Compare ADHD Drug Treatments & Side Effects

Written by WebMD Editorial Contributors

• ARTICLES ON ADHD MEDICATIONS SIDE EFFECTS
• Types of Short-Acting Stimulants and Side Effects
• Types of Intermediate and Long-Acting Stimulants and Side Effects
• Types of Non-Stimulant ADHD Medications and Side Effects
• Types of Antidepressant ADHD Medications and Side Effects
• ADHD Medicines and Safety
• Treatment for ADHD and Other Conditions
• More

• ADHD Medication Chart
• Long-Term Effects of Stimulants
• ADHD Stimulants and Your Weight
• ADHD and Exercise

Medication is an important part of your ADHD treatment. Doctors can choose from many types of drugs to control symptoms of the disorder.

You and your doctor will work together to figure out which medication is right for you, along with the ideal dose (amount) and schedule (how often or when you need to take it). It may take some time to find the best combination.

Medications may not work for all ADHD symptoms or affect everyone the same way. A combination of medication, therapy, behavior changes, and skills training is often the most effective treatment. This is called multimodal treatment.

The ones most widely used to treat ADHD include:

• Stimulants. This group of drugs has treated ADHD for several decades. These medicines might help you focus your thoughts and ignore distractions. Stimulant meds work for 70% to 80% of people. They’re used to treat moderate and severe ADHD. They may be helpful for children, teens, and adults who have a hard time at school, work, or home. Some stimulants are approved for use in children over age 3. Others are approved for children over age 6.
• Non-stimulants. In cases where stimulants don’t work or cause unpleasant side effects, non-stimulants might help. These medications can improve symptoms like concentration and impulse control.
• Antidepressants. People with ADHD often have depression, anxiety, and bipolar disorder too. They may take an antidepressant to control mental health issues or other conditions along with a stimulant for ADHD.

Side effects of short-acting stimulants include loss of appetite, weight loss, sleep problems, crankiness, and tics. You have to take them often.

The FDA has issued a warning about the risk of drug abuse with amphetamine stimulants. FDA safety advisers are also concerned that all amphetamine and methylphenidate stimulants used for ADHD may make heart and psychiatric problems more likely.

Side effects of these medications include loss of appetite, weight loss, sleep problems, crankiness, and tics. Long-acting medicines may have greater effects on appetite and sleep. The FDA warns about the risk of drug abuse with amphetamine stimulants. FDA safety advisers are also concerned that all amphetamine and methylphenidate stimulants used for ADHD may make heart and psychiatric problems more likely.

Non-stimulant medications usually take a while to start working. It could be several weeks before you feel the full effects. Also, they may not work as well as stimulants. Some non-stimulant medications may raise the risk of suicidal thoughts and death by suicide in teens. The FDA warns that anyone taking atomoxetine (Strattera) should be monitored for suicidal thoughts, especially during the first few weeks. Common side effects of these drugs include fatigue, upset stomach, dry mouth, and nausea. Your blood pressure often rises when you stop taking them.

Drug Name	Brand Name	Duration	Notes
Atomoxetine	Strattera	24 hours	Sleep problems, anxiety, fatigue, upset stomach, dizziness, dry mouth. Although rare, can cause liver damage. Higher risk of suicide in adults ages 18-24.
Clonidine	Catapres	4-6 hours	Fatigue, dizziness, dry mouth, crankiness, behavior problems, low blood pressure. Stopping this medicine suddenly can result in high blood pressure.
Clonidine	Catapres-TTS patch	Up to 7 days	Fatigue, dizziness, dry mouth, crankiness, behavior problems, low blood pressure. Stopping this medicine suddenly can result in high blood pressure.
Clonidine	Kapvay	12 hours	Fatigue, dizziness, dry mouth, crankiness, behavior problems, low blood pressure. Stopping this medicine suddenly can result in high blood pressure.
Guanfacine	Intuniv	24 hours	Fatigue, dizziness, dry mouth, crankiness, behavior problems, low blood pressure. Stopping this medicine suddenly can result in high blood pressure.
Guanfacine	Tenex	6-8 hours	Fatigue, dizziness, dry mouth, crankiness, behavior problems, low blood pressure. Stopping this medicine suddenly can result in high blood pressure.
Viloxazine	Qelbree	12 Hours	Tiredness, sleepiness, nausea, vomiting, sleeplessness, irritability, decreased appetite

These medications can be used off-label to treat ADHD symptoms. That means doctors can prescribe them even though they haven’t been approved by the FDA for use with ADHD, Side effects often include trouble sleeping, nausea, constipation, dry mouth, sweating, and changes in sex drive. The FDA has also warned about a connection between antidepressants and a higher risk of suicide in adults ages 18-24, especially in the first 1 or 2 months.

