Choosing ADHD Medication: A Guide for Adults and Children

If you’re new to the world of attention-deficit hyperactivity disorder (ADHD) medications, the choices can be mind-boggling. Should you opt for a stimulant medication or a non-stimulant? And how do you navigate all the different brands and formulations? Here, we’ll walk through your options. This way, you’ll know what to consider along the way. 

What is ADHD medication?

Medication is one of the main treatments for ADHD. Though medication isn’t an ADHD cure, it’s effective and even life-changing for many people. It can help you pay attention and stay focused, and be less hyperactive and impulsive. It can also help you stay organized and have more self-control.

For most adults with ADHD, treatment with a stimulant medication is generally the first step. For children, the best ADHD treatment typically involves a combination of behavioral therapy, school interventions, and, if necessary, medication. 

How do ADHD meds work?

Different ADHD medications work in different ways. Most of them help certain chemical messengers in your brain function more effectively — especially dopamine and norepinephrine. These chemical messengers affect your ability to pay attention, concentrate, and stay focused.

Types of ADHD medications for children and adults

When it comes to prescription medications for ADHD, the options for children and adults are pretty similar. But there are some important differences. Let’s take a closer look. 

1. Stimulant medications for ADHD

Stimulants are the most common prescription medications for ADHD in both children and adults. They work well, act fast, and have been used safely for many decades. As mentioned above, researchers think they work by boosting levels of dopamine and norepinephrine –– the chemicals that fuel messaging within different parts of your brain and body.

There are two types of stimulants for ADHD:

• Methylphenidate 

• Amphetamine

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Methylphenidate and amphetamine come in different forms, including short-acting and long-acting versions. There’s no difference in how well short-acting and long-acting stimulants work to treat ADHD. Both are suitable for children and adults. The choice boils down to when you prefer taking your dose, whether you can swallow ADHD pills, and the cost. 

Here are some of the options currently available. 

Short-acting stimulants belong to an older category of medication. They have a great safety record and are available in generic formulations, which means they’re usually cheaper. They start working in less than 1 hour. But because they’re short-acting, they typically need to be taken 2 to 3 times a day for an around-the-clock effect. As a result, their effects can sometimes wear off between doses. 

On the other hand, long-acting stimulants are only taken once a day and don’t have a wearing off effect. Like the short-acting stimulants, they start working in under 1 hour. But their side effects can last throughout the day, and they tend to be more expensive since fewer generics are available. 

2. Non-stimulant medications for ADHD

Non-stimulant ADHD meds are less effective at treating symptoms. They also take several weeks to start working, compared to under 1 hour for most stimulants. But they’re an option for people who have a medical reason not to take stimulants — like a risk or history of substance abuse — or those who prefer not to. They can also be an option if stimulants haven’t worked or if they make other symptoms worse, like tics or anxiety.

Types of non-stimulant medications for ADHD include:

• Atomoxetine (Strattera)

• Viloxazine (Qelbree)

• Guanfacine ER (Intuniv)

• Clonidine ER (Kapvay)

• Bupropion (Wellbutrin)

• Nortriptyline (Pamelor)

These medications all work in different ways. But just like stimulants, most seem to affect neurotransmitter activity on some level, especially norepinephrine. 

In terms of non-stimulant medications, ADHD specialists recommend using atomoxetine as a first-choice medication for both children and adults. Second-choice options include guanfacine or clonidine for children, and bupropion or nortriptyline for adults.

What are the side effects and risks of ADHD medication?

All medications have side effects and risks. It’s important to weigh the potential benefit against the potential risks. This calculation is different for each individual’s unique situation. 

When it comes to ADHD medications, the side effects and risks to consider will also depend on whether you’re taking a stimulant or a non-stimulant. 

It’s also good to know that stimulant medications are controlled substances, which means they come with extra warnings and precautions. This includes a risk for dependence (more on this below).

Stimulant side effects

Common side effects of both methylphenidate and amphetamines include: 

• Nervousness

• Headaches

• Changes in sex drive

• Muscle tightness or cramps

• Dry mouth

• Diarrhea

• Nausea

• Weight loss

These medications can cause other side effects, too. But many times, side effects are mild, settle quickly, and can be managed with small adjustments to doses or dosage schedules.

Stimulant medications can also have more serious side effects. Make sure to read the package information that comes with your prescription, so you know what to watch for — and when to talk to your prescriber. 

Keep in mind: Stimulants have been linked to heart problems in some people. Because of this, your prescriber might look for underlying heart problems before you start the medication. They might also check your blood pressure and heart rate regularly to make sure everything is okay. 

Non-stimulant side effects (atomoxetine)

Side effects of non-stimulant ADHD medications vary depending on the drug. That’s because these medications all work slightly differently. 

The most common side effects of atomoxetine include: 

• Nausea

• Dry mouth

• Low appetite

• Sleep problems

• Headache

• Stomach pain

• Tiredness

Other serious but rare side effects of atomoxetine include:

• Liver toxicity

• A serious risk of sudden cardiac death in children and adolescents, and heart attack in adults

• Increased risk of suicide and suicidal thoughts in children and adolescents

Because of the risk of cardiac death and heart attacks, you should be tested for heart problems before taking atomoxetine. Children and teens should also be closely monitored for changes in behavior or suicidal thoughts, especially in the first 4 to 5 months of treatment and after any dose increases.

What other treatments can be helpful for ADHD?

For some people with ADHD, non-medication treatments can also help. Options include:

• Diet changes

• Exercise

• Natural supplements

• Acupuncture

• Meditation and mindfulness

• Behavioral therapy

• Skills training

If you’re interested in alternatives to medication, talk to a healthcare professional to learn more. In some cases, these strategies are enough to keep ADHD symptoms under control. Other times, they’re used along with medication. 

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Written by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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