Exploring Non-Stimulant Medications for ADD/ADHD in the US

ADHD / ADD

Stimulant medications like Ritalin and Adderall are often a doctor’s first choice for treating Attention Deficit Hyperactivity Disorder (ADHD). However, they aren’t always effective. In some patients, they can even cause notable side effects.

Stimulant medications like Ritalin and Adderall are often a doctor’s first choice for treating Attention Deficit Hyperactivity Disorder (ADHD).

However, they aren’t always effective. In some patients, they can even cause bad side effects.

Non-stimulants, antidepressants, and blood pressure medicines are the three most common alternatives.

In this guide, we’ll focus on the non-stimulant ADD/ADHD medications available in the US, the pros and cons of this treatment option, and more.

Let’s dive in.

Stimulant vs. Non-Stimulant Medications for ADHD

Stimulant medications improve the availability of dopamine and norepinephrine neurotransmitters in the brain.

These neurotransmitters improve communication between different parts of the brain, which in turn, helps reduce hyperactivity and impulsiveness.

However, since these medications contain methylphenidate or amphetamine, there’s a potential for abuse. The dosage and distribution are, therefore, carefully administered by USDA.

Non-stimulants don’t have these ingredients, which is why they can’t be used as a recreational drug. Although non-stimulants aren’t as effective as stimulant medications, they make a perfect alternative.

When Are Non-Stimulant ADHD Medications Prescribed?

Here are the most common scenarios where your healthcare provider may prescribe non-stimulant medications:

- Stimulants didn’t work

- Stimulants had bad side effects

- The patient has another disorder

- Non-stimulants can be used for added benefits

- The patient has a drug use history or at risk for drug abuse

Let’s discuss the best non-stimulant ADHD medications available in the US and their side effects.

Best Non-Stimulant ADHD Medicines Available in the US

Strattera

Strattera, which comes as an oral capsule, is one of the most common and effective non-stimulus ADHD medications out there. The ADHD medicine increases the activity of the neurotransmitter norepinephrine in your brain and has been known to improve symptoms like inattentiveness and hyperactivity.

The exact dosage of Strattera depends on the body weight of the patient. The dosage may increase depending on how the patient responds to the medication.

However, although it’s an effective medicine for ADHD, there are some side effects you should be aware of.

Adults may experience dry mouth, nausea, and constipation. Whereas, its side effects in children include decreased appetite and upset stomach.

Importantly, it’s important to keep an eye on the patient while they’re on Straterra as the medication can cause suicidal thoughts in adolescents and children.

Qelbree

Qelbree (viloxazine) is one of the latest names in the market. The ADHD medication can be taken as an oral capsule or sprinkled on food for easier consumption.

Children above the age of 6 years can safely take Qelbree. The dosage depends on the age of the patient. Children less than 12 years old usually start at a low dose of 100 mg daily.

Like Straterra, the use of Qelbee also comes with potential side effects. You may experience fatigue, headache, and insomnia if you’re an adult.

Decreased appetite, sleepiness, and nausea are common side effects in children.

Another similarity between Qelbree and Straterra is that both have a boxed warning for suicidal thoughts. The good thing is this side effect is very rare and can be effectively managed with a watchful eye.

Intuniv

Intuniv (guanfacine ER) is an orally administered tablet aimed at helping ADHD children aged between 6 and 17 years.

In cases where ADHD is relatively harder to treat, doctors often use Intuniv in combination with a stimulant.

Intuniv belongs to a different class than Qelbree and Strattera and works in its own way.

Like other ADHD medications, your healthcare professional will administer it in small doses in the beginning, gradually increasing it as the patient ages.

Side effects include dizziness and nausea. Low heart rate and blood pressure are a bit more concerning side effects of Intuniv. This is why the doctor will periodically monitor your blood pressure when you’re on this medicine.

Kapvay

Kapvay (clonidine ER) is another ADHD tablet that you can take with or without food. The medication is effective for ADHD in kids between 6 and 17 years of age.

The starting dose of Kapvay is usually once daily, which may increase to twice a day later in the treatment process.

Clonidine ER may induce the following side effects:

- Constipation

- Insomnia

- Sleepiness

However, like Intuniv, the more concerning side effects of Kapvay are low blood pressure and heart rate. When it’s time to stop, it’s crucial to reduce the dose gradually.

Off-label medications

Off-label medications aren’t officially approved by the FDA for the treatment of ADHD. However, doctors who are certified to treat conditions like anxiety and depression may prescribe these medicines.

