ADHD Stimulant vs. Non-Stimulant Medications
ADHD Stimulant vs. Non-Stimulant Medications: Attention Deficit Hyperactivity Disorder (ADHD) medications come in two forms: stimulants and non-stimulants. They are used in combination of educational, behavioral and psychological interventions to treat ADHD. These medications work by helping the areas in the brain to control an individuals behaviors, increase attention and memory; and decrease hyperactivity and impulsive behaviors.
ADHD treatment is tailored to the unique needs of the family and child. This consists of parent and child education about diagnosis, treatment, individual and/or family counseling, behavior management techniques, school supports and the role of medication management. This article discusses the difference between ADHD Stimulant vs. Non-Stimulant Medications.
It is important to note that I am a mental health therapist and not a doctor. This information is provided to you as an overview of how medications are an effective tool in treating mental health with children and teens with mental illness.
ADHD Stimulant Medications
Stimulants are the most researched and most common prescribed medications to treat children and adolescents diagnosed with ADHD and depending on the prescription, effects can last 3-5 hours (short acting) or 8-12 hours (long-acting).
Stimulant Medications & Side Effects
Below is a list of ADHD Stimulant Medications provided by WebMD:
- Amphetamine (Adzenys XR ODT, Evekeo)
- Amphetamine/Dextroamphetamine (Adderall and Adderall XR)
- Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)
- Dexmethylphenidate (Focalin and Focalin XR)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (Concerta, Daytrana, Metadate CD and Metadate ER, Methylin and Methylin ER, Ritalin, Ritalin SR, Ritalin LA, Quillivant XR)
Most common side effects may include:
- Decrease in appetite
- Weight loss
- Headaches
- Anxiety
- Agitation and moodiness (higher risk for children under age of 9 and developmentally disabled individuals)
- Consult your pharmacist and/or physician for more information on side effects
**These medications do not treat any type of learned behavior or other types of learning problems.
Stimulant Medication Benefits
Children and teens demonstrate improvements in the following areas:
- Frustration tolerance
- Attention span
- Impulsivity
- Ability to Stop, Listen, Think, Respond vs React
- On-task behavior in structured environments
- Oppositional behaviors
- Handwriting and reading
- Retaining information
- Relationships with parents, siblings, peers, teachers and authorities
- Organizational skills
- Patience
- Academic performance
- Self Control
- Physical coordination
- Memory
Benefits:
- The most beneficial advantage that stimulants have over non-stimulants is that it is fast acting and you may see improvement in overall impulsivity and ADHD symptoms within two hours.
- Short acting meaning medications effectiveness stops working once an individual stops taking them
- Reduced side effects
- Minimized long term consequences
- Fewer behavioral and social problems
“Between 70–80 percent of children with ADHD respond positively to these medications. In some instances, the first medicine tried may not be the right one, or perhaps a higher dose may be needed. – The National Resource on ADHD
Non-Stimulant ADHD Medications
Stimulants may not be as effective as one would prefer for every individual. Non-stimulants can be used in conjunction with stimulants to boost the effectiveness. They can be used independently when the child or teen experiences side effects such as significant weight loss or other side effects of stimulants. They may also be preferred if an individual has a strong history of addiction. Non-stimulants improve overall concentration and impulse control, but must be taken daily and may take 3-6 weeks to notice effectiveness.
Stimulant Medications & Side Effects
Below are non-stimulants provided by WebMD:
- Atomoxetine (Strattera) was the first nonstimulant medication approved by the FDA for children, adolescents, and adults.
- Clonidine hydrochloride (Kapvay) has also been approved for use alone or in combination with a stimulant to boost the effectiveness.
- Guanfacine (Intuniv) is approved for children and teens between ages 6 and 17.
The most reported side effects:
- Fatigue
- Dizziness
- Rash
- Effect on blood pressure
- Please consult with your pharmacist and/or physician for more side effects.
Non-Stimulant Medication Benefits
Non-Stimulant medications show the same improvements as stimulants:
- Decrease ADHD symptoms especially with impulsivity and aggression
- Ability to treat tics in Tourette’s Disorder
- Fewer behavioral and social problems
- Recent research has shown that long-acting clonidine (Catapres) and guanfacine (Tenex), which are sometimes prescribed to reduce excessive hyperactivity or severe insomnia in children with ADHD, can also improve attention span in children with ADHD – National Resource on ADHD
Special Considerations for Children
Symptoms of mental health may be expressed differently in children than in teens or adults. For example: A child may show irritability rather than depressed mood or major depression. It is important to consider the child’s developmental stage to recognize if symptoms are of concern or appropriate.
- Children metabolize medications faster than adults due to greater functioning of their livers, kidneys and gastrointestinal tracks resulting in lower drug concentrations in their bodies.
- Medications may need to be adjusted or changed more frequently due to growth and development.
- Side effects of medications differ to adults.
- Most psychiatric medications have not undergone rigorous testing for FDA approval due to ethical concerns.
Questions to ask about Medications
It is highly recommended to advocate for your child when seeking psychiatric medications as a tool in aiding mental health issues. Below is an important list of questions to ask:
- What is the name of the medication and the generic names?
- Is the effectiveness of generic medication the same as name brand medications?
- What is the difference between generic medication and brand name medication?
- What is the medication used for?
- How long will it take before we begin to see improvement?
- Is the medication addictive?
- When does the medication need to be taken and should it be taken with food?
- What are the side effects I should be aware of?
- What should we do if we experience side effects?
- How long will my child need to take the medication?
- If we choose to stop taking medication, do we wean off or stop completely?
- Are there long term effects of taking the medication?
Some state laws may require your adolescents (16 and older) to consent to medication management. If your teen refuses, it is important for your prescribing physician and therapist to educate and discuss their willingness to try proposed medication.