The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
The Food and Drug Administration (FDA) has directed all manufacturers of ADHD drugs to notify patients about a slight increased risk of cardiovascular and psychiatric side effects. There have been reports of sudden death in patients with underlying serious heart problems and reports of
stroke
and
heart attack
in adults with certain risk factors.
Recent research, though, has not shown a clear link between stimulants and sudden death, heart attack, and stroke. There is a slight increased risk (about 1 per 1,000) for psychiatric side effects, such as hallucinations, paranoia, and mania, even in patients without previous psychiatric problems.
The stimulants that are the focus of the labeling are:
-
Amphetamine
(Adderall, Adderall XR)
-
Methylphenidate
(Concerta)
-
Methamphetamine
(Desoxyn)
-
Detroamphetamine
(Dexedrine)
-
Dexmethylphenidate
(Focalin, Focalin XR)
-
Methylphenidate
(Metadate CD, Ritalin, Ritalin SR, Ritalin LA)
-
Lisdexamfetamine
(Vyvanse)
-
Atomoxetine
(Strattera)
Because of the concern of serious heart problems, the American Heart Association suggests that children have an
electrocardiogram
(ECG) before starting stimulant medication for ADHD.
Talk to your doctor about these warnings before you take the medication.
Common names include:
-
Methylphenidate
(Ritalin, Concerta, Metadate)
-
Dextroamphetamine
(Dexedrine, Adderall)
-
Amphetamine
(Adderall)
- Methylphenidate patch (Daytrana Transdermal System)
-
Lisdexamfetamine
(Vyvanse)—This medication can be used to treat children aged 6-12 years and adults.
-
Dexmethylphenidate
(Focalin, Focalin XR)
Stimulants are the most common treatment for ADHD. These drugs increase activity in parts of the brain that appear to be underactive in children with ADHD. When used properly to treat ADHD, they produce a calming effect that promotes concentration, rather than a stimulating effect. However, they also have the potential to become addictive. Your child’s doctor will prescribe the lowest effective dose, monitor the response closely, and stop treatment occasionally to determine the need for on-going treatment.
Common side effects of stimulants include:
- Insomnia
- Stomach ache
- Headache
- Reduced appetite
- Irritability
- Rage
- Confusion
- Shakiness
- Hallucinations
- Seizures
- Possible decrease in growth rate
There are numerous kinds of antidepressants, and new ones appear frequently. Common names include:
-
Bupropion
(Wellbutrin)
-
Doxepin
(Sinequan)
-
Protriptyline
(Vivactil)
-
Fluoxetine
(Prozac)
-
Sertraline
(Zoloft)
-
Amitriptyline
(Elavil)
-
Imipramine
(Tofranil)
-
Desipramine
(Norpramin)
All of these drugs prevent the inactivation of natural chemical stimulants in the body, either norepinephrine (noradrenalin) or serotonin. Most of these drugs act on both chemicals, but some act mainly or exclusively on only one. All are used to treat depression.
Common side effects include:
- Dry mouth
- Dizziness
- Sedation
- Insomnia
- Sweating
- Nausea
- Weight gain
- Constipation
- Urine retention
- Blurred vision
- Mental changes
Side effects of
bupropion
include:
- Weight loss
- Agitation
- Anxiety
- Seizures
- Dry mouth
- Insomnia
Atomoxetine
is not a stimulant but prevents the inactivation of norepinephrine.
Note:
There have been a small number of reports of severe liver injury associated with atomoxetine, which reversed after stopping the drug. Atomoxetine should be discontinued in patients who exhibit
jaundice
or laboratory evidence of liver injury.
Common side effects include:
- Decreased appetite
- Nausea
- Vomiting
- Fatigue
- Weight loss
- Slowed growth rate
- Mild increase in blood pressure and heart rate
Modafinil
is a drug that is used to promote wakefulness in
narcolepsy, a neurological condition. It has also been somewhat effective in patients with ADHD.
Common side effects include:
- Insomnia
- Abdominal pain
- Decreased appetite
- Cough
- Fever
- Runny nose
- Headache
Clonidine
acts in the brain to stimulate certain areas, but not others, in a fashion similar to the stimulants. It is also used to treat
Tourette syndrome. Morning dosing increases the sedative effect; bedtime dosing minimizes it. It is also available in a patch that provides a steady dose for a week at a time.
Clonidine is relatively safe except in patients with certain forms of heart and circulatory disease.
Possible side effects include:
- Dry mouth
- Sleepiness
- Dizziness
- Constipation
- Stomach upset
- Mental changes
Guanfacine
(Intuniv), which is also used to treat
high blood pressure, seems to help with attention and impulsivity problems.
Guanfacine is available as an extended-release formulation, which only has to be taken once a day (usually at bedtime). The medicine should not be taken with a meal that is high in fat. The tablets should be swallowed whole (not chewed, broken, or crushed).
It may take two weeks before the medicine produces positive effects. Never take guanfacine with other preparations that contain the same drug.
Possible side effects include:
- Headache
- Dizziness
- Lightheadedness, sleepiness, blurred vision, change in the ability to think clearly
- Constipation
- Dry mouth
- Sexual problems