Examples of off-label non-stimulant medications are Venlafaxine, Provigil, and Norpramin. It’s important to note that these haven’t been proven to be as effective for ADHD as the ones we discussed before.

Wellbutrin

Wellbutrin is a common off-label non-stimulant medication for ADHD. It reduces the reuptake of certain neurotransmitters in your brain. Studies, like this one, indicate that the medication helps alleviate the symptoms associated with ADHD.

However, for FDA approval, Wellbutrin may need more studies that can back its effectiveness.

The side effects of this off-label ADHD medicine are no different than its traditional counterparts.

For instance, it comes with a black box warning, meaning that it has the tendency to induce suicidal thoughts in adolescent patients. Plus, its use in patients with a seizure disorder history isn’t recommended.

Wellbutrin may also cause:

- Insomnia

- Increased heart rate

- Tremors

Effexor

Effexor (venlafaxine) is another off-label Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) used for treating ADHD symptoms.

It’s typically used for treating depression and anxiety but has also proved to be an effective medicine for ADHD.

Common side effects of Effexor include:

- Nausea

- Insomnia

- Headache

More serious ones are:

- Serotonin syndrome

- Potential for increased suicidal thoughts

Advantages of Choosing Non-Stimulants Over Stimulants

A major benefit of non-stimulant medications for ADHD is that, unlike stimulants, they’re non-addictive in nature.

In addition, non-stimulants are unlikely to cause sleeplessness, agitation, and lack of appetite.

Not only that, non-stimulants also tend to have a longer-lasting effect, which lasts about a complete day. Stimulants, on the other hand, are more abrupt, i.e., they affect and wear off relatively quickly.

Stimulants act fast. You’ll feel their effect almost right away. Non-stimulants are slow to work. They may take more than two weeks to start showing any significant results.

However, since non-stimulants are slow-acting, they’re generally easier to taper off. The quitting process is relatively lengthy to avoid withdrawal symptoms.

Side Effects of Non-Stimulants

We’ve discussed the common side effects of these medications. Some less common ones include:

1. Liver and jaundice problems. The most common sign of a liver problem is the yellowing of the white part of your eye.

1. Erections lasting over four hours.

1. Allergic reactions. This is a rare side effect, but the patient can get rashes or swelling.

In addition, some of these medications may cause drowsiness. Although rarely, patients may experience lowered blood pressure and heart rhythm changes.

Who Shouldn’t Take Non-Stimulant Medication?

You must talk to your doctor and tell them your medical history before starting any non-stimulant ADHD medication. Common scenarios where you shouldn’t take such medicines include:

- Diagnosis of glaucoma in the patient

- Use of an antidepressant

- The patient is allergic to any of the ingredients

- Existence of liver problems

Non-Stimulant ADHD Medications: FAQs

Let’s address some frequently asked questions about non-stimulant ADHD medications.

What are the New Non-Stimulant Drugs for ADHD?

The latest non-stimulant medication that got FDA approval for the treatment of ADHD is Qelbree. It’s in tablet form and is designed to be taken once a day. The medicine is approved for children above 6 years of age as well as adults.

What is the Safest Drug for ADHD?

Strattera and Qelbree are proven to be safe and effective for children, teenagers, and adults. The medications work by enhancing norepinephrine, an important neurochemical in our brain. The result is an increased attention span and decreased hyperactivity.

Are Non-Stimulants Better for ADHD?

Stimulants and non-stimulants are used for the same purpose, i.e., treating ADHD symptoms. However, the way they work is different. The response of every patient is different. Most patients find stimulants to be effective while others need non-stimulants.

What is the Safest ADHD Medication for a Child?

Atomoxetine (Strattera) and Viloxazine (Qelbree) are both suitable for children, teenagers, and adults. These non-stimulants work by increasing the amount of norepinephrine, an important neurochemical in the brain. These medications have proven to improve a child’s attention span and reduce impulsive behavior.

Conclusion

Stimulants are often a doctor’s preferred choice when it comes to treating ADHD symptoms. However, not all patients react well to them, so doctors must turn to non-stimulants.

In contrast to stimulants, they offer a longer-lasting relief and can’t be used as a recreational drug.

Common FDA-approved non-stimulant medicines available in the US are:

- Strattera

- Qelbree

- Intuniv

- Kapvay

Along with these medications, patients can include other options in their treatment plans, including self-help and therapy.