While stimulants such as methylphenidate and amphetamines are commonly prescribed for ADHD, non-stimulant medications are an effective alternative treatment approach.

Non-stimulants are good options for individuals who do not respond well to stimulants or experience intolerable side effects, or those with concurring mental health conditions.

Strattera (Atomoxetine):

Strattera is a selective norepinephrine reuptake inhibitor (SNRI) approved by the FDA for the treatment of ADHD in children, adolescents, and adults. Research has shown that Strattera is effective in reducing symptoms of inattention, hyperactivity, and impulsivity in individuals with ADHD.

A meta-analysis published in the Journal of Clinical Psychiatry found that Strattera significantly improved ADHD symptoms compared to placebo. Additionally, Strattera may have a lower risk of abuse and dependence compared to stimulant medications, making it a preferred option for individuals with a history of substance abuse or addiction.

Wellbutrin (Bupropion):

Wellbutrin is an antidepressant medication that is used off-label for the treatment of ADHD, particularly in adults. Bupropion works by inhibiting the reuptake of dopamine and norepinephrine in the brain, leading to improvements in mood and attention.

A systematic review published in Biological Psychiatry in 2005 analyzed multiple studies investigating Wellbutrin SR in adults with ADHD. The review concluded that Wellbutrin SR was associated with significant improvements in ADHD symptoms compared to placebo, as measured by standardized rating scales.

Additionally, individual studies published in the same journal in 2005 found similar results, with adults receiving Wellbutrin SR showing greater reductions in ADHD symptom severity scores compared to those receiving a placebo.

Wellbutrin is a good option for individuals who cannot tolerate or do not respond well to stimulants, as well as those with comorbid mood disorders.

Quelbree (Viloxazine Hydrochloride):

Quelbree is a recently approved non-stimulant medication for ADHD in pediatric patients aged 6 to 17 years. Viloxazine hydrochloride, the active ingredient in Quelbree, is a selective norepinephrine reuptake inhibitor (NRI) with a dual mechanism of action involving both noradrenergic and serotonergic systems.

Clinical trials have demonstrated the efficacy of Quelbree in reducing symptoms of ADHD in children and adolescents. A randomized controlled trial published in the Journal of Child and Adolescent Psychopharmacology found that Quelbree significantly improved ADHD symptoms compared to placebo, with a mean reduction of 7.6 points on the ADHD Rating Scale-5 (ADHD-RS-5) total score. Quelbree has a favorable side effect profile compared to stimulant medications, with lower rates of insomnia, appetite suppression, and cardiovascular effects.

Guanfacine (Intuniv) and Clonidine (Kapvay):

Guanfacine and clonidine are alpha-2 adrenergic agonists that have been FDA-approved for the treatment of ADHD in children, either as monotherapy or as adjunctive therapy to stimulants. These medications work by modulating noradrenergic activity in the prefrontal cortex, improving attention and impulse control.

A meta-analysis published in Pediatrics found that Guanfacine and clonidine significantly improved ADHD symptoms compared to placebo, with moderate effect sizes observed for both medications. Guanfacine and clonidine have less insomnia, appetite suppression, and incidence of tics compared with stimulants.

Amantadine:

Amantadine is a medication that has been used effectively off-label for the treatment of ADHD, particularly in individuals with comorbid mood disorders.

A randomized controlled trial published in the Journal of the American Academy of Child and Adolescent Psychiatry found that amantadine significantly improved ADHD symptoms compared to placebo in children with comorbid tic disorders.

Amantadine may also be preferable over stimulant medications in individuals with tic disorders or stimulant-induced dyskinesias.