Drug Name	Brand Name	Duration	Notes
Bupropion	Wellbutrin	4-5 hours	Headaches. Although rare, may make you more likely to have seizures.
Bupropion	Wellbutrin SR	12 hours	Headaches. Although rare, may make you more likely to have seizures.
Bupropion	Wellbutrin XL	24 hours	Headaches. Although rare, may make you more likely to have seizures.
Desipramine	Norpramin	8-24 hours	Not recommended for children. Associated with rare cases of fatal heart problems.
Imipramine	Tofranil	8-24 hours	Anxiety, fatigue, upset stomach, dizziness, dry mouth, higher heart rate, risk of heart arrhythmias.
Nortriptyline	Aventyl, Pamelor	8-24 hours	Anxiety, fatigue, upset stomach, dizziness, dry mouth, higher heart rate, risk of heart arrhythmias.

Experts generally consider these medicines safe when they are monitored properly by a professional. Serious problems are rare. Discuss the risks and benefits of these drugs with your doctor.

Up to 80% of people with ADHD also have another mental health condition such as anxiety, depression, personality disorders, and substance use disorders. These issues and their treatment can affect ADHD, and vice versa. For example, some stimulant medications can make anxiety symptoms worse. But your doctor can often safely combine treatments for depression and ADHD. Your treatment plan will depend on your overall mental health.

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The 15 Best Exercises to Manage ADHD Symptoms

Written by Rachel Reiff Ellis

• Does Exercise Help ADHD?
• Types of Exercise You Can Do
• How to Keep at It

You may have heard that regular exercise can give your mood a boost. If you have ADHD, a workout does more than make you feel good. It can help control your symptoms, too.

Even a single session of moving your body can make you more motivated for mental tasks, increase your brainpower, give you energy, and help you feel less confused. It acts on your brain in a lot of the same ways as your ADHD medication.

To reap these rewards, though, you need to exercise the right way and the right amount. The key is to find an activity that fits your lifestyle and then stick with it.

Exercise isn’t just good for shedding fat and toning muscles. It can help keep the brain in better shape, too. When you exercise, your brain releases chemicals called neurotransmitters, including dopamine, which help with attention and clear thinking. People with ADHD often have less dopamine than usual in their brain.

Fitness can have the following benefits for adults with ADHD:

• Ease stress and anxiety.
• Improve impulse control and reduce compulsive behavior.
• Enhance working memory.
• Improve executive function. That’s the set of skills needed to plan, organize, and remember details.
• Increase levels of brain-derived neurotrophic factor. That’s a protein involved in learning and memory. It’s in short supply in people with ADHD.

The effects of exercise only last for so long, just like medicine. Think of your workout as a treatment “dose.” Aim for at least one 30- to 40-minute activity a day, 4 or 5 days a week.

The exercise you choose is up to you, but make sure it’s “moderately intense,” which means that during your workout:

• Your heart rate goes up
• You breathe harder and faster
• You sweat
• Your muscles feel tired

Talk to your doctor if you’re unsure how intense your exercise should be. They may recommend you use a heart rate monitor or some other device to make sure you get the most out of your workout.

1800x1200_treadmill_exercise_minibead

Exercise can help control your ADHD symptoms. Photo credit: Nd3000/Dreamstime

Aerobic exercise. This is anything that gets your heart pounding. You want to do something that raises your heart rate and keeps it there for a set amount of time, like half an hour to 40 minutes.

Aerobic exercise creates new pathways in your brain and floods it with the chemicals that help you pay attention.

