ADHD Prescription Drugs (cont.)
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
In this Article
- Overview of Adult ADHD
- For what conditions are ADHD medications used?
- What are the different types of ADHD drugs?
- What are the non-stimulating ADHD medications for adults?
- Are there differences among ADHD drugs?
- What are the side effects of ADHD drugs?
- What are the warnings/precautions when using ADHD drugs?
- ADHD medications for adults with anxiety
- ADHD medications for adults with high blood pressure
- What are the drug interactions of ADHD drugs?
- What are some examples of ADHD drugs?
What are the different types of ADHD drugs?
ADHD medications can generally be split into two categories: the stimulants and the non-stimulants. Stimulant drugs used for ADHD include various amphetamines and methylphenidates. Amphetamines and methylphenidates increase the levels of the neurotransmitters, dopamine and norepinephrine in the brain. Both drugs also inhibit monoamine oxidase (MAO), an enzyme that breaks down dopamine and norepinephrine.
Non-stimulant drugs such as Atomoxetine (Strattera) works by increasing levels of norepinephrine.
The tricyclic antidepressants and bupropion (Wellbutrin) are not FDA-approved for treatment of ADHD but are often used off-label. The tricyclic antidepressants affect levels of norepinephrine while bupropion affects levels of both norepinephrine and dopamine. Imipramine and desipramine are the most commonly used tricyclic antidepressants. However nortriptyline is also effective.
What are the non-stimulating ADHD medications for adults?
- Tricyclic antidepressants (imipramine, desipramine, nortriptyline)
- buproprion (Wellbutrin)
Are there differences among ADHD drugs?
Although just a handful of compounds specifically target ADHD, numerous dosage forms exist. The main variable between these is duration of action- that is, how long the drug works. Short-acting stimulant drugs usually last four to five hours and are usually taken two to three times a day. Long-acting versions are effective from six to eight or even 12 hours.
Atomoxetine has a 24-hour duration of action. It also differs from the stimulants in that it is not a potential drug of abuse and, therefore, not a controlled substance.
Selection of an ADHD medication selection depends on patient specific factors as well as drug side effects, interactions and existing conditions. However, stimulant medications have more evidence of use and are more effective than non-stimulants.
Stimulants have the fastest onset of effect, usually within 1 to 2 hours of an effective dose. If there is poor response to one stimulant, for instance methylphenidate, another stimulant such as dextroamphetamine may be tried.
Although non-stimulants are less effective than stimulants, they have no potential for abuse.
Atomoxetine has a slower onset of effect, about 2 to 4 weeks. However, the full effect may take 6 to 8 weeks to occur.
Guanfacine causes more sedation than stimulants and atomoxetine. Its duration of action is 18 hours.
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