It can take a lot of trial and error to find the proper medication for adults with ADHD. The best medication to treat adult ADHD is determined by a person’s genetics, history, and response to the drug.
The most common neurodevelopmental disorder that healthcare professionals diagnose is ADHD. The disorder can persist into adulthood; more people are diagnosed later in life.
This condition can make staying calm, organizing, focusing, and controlling impulses challenging.
Adults with ADHD can benefit from medication to help them manage their symptoms. They will be able to focus better, perform better at work, and have improved interactions with family and friends.
In the United States, eight million adults have ADHD. Less than 20% of these adults receive a diagnosis and treatment. Fewer than a quarter ask for help.
This article discusses adult ADHD and the best medication for adults with ADHD.
Adult ADHD medication
Most medications doctors prescribe to adults and children with ADHD are similar. A child with ADHD might need to take different medications as they age. The symptoms and their bodies may change as they age.
A doctor will take into account how ADHD is affecting a patient’s life to prescribe medication that suits their needs.
Find out how to determine if ADHD medications are working.
ADHD medications are divided into two main categories.
Stimulants, psychostimulants, or stimulants are the first treatment option for ADHD. They slow down the absorption in the brain of neurotransmitters such as dopamine and norepinephrine.
These chemicals are more readily available in the brain and can be used to improve communication between brain pathways. These drugs produce a rapid response. These drugs are controlled substances due to their habit-forming properties and possible misuse.
The following stimulants are commonly used to treat ADHD:
- methylphenidate (Concerta et al.)
- Amphetamine (Adderall and Adderall XR).
- Dextroamphetamine (Dexedrine, Dextrostat)
- lisdexamfetamine (Vyvanse)
Most stimulants have side effects that include:
- Lack of appetite
- Trouble sleeping
- Dry mouth
- stomach pain
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- weight loss
People should not take these medications with glaucoma or advanced arteriosclerosis. Those with moderate to severe hypertension and hyperthyroidism should also not take them. People who have taken monoamine oxidase inhibitors (MAOIs) in the past 14 days should avoid stimulant drugs.
When a patient has an adverse reaction to stimulant drugs or does not respond well to them, a doctor can prescribe non-stimulants.
If the patient has a history of severe heart problems, such as hypertension or cardiovascular disease, they may recommend non-stimulants.
Non-stimulants have less potential to be misused than stimulants. They are less effective than stimulants, and their onset is slower.
Non-stimulant medications commonly used for ADHD include
- atomoxetine (Strattera)
- guanfacine (Intuniv)
- clonidine (Kapvay)
- Bupropion (Wellbutrin) prescribed off-label to adults with ADHD
- viloxazine (Qelbree)
Find out more about the non-stimulant ADHD medication.
Types of medications
Here are the most common medications prescribed for ADHD in adults.
Adderall (dextroamphetamine, amphetamine)
Adderall combines dextroamphetamine with amphetamine. This central nervous (CNS) stimulant helps to improve concentration and reduces impulsivity.
There are two types of release: immediate release and extended-release. Standard doses range from 5-20 milligrams. This drug is taken by mouth once daily.
Adderall XR can be taken once or three times daily, but Adderall IR may only be taken one time per day. Adderall XR can last for up to 12 hours. Adderall IR’s effect lasts about 4-6 hours. Adderall is effective within 30 minutes up to an hour. However, its maximum effect can be felt within 1-3 hours.
Concerta is a stimulant. This drug is usually taken once daily, in the morning. The drug is available in 18 mg, 27 mg, 36mg, and 54mg, with a 12-hour-long effect.
Concerta has a longer-lasting effect than Adderall because it releases the drug more slowly. It is a new formulation that works in an hour and reaches peak levels after 6-10 hours.
Dexedrine, a stimulant, contains dextroamphetamine as its active ingredient. It is available in both short-acting as well as long-acting versions.
If you are prescribed Dexedrine short-acting, taking the medication two to three times a day at 4-6 hour intervals may be necessary. Those prescribed the long-acting version may only have to take it in the morning.
Dexedrine is similar to Adderall in that it takes only 30 minutes to kick in. The Dexedrine Spansule is long-acting and can last up to 12 hours.
Focalin is a brand name of dexmethylphenidate. This drug is available in IR or XR form.
A person may have to take two doses four hours apart for the IR. Focalin is taken in one dose, usually first thing in the morning. Focalin IR or XR has similar effects to Adderall.
Applesauce can be sprinkled on the inside of the capsule by people who have difficulty swallowing pills.
Concerta and Ritalin both contain the same active ingredient. The main difference between Ritalin and Concerta is that Ritalin has a shorter-acting drug released immediately into the body. Even the long-acting formula of Ritalin does not last as long as Concerta.
The drug can be useful for individuals who need immediate relief from symptoms. Ritalin should be taken two to three times per day. It is best to take it 30 to 45 minutes before meals.
Vyvanse is an amphetamine-based drug. Experts believe it reduces ADHD symptoms by restoring a balance of chemicals within the brain.
Healthcare professionals prescribe this stimulant medication to people with ADHD or binge eating disorder.
This drug is available in chewable tablets and capsules. This drug’s typical starting dose is 30mg, and the maximum is 70mg.
Strattera was the first medication that did not contain stimulants to be approved by the Food and Drug Administration to treat ADHD. It is an antidepressant called a selective norepinephrine reuptake inhibitor.
Strattera is usually taken once or twice daily, with or without eating. The safety profile is excellent, with reported side effects, including
In general, sleepiness and lack of appetite are mild.
Find out more about ADHD medications.
Adult ADHD medications that are off-label
Sometimes doctors may use drugs that are not on the label. The FDA has not approved these drugs for ADHD.
Antidepressants like tricyclic antidepressants, MAOIs and bupropion, and venlafaxine raise the norepinephrine levels in the brain. This has a positive impact on ADHD symptoms.
Many doctors prescribe antidepressants for people with ADHD who have anxiety, depression, or bipolar disorder.
Bupropion (Wellbutrin) is a norepinephrine-dopamine reuptake inhibitor antidepressant. It has been approved for conditions such as depression, seasonal affective disorder, and smoking cessation.
Adults usually take 100 mg three times a day. They may also take 150 mg once or twice daily if they take the sustained-release formulation. The maximum dosage is 450mg.
Venlafaxine, or Effexor (Venlafaxine), is an antidepressant doctors prescribe off-label for people with ADHD. It is a serotonin-norepinephrine reuptake inhibitor. Doctors prescribe it for conditions like:
- Post-traumatic Stress Disorder
- obsessive-compulsive disorder
- diabetic neuropathy
- Migraine prevention
Blood pressure medication
Experts believe they act on receptors in the prefrontal cortex and mimic norepinephrine. It improves inattention, impulsivity, and distractibility for those with ADHD. These drugs are only for children and adolescents. They do not treat ADHD in adults. The FDA approves both of these drugs for hypertension adults. Many doctors prescribe them for adults who have ADHD off-label.
These drugs can worsen depression in children and adolescents.
Depressive symptoms. These drugs can cause:
- Dry mouth