You can try one of these:

• Running
• Walking briskly
• Biking
• Swimming laps

You can do these activities outdoors or indoors, but if you have a choice, go outside. Studies show that being in nature while you move can reduce your ADHD symptoms even more than when you exercise inside.

Martial arts. Experts say the more complex your exercise is, the better for your brain. Sports like karate, taekwondo, jiujitsu, and judo focus on self-control and bringing together your mind and body.

When you do martial arts, you get training in skills like:

• Focus and concentration
• Balance
• Timing
• Memory
• Consequences of actions
• Fine motor skills

Other complex exercises. If martial arts isn’t your thing, other physical activities that challenge your mind and body are:

• Rock climbing
• Dance
• Gymnastics
• Yoga

Strength training. If you’re only just starting out with exercise, go for aerobic activities like walking or jogging at first. After you’ve been at it for a while, add in some strength work for variety. Try exercises like:

• Lunges
• Squats
• Pushups
• Pullups
• Weightlifting

Team sports. If you join a softball or soccer league, it may be just the thing to get you up and moving several times a week. Organized sports have all the benefits of physical exercise with the added bonus of a social group to motivate you.

Teamwork hones your communication skills and helps you think through your actions and plan ahead. Being part of a team can also improve your self-esteem.

Just like medicine, exercise only helps you treat ADHD if you keep it up. But if you have problems with your attention span, how do you stay the course? Try these tips:

Keep it interesting. Switch up the type of exercise. You can stay out of a rut if you change your activity every day or week.

Find a partner. A workout buddy can help you stay on track and help pass the time while you sweat.

Move in the morning. If it fits in your schedule, exercise first thing in the morning before you take your medication. That way, you’ll get the most benefit from all the extra mood-boosting chemicals in your body.

Maintain meds. Exercise can give you a huge leg up on your ADHD symptoms, but it doesn’t replace your medication. Don’t stop your other treatments unless your doctor says it’s OK.

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Is methylphenidate an effective treatment for children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and does it cause unwanted effects?

Basic provisions

– Methylphenidate may reduce hyperactivity and impulsivity and help children concentrate. Methylphenidate may also help improve the overall behavior and quality of life of children with ADHD.

Methylphenidate does not appear to increase the risk of serious (life-threatening) adverse effects when used for up to six months. However, it is associated with an increased risk of non-serious adverse effects such as sleep problems and decreased appetite.

– Future studies should be more focused on reporting adverse effects and should be conducted over longer periods of time.

What is Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is one of the most commonly diagnosed and treated childhood psychiatric disorders. Children with ADHD have difficulty concentrating. They are often hyperactive (fidgety, unable to sit still for long periods of time) and impulsive (do things without stopping to think). ADHD can make it difficult for children to do well in school because they have difficulty following instructions and concentrating. Their behavioral problems can prevent them from getting along well with family and friends, and they often get into more trouble than other children.

How is ADHD treated?

Methylphenidate (eg Ritalin) is the most commonly prescribed drug for children and adolescents with ADHD. Methylphenidate is a stimulant that helps increase the activity of certain areas of the brain, such as those associated with concentration. Methylphenidate can be taken as a tablet or applied to the skin as a patch. Its dosage form can be formulated to act immediately or act slowly over several hours. Methylphenidate may cause unwanted effects such as headaches, stomach pain, and sleep problems. Sometimes it causes serious unwanted effects such as heart problems, hallucinations, or “tics” (twitches) of the face.

What did we want to find out?

We wanted to find out whether methylphenidate improves children’s ADHD symptoms (attention, hyperactivity), based primarily on teachers’ ratings on various scales, and whether it causes serious adverse effects such as death, hospitalization, or disability. We were also interested in less serious adverse effects such as sleep problems and loss of appetite, as well as its impact on children’s overall behavior and quality of life.

What have we done?

We searched for studies investigating the use of methylphenidate in children and adolescents with ADHD. Study participants had to be 18 years of age or younger and have a diagnosis of ADHD. They may have had other disorders or diseases, they may have taken other medications, or they may have received behavioral therapy. They were supposed to have a normal IQ (intelligence quotient). Most of the trials compared methylphenidate to a placebo, a pacifier that looks and tastes like methylphenidate but does not contain the active ingredient. Participants were to be randomly selected to receive or not receive methylphenidate. We compared and summarized the results of these studies, and assessed our confidence in the evidence, based on factors such as study methods and study size.

