Fast Facts
- 50-65% of adults with ADHD will find significant symptom relief with medication. Another 20-30% will find that medication can substantially improve their symptoms (1)
- Research with children suggests that the combination of lower doses of medication plus behavior training, such as CBT, may be the most effective treatment (2)
- Research suggests that behavior modification becomes more likely when adults experience about a 50% diminishment of symptoms from their medication (3)
- Dosage and coverage across the day are at least as important as the type of medication used. See the effect size overview
- Finding the right medication is a matter of experimenting under a doctor's supervision.
- Never just use medication to manage ADHD. Research clearly indicates this results in sub-optimal treatment.
Overview and notes
An overview of medication options and how to optimize treatment can be found in our free treatment e-book on the home page.
The Mayo Clinic overviews of individual medications are the best resource to get informed about each medication. We include other resources as makes sense.
Finding the right medication dosage and hours of coverage, as well as type of medication, is extremely important. Expect the process of figuring out what works for you to take some time (sometimes as long as a year or more, depending upon how often you see your doctor and how you respond.). Dr. Dodson provides a short article on the 5 mistakes providers make when prescribing ADHD meds.
Those who seem to be resistant to medications, or who wish to speed up the process of locating the best medication may wish to consider genetic testing with a product such as Genecept Assay. This particular test looks at 18 genes that are relevant in psychiatric treatment for things such as dopamine uptake, and is administered with a cheek swab. More details are here.
Different treatments have different effect sizes. One reason doctor's often start with stimulant medications is that the effect size of stimulants properly dosed for a patient is, on average, higher than other options. More information about effect size here.
Crenshaw and Daughtery's book, ADD & Zombies as a really good overview of medication management, including specifics about how different meds work and what they are good for. Highly recommended reading for the layperson.
All medication options should be discussed with your doctor.
General
- Dr. Larry Silver provides a good overview of dosing and release mechanisms, as well as what different types of medications are most useful for, and how they work in the brain. He also talks about taking multiple drugs at the same time, in this article.
- Good overview of basic meds that are available in Canada (and the US) - their dosing, recommendations for how to use and how to increase dosage at treatment outset to find the right dose. From CADDRA, and updated in Jan, 2020.
Alpha Agonists (Kapvay, Intuniv, Clonidine, Tenex)
- Mayo Clinic overview - Clonidine (Kapvay)
- Mayo Clinic overview - Guafacine (Tenex, Intunive)
Amphetamines (stimulants - brand names Adderall, Vyvanse, Evekeo, Mydayis)
- Mayo Clinic overview - Adderall
- Mayo Clinic overview - Evekeo
- FDA overview - Mydayis and 8/28/17 press release on Mydayis
- Mayo Clinic overview - Vyvanse
Article: Vyvanse vs. Adderall: What to Know
Atomoxetine (brand name Strattera)
Beta Blockers
- Mayo Clinic overview of the drug class
- Some information on beta blockers is also in the general article by Dr. Silver, above
Bupropion (anti-depressant, brand names Wellbutrin, Zyban)
Methylphenidates (stimulants - brand names Daytrana, Ritalin, Concerta, Metadate )
- Mayo Clinic overview - Ritalin, (Metadate), Concerta
- Dr. Hallowell's response to NYTimes article Ritalin Gone Wrong
Modafinil (NuVigil, Provigil)
- Mayo Clinic overview - Provigil
- Mayo Clinic overview - NuVigil
Is something missing? Contact us here.
References
(1) Barkley, R., & Benton, C. (2010). Taking charge of adult ADHD. New York, NY: Guilford Press. p. 16
(2) Pelham, W. E. E. A. (n.d.). A dose-ranging study of behavioral and pharmacological treatment in social settings for children with ADHD. Journal of Abnormal Child Psychology. Epub ahead of print. Abstract obtained from The ADHD Report, 2014, 22(2), 12.
(3) Mason, O. (n.d.). When two meds are better than one: Combination medication management for ADHD [PowerPoint presentation]. Retrieved from http://www.attentionmd.com/. Presented at 2013 CHADD conference on 11/9/13. Symptom reduction studies cited specifically in presentation.
Last updated 3/28/17
