Stimulant vs Non-Stimulant ADHD Medications

Attention-Deficit/Hyperactivity Disorder (ADHD)
Read Time: 5 Minutes
Written by:Dr. Muhammad Munir, MD

Published On: July 24, 2024

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: July 24, 2024

Updated On: July 24, 2024

Overview

Attention Deficit Hyperactivity Disorder (ADHD) is manageable through various therapies and medication. ADHD medications are broadly categorized into stimulants and non-stimulants, with no universal “best” option for everyone. When looking at stimulant vs non-stimulant ADHD medication, the effectiveness of each depends on multiple factors, including individual preferences.

Research shows that stimulants can effectively treat ADHD by altering the brain’s neurotransmitter levels to improve attention and focus. On the other hand, non-stimulant medications, which target different brain pathways, are also effective in treating ADHD but may require more time to produce noticeable results.

Understanding the mechanisms of ADHD medications (stimulants vs. non-stimulants) is crucial for choosing the most effective treatment that best suits your specific needs and symptoms. Continue reading to explore the distinctions and benefits of non-stimulant vs stimulant ADHD medication.

Understanding Stimulant ADHD Medications

Stimulant medications are often the first-line treatment for ADHD due to their significant impact on enhancing daily functionality and improving ADHD symptoms. Understanding how these medications operate, their advantages, and possible side effects is essential for making well-informed treatment decisions with your doctor or psychiatrist.

Types of stimulant medications for ADHD

The primary categories of stimulant ADHD medication include methylphenidate, such as Ritalin and Focalin, and amphetamines, like Adderall and Vyvanse. These medications are commonly prescribed to treat ADHD, as they increase dopamine and norepinephrine levels in the brain, leading to improved attention, focus, and self-regulation.

Benefits of stimulant medications 

Stimulant medications are highly effective in alleviating symptoms of ADHD for many individuals. They can quickly enhance focus and behavior, potentially boosting academic, professional, and social performance significantly when effective.

Side effects & risks of stimulant medications

Like any medication, there are side effects and potential risks to using stimulants for ADHD treatment. Common side effects of stimulant medications can include:

  • Insomnia
  • Decreased appetite
  • Increased heart rate
  • Increased anxiety
  • Mood swings

iconExpert Insight

“Watch your hydration, certain medications can potentiate the impact of stimulants. Discuss this with your doctor. Don’t drink energy drinks, high-caffeinated drinks, or 5-hour drinks with stimulants; it can cause cardiac rhythm issues and can be life-threatening.”
Psychiatrist, MD, DFAPA Muhammad Munir

Understanding Non-Stimulant ADHD Medications

Exploring non-stimulant ADHD medications is crucial, especially for individuals who experience unpleasant side effects or insufficient relief from stimulants. These alternatives manage symptoms through a unique mechanism—by modifying norepinephrine levels in the brain, they improve attention and reduce hyperactivity. Non-stimulants also target specific brain receptors to temper impulsivity and foster calmness, offering a distinct therapeutic approach.

Types of non-stimulant medications for ADHD

Non-stimulant medications for ADHD include Atomoxetine (Strattera), Guanfacine (Intuniv), and Clonidine (Kapvay). Atomoxetine works by preventing the reuptake of norepinephrine, maintaining higher levels in the brain, which helps increase attention and decrease impulsivity and hyperactivity. Guanfacine and Clonidine, both alpha-2 adrenergic agonists, are known to reduce impulsivity and hyperactivity, contributing to a calming effect.

iconExpert Insight

“Strattera, Qelbree, and Wellbutrin can be used as non-stimulants for ADHD symptoms. At times, we use Tenex, Gunafacine, and Clonidine for young children with ADHD.”
Psychiatrist, MD, DFAPA Muhammad Munir

Benefits of non-stimulant medications 

Non-stimulant ADHD medications offer several advantages, including a gradual improvement of symptoms and a reduced risk of abuse compared to stimulant drugs. These medications are particularly beneficial for individuals who may experience anxiety or sleep disturbances with stimulant medications. Offering up to 24-hour relief, non-stimulant medications can effectively manage symptoms that occur in the evening or early morning when the effects of stimulants have diminished.

iconExpert Insight

“Therapy, combined with medications, can address a lot of ADHD symptoms. Learning new behaviors, triggers, and routines can be life-changing and enhance the life of a person with ADHD. These tools impact functioning and outcomes improve.”
Psychiatrist, MD, DFAPA Muhammad Munir

Side effects & risks of non-stimulant medications

Similarly to stimulants, there are side effects and risks associated with non-stimulant ADHD medications. Some common side effects can include:

  • Fatigue
  • Stomach upset
  • Change in blood pressure
  • Change in heart rate
  • Mood change
  • Drowsiness
Key Differences Stimulants Non-Stimulants
Mechanism of action Increases dopamine and norepinephrine levels in the brain It varies – some alter norepinephrine levels by inhibiting reuptake; alpha-2 adrenergic agonists affect specific brain receptors
Benefits
  • Rapid onset
  • High efficacy
  • Well-studied
  • Lower risk of abuse or dependency
  • 24-hour symptom management
  • Fewer sleep disturbances
  • Gradual symptom improvement
  • Suitable with cardiovascular concerns
Onset of action Works within 30 – 60 minutes after taking Can take several days to weeks to see a noticeable impact
Duration
  • Immediate-release (IR) last 4 – 6 hours
  • Extended-release (ER) can last 8 – 12 hours
Can last up to 24 hours
When it’s used Usually first line of treatment Used when stimulants aren’t suitable due to efficacy or unpleasant side effects
Possible side effects
  • Insomnia
  • Loss of appetite
  • Increased heart rate
  • Increased anxiety
  • Mood swings
  • Fatigue
  • Stomach upset
  • Change in blood pressure
  • Change in heart rate
  • Drowsiness
  • Mood changes
Potential for abuse or misuse Significant potential for abuse and misuse; can cause euphoric effects at high doses and is classified as controlled substances that require monitoring Lower potential for abuse compared to stimulants; a safer option for anyone with a history of substance abuse

Are Stimulants or Non-Stimulants Better for ADHD?

When comparing the efficacy of ADHD medications stimulants vs non-stimulants, it’s important to understand that outcomes vary from person to person. What works for one person may not be effective at all for another. 

It is true that stimulants can be more effective at reducing symptoms quickly. Stimulant medication typically improves symptoms like inattention, hyperactivity, and impulsivity, with noticeable improvement often felt within 30 to 60 minutes. The quick onset of action is one of the main reasons why stimulants are generally the first line of treatment. 

With that said, non-stimulant medication can also be highly effective in ADHD management. It’s a viable option for many people who don’t respond to stimulants or who have unwanted side effects.

When stimulants vs non-stimulants might be preferred

  • Stimulants: These might be preferred for their rapid onset and high efficacy. They can be recommended when immediate relief is desired.
  • Non-stimulants: These might be chosen when stimulants aren’t suitable. People with a history of substance abuse, who also experience anxiety, or who have cardiovascular issues might not want to take stimulants. Non-stimulants can also be a good alternative for people who have severe side effects from stimulants.

Considerations for abuse and dependency

It’s worth pointing out again that stimulants have a higher potential for dependency and abuse. Their classification as a controlled substance means your doctor will carefully monitor your treatment plan to prevent misuse. If this is a concern for you, there are many alternatives to Adderall and popular stimulant medications.

Non-stimulants have a lower risk of abuse or dependency, which can make them a safe option for some people who want or need a less addictive form of treatment. Non-stimulants can be highly effective in treating ADHD, especially when coupled with talk therapy as part of a comprehensive treatment plan.

Choosing the Right Medication

When trying to decide between a stimulant or a non-stimulant treatment plan for ADHD symptoms, several factors should be considered. Key medication management considerations include:

Personal medical history:

  • History of substance abuse or addiction
  • Existing cardiovascular issues
  • Comorbid mental health conditions, like anxiety or depression

Side effect profile:

  • Tolerance to potential side effects
  • Tolerance to possible drowsiness
  • Concerns about blood pressure change with certain drugs

Lifestyle considerations:

  • Is there a need for 24-hour symptom management?
  • Is there a need for medication flexibility?
  • Is there a preference for immediate versus gradual symptom relief?

Response to previous medications:

  • Assess the effectiveness and side effects of past treatments
  • Discuss family history of medication response

Age and development stage:

  • Appropriateness of drug type for children, adolescents, and elderly
  • Impact on growth and development

Your healthcare provider will be essential in determining the right medication option and personalized treatment plan for you. They’ll be able to assess your medical history, monitor your treatment response, and adjust your dosage when and if needed. Regular consultations ensure that side effects do not outweigh the benefits of a drug and that an existing treatment plan remains aligned with the needs and goals for symptom improvement.

Get Comprehensive Treatment for ADHD Online

Wondering how to get ADHD medication? Personalized care plans and the convenience of online access can make getting help for ADHD easier and more effective than ever. Our online mental health platform offers accessible consultations for medication and therapy when, where, and how you need it. 

While we don’t prescribe stimulant medication, Talkspace can prescribe non-stimulant ADHD drugs if a psychiatrist determines that medication is  a beneficial addition to your treatment plan.

Interested in how to manage ADHD without medication? Talkspace offers a comprehensive approach to ADHD treatment, ensuring you get the support and plan you need to thrive in the best ways possible. Start online treatment for ADHD today with therapy and medication, if prescribed.

See References

Muhammad Munir

Dr. Muhammad Munir, MD, DFAPA, has over 20 years of clinical experience specializing in mood disorders, anxiety disorders, bipolar disorder, PTSD, panic disorder, and ADHD. Dr. Munir believes in “back to basics” the therapeutic alliance between the physician and patients. The hallmark of this alliance is the emphatic process whereby the patient is not only enabled, but educated and encouraged, to take an active role in their psychiatric care and wellbeing.

Effective and affordable mental health treatment

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