What did we find?

We found 212 studies involving 16,302 children or adolescents with ADHD. Most studies have compared methylphenidate with placebo. Most of the studies were small and included about 70 children with an average age of 10 years (age ranged from 3 to 18 years). Most studies were short, averaging about a month; the shortest study lasted only one day, and the longest 425 days. Most of the research has been done in the USA.

Based on teacher ratings compared to placebo or no treatment, methylphenidate:

– may reduce ADHD symptoms (21 studies, 1728 children)

– may not cause serious adverse effects (26 studies, 3673 participants)

– may cause more non-serious adverse effects (35 studies, 5342 participants)

– may improve general behavior (7 studies, 792 participants)

– may not affect quality of life (4 studies, 608 participants)

Limitations of evidence

Our confidence in the evidence is limited for several reasons. Often, the people who participated in the studies might have known what treatment the children were taking, which could affect the results. In many studies, the results were not fully reported, and for some outcomes, the results varied between studies. The studies were small and used different scales to measure symptoms. In addition, most of the studies have only lasted for a short period of time, which makes it impossible to assess the long-term effects of methylphenidate. About 41% of the research was wholly or partly funded by the pharmaceutical industry.

How relevant is this evidence?

This is an update of a 2015 survey. The evidence is current to March 2022.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

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Translation notes:

Translation: Airat Usmanovich Ziganshina. Editing: Ziganshina Lilia Evgenievna. Russian translation project coordination: Cochrane Russia – Cochrane Russia on the basis of the Russian Medical Academy of Continuing Professional Education (RMANPE). For questions related to this transfer, please contact: [email protected]

How to treat ADHD – Attention Deficit Hyperactivity Disorder?

Read the first part of the article (on diagnosing ADHD) here.

Passionate controversy accompanies the use of drugs. In the United States, stimulants are used to treat the symptoms of ADHD, the most common of which is Ritalin (methylphenidad). Their use is sharply criticized by some experts, the public, the World Health Organization expresses concern about them, but a number of medical agencies insist on the effectiveness and safety of stimulants.

Studies confirming the effectiveness of stimulants and counter-work demonstrating inefficiencies, harmful side effects, and the risk of cocaine addiction in adolescence in children who have taken stimulants for a long time could be devoted to a separate article.

Both in the West and in Russia, antipsychotic drugs (Sonapax, Neuleptil, Rispolept, Abilify, Seroquel) are widely used to reduce hyperactivity and excitability of a child. Meanwhile, studies show that these drugs reduce the volume of brain tissue, not to mention such side effects as weight gain, increased blood cholesterol levels, increased blood pressure, the development of diabetes, tremors, up to tardive dyskinesia.

In the UK, the right to prescribe antipsychotics is given not only to narrow specialists, but also to pediatricians. In 2011, the British found that over the past 10 years the number of children taking these drugs has doubled, and among them there are many who are barely 5 years old.

This made a strong impression on the government, which decided to allocate 32 million pounds to expand mental health services for children and adolescents.

As mentioned in the first part of the article, it is very important to conduct a medical examination of a child with ADHD. In some cases, by taking control of physical problems, it is possible to reduce the symptoms of hyperactivity and impaired attention. For example, this happens when the normal blood supply to the brain is restored after the correction of birth injuries of the cervical spine.

In Russia, to improve brain metabolism, increase cortical tone, children with ADHD are often prescribed nootropic drugs (piracetam, encephabol, akatinol memantine, glycine, phenibut). We often hear from doctors that they observe a positive effect of drugs in their practice, but their effectiveness has not been clinically proven.

The image of a child with an unnamed diagnosis of ADHD – inattentive in class, poorly in time, unorganized in everyday life – is often used to advertise multivitamins. I drank the Alphabet and immediately mastered the alphabet and other academic knowledge and skills. In fact, it is unlikely that multivitamins will produce just such an effect. This does not exclude the possibility that a number of specific nutrients may have a positive effect on ADHD symptoms.

