same dosage regimen as adults. The typical adult Strattera starting dosage is 40 mg per day. After 3 days, your dose may go up depending on your response to the medication.

Strattera is beneficial for many people, but some side effects are possible. Common side effects of Strattera in children include an upset stomach, a decreased appetite, and nausea. Common side effects in adults include constipation, dry mouth, and dizziness. Managing Strattera side effects is discussed more in another GoodRx Health article.

Keep in mind: Strattera has a boxed warning — the FDA’s most serious medication warning. Strattera may increase the risk of thoughts of suicide in children and adolescents. This side effect is rare, but it’s important to talk to your child about their feelings and maintain a watchful eye for possible changes in their behavior.

2. Qelbree

Qelbree (viloxazine) is a newer nonstimulant medication for ADHD. It’s an oral capsule that can be taken with or without food. You can swallow it whole or open it up and sprinkle its contents into applesauce or pudding for easier consumption — whichever you prefer.

This brand-name NRI medication is approved to treat ADHD in people ages 6 and older. The recommended Qelbree dosage for children depends on their age. Children under 12 usually start by taking 100 mg once daily. Adults and children 12 and older start at a dosage of 200 mg once daily. The maximum daily Qelbree dosage is 400 mg in children under 18 and 600 mg in adults.

Frequent and expected side effects of Qelbree include sleepiness, decreased appetite, and nausea in children. Insomnia, fatigue, and headache are more common in adults. Because Qelbree is taken once a day, you or your child can take it later in the day if you feel sleepy or tired after taking the medication. In turn, if Qelbree makes you feel more awake, you may want to take it earlier in the day.

Similar to Strattera, Qelbree also has a boxed warning for thoughts of suicide. This is very rare, but make sure to watch for changes in your or your child’s behavior. Talk to your child about their emotions, especially when starting Qelbree.

3. Intuniv

Intuniv (guanfacine ER) is an oral tablet approved to treat ADHD in children ages 6 to 17. Your child’s healthcare team may recommend Intuniv by itself or in combination with a stimulant medication if they have harder-to-treat ADHD. It’s available as a brand-name and generic medication.

Intuniv works differently from Strattera and Qelbree, which might benefit some people. It belongs to a class of medications known as central alpha 2-adrenergic receptor agonists. But the exact way that Intuniv works for ADHD isn’t clear.

The typical starting Intuniv dosage for children and teens is 1 mg once daily. Your child’s healthcare professional may gradually increase their dose over a few weeks to a safe and effective dose. If your child is taking Intuniv alone (without a stimulant medication), the maximum once-daily dosage is 4 mg for children ages 6 to 12. For teenagers, the maximum is 7 mg per day. If your child is taking Intuniv with a stimulant medication to treat ADHD — regardless of their age — the maximum dosage is 4 mg daily. You should avoid giving Intuniv with a high-fat meal, since this can cause Intuniv levels in your blood to increase. This raises the risk of side effects.

Common Intuniv side effects include sleepiness, dizziness, and headache. More serious side effects include low blood pressure, low heart rate, and fainting. Your healthcare team will likely monitor your child’s blood pressure and heart rate when they start the medication and periodically thereafter.

If your child needs to stop Intuniv, talk with a healthcare professional. They can give advice on how to stop the medication gradually to avoid dangerous spikes in blood pressure.

4. Clonidine ER (Kapvay, Onyda XR)

Kapvay (clonidine ER) is another oral tablet that treats ADHD in kids ages 6 to 17. It’s a centrally acting alpha 2-adrenergic agonist that can be used alone or in combination with stimulants. It’s available as a generic tablet (brand-name Kapvay is no longer available). The medication also comes as an extended-release liquid as brand-name Onyda XR.

Kapvay dosages range from 0.1 mg to 0.4 mg per day. It usually starts as a once-daily 0.1 mg dose at bedtime. If needed, the dose may be increased over time to a larger total daily dosage that’s split between 2 doses — one in the morning and one in the evening. Your child can take it with or without food.

Onyda XR is taken in a similar way to Kapvay. A key difference, however, is that you should take Onyda XR only once daily — even at higher dosages.

Common side effects of clonidine ER include dry mouth, fatigue, and headache. More serious side effects include low blood pressure and low heart rate.

Like Intuniv, clonidine ER shouldn’t be stopped suddenly. If your child needs to stop taking it, tell their healthcare professional first. Their care team will likely lower the dose gradually to help prevent withdrawal symptoms.

5. Off-label nonstimulant alternative medications

Some medications aren’t officially FDA approved to treat ADHD. But your healthcare professional may recommend them as an off-label treatment, especially if you have other conditions they’re approved to treat — like anxiety or depression.

Some off-label medications used for adults with ADHD include:

• Wellbutrin (bupropion) — generic only

• Effexor (venlafaxine) — generic only

• Tricyclic antidepressants (TCAs), such as nortriptyline and Norpramin (desipramine)

These medications might be helpful for some adults with ADHD, but they haven’t been shown to be as effective as more formal nonstimulant ADHD medications.

How do you know which nonstimulant ADHD medication is right for you or your child?

There isn’t a one-size-fits-all medication for ADHD. If you or your child needs something other than a stimulant, the best one will ultimately depend on the response to the medication.

Strattera is considered the most effective nonstimulant ADHD medication by pediatric clinical guidelines. But these guidelines came out before Qelbree was approved for use. And not everyone responds well to Strattera. One small study found that people who switched from Strattera to Qelbree had greater symptom improvement. But more research is needed to determine which medication is more effective overall.

If stimulants or other treatment options — such as Strattera — aren’t working for you, your healthcare professional may recommend trying another medication. They may even recommend combining two or more ADHD medications.

Keep in mind: Before switching to a different medication, it’s important to make sure that you or your child is taking your ADHD medication(s) as prescribed. Your healthcare team may suggest you try a larger dose — up to the maximum recommended and tolerated dose — before prescribing another medication. In some cases, you or your child may experience an intolerable side effect, which may also prompt a change in medication.

When are nonstimulant ADHD medications preferred over stimulants?

Stimulant medications are first-choice treatments for ADHD, generally speaking. The evidence for nonstimulant medications is good, but it’s not as strong as it is for stimulants.

But this isn’t always the case. Nonstimulant medications are ideal choices in a few situations. One is when the stimulant medications don’t work. Another is if you or your child has intolerable side effects from them.

Stimulant medications also have potential for dependence and misuse. Some people shy away from taking stimulants for this reason.

Treating ADHD symptoms without medication

ADHD treatment doesn’t include only medications. In fact, staying consistent with therapy and positive lifestyle changes can help you keep your symptoms well managed.

Here are some things that you and your child can do to help manage ADHD, with or without medication:

• Declutter your home to create a calm environment that’s optimized for focus.

• Get a planner and use it for your day-to-day tasks.

• Create daily routines to provide structure (e.g., morning routine, bedtime routine).

• Set reminders using your mobile phone to make sure you don’t miss tasks.

• Complete one task at a time. Multitasking can make you feel overwhelmed and lose focus.

• Ask your healthcare team about cognitive behavioral therapy.

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Written by:

Mandeep Sohal, PharmD

Mandeep Sohal, PharmD, is a licensed pharmacist in California with over 7 years of experience. In his career, he’s worked in specialty and community pharmacy, pharmacy benefit management, and pharmaceutical manufacturers.

Written by:

Jenna Clayton, PharmD

Jenna Clayton, PharmD, earned her doctorate from the University at Buffalo School of Pharmacy and Pharmaceutical Sciences. There, she gained experience in a variety of settings, including community, hospital, and long-term care.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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