There are studies (like this one) that show a lack of omega-3 fatty acids in children and adolescents with ADHD, as well as a positive effect of taking them (like this). The best source of omega-3 fatty acids is fish oil, which is beneficial in many ways and has no harmful side effects, except for individual intolerance.

Photo courtesy of huffingtonpost.com

In this French study, 40 children with symptoms of ADHD were given vitamin B6 (0.6 mg per 1 kg of body weight) and magnesium (6 mg per 1 kg of body weight) daily for 8 weeks. The study participants significantly decreased hyperactivity and aggressiveness, and improved attention. Children in the control group who took placebo showed no such changes. A few weeks after the end of the course, the symptoms of ADHD in children from the experimental group resumed, which also indicates that the improvements were provided precisely by the intake of B6 and magnesium.

For a child and adolescent with ADHD, dietary patterns are important. Some parents are very happy with the effects of a gluten-free/casein-free diet (eliminating the protein gluten found in wheat, rye and a number of other grains, and casein found in milk), which is often recommended for children with autism who share some of the common symptoms of ADHD. (Mercy published a detailed article on the gluten-free diet). Others praise the sugar-free diet (excluding polysaccharides, that is, sucrose and starches), which is also called the specific carbohydrate diet or paleo diet in Russian-language sources, and SCD, GAPS, Paleo Diet in English-language sources.

A recent meta-analysis by Danish scientists suggests that elimination diets that eliminate certain foods that provoke hyperactivity, impulsivity, and inattention gave the best results in ADHD. By the way, the same study also revealed the usefulness of fish oil for children with ADHD.

Experts advise parents to identify foods to which a child may have an individual intolerance. To do this, you need to rotate products, alternately removing them from the diet for a week or two, observing the severity of ADHD symptoms and evaluating the result.

Dr. Richard Sogn, a child psychiatrist and one of America’s leading experts on ADHD, believes that whatever is good for the brain is good for children with ADHD. First of all, their diet should be rich in protein in the form of meat, eggs, nuts, cheese, legumes. He advises to give these products to the child for breakfast, and also as a snack between lessons.

Carbohydrates are necessary, but in the form of vegetables and fruits, but sugar, sweets, flour products, rice and potatoes should be eliminated or severely limited. It is important to include fish and other sources of omega-3 fatty acids such as walnuts, Brazil nuts, olive oil, and canola oil in your diet.

The American Academy of Pediatrics recommends avoiding foods with preservatives and artificial food coloring in children with ADHD, and some experts believe that all food additives should be avoided.

The most important method of treating ADHD is behavioral therapy: for children, this is primarily Applied Behavior Analysis (ABA), for adolescents and young people – Cognitive Behavioral Therapy.

Applied Behavior Analysis is considered the gold standard in behavioral intervention for autistic children in the US and the UK, but is also being applied to children with ADHD.

In Russia, this method appeared not so long ago and mainly due to the efforts of parents-activists with the continuing resistance of domestic defectology and correctional pedagogy, who declared this therapy to be training. Such an opinion can only be formed with a very superficial acquaintance with this technique. In fact, it is based on a careful analysis of the child’s behavior, allowing to identify his strengths and weaknesses and create a carefully structured behavior modification program based on the encouragement of the desired behavior of the child.

Unfortunately, it is almost impossible to find a competent behavioral analyst and therapist outside the capital, but many parents complete distance courses, participate in conferences, seminars and webinars in order to learn the basics of therapy and help their child on their own. (You can learn more about this in the group “Autism Problem Center”).

There are also home behavioral strategies that experts recommend parents use :

• Daily routine is very important for a child with ADHD. Make it up and make sure your child follows it.
• Organize the space so that all the items the child needs (clothes, toys, school supplies) have a strictly defined place. This will allow the child to lose them less often.
• Avoid distractions, especially when the child is doing homework. Be sure to turn off the radio and TV during this time.
• Give the child a choice, but reduce the number of choices to make it easier. Offer a choice of two options for clothing, food, toys, so as not to create sensory and emotional overload.
• When you remind your child of the need to fulfill a particular duty, try to keep all explanations and instructions short and clear. If possible, avoid both persuasion and the threat of punishment.