ADD & ADHD Health Center

Nonstimulant Therapy and Other ADHD Drugs

While stimulants are usually the first choice of medications for ADHD, they’re not for everyone. In some people, they cause intolerable side effects; in others, they just don’t work very well. The good news is that other effective options for ADHD treatment are available.

Nonstimulant Therapy for ADHD

Three long-acting nonstimulants have been approved by the FDA for treating ADHD:

• Strattera was the first nonstimulant drug approved for ADHD. It’s now used in both children and adults.
• Intuniv is approved for ADHD in children ages 6 to 17.
• Kapvay is approved for ADHD in children ages 6 to 17.

How Do Nonstimulants for ADHD Work?

Strattera seems to increase the amount of norepinephrine, an important brain chemical. This increase appears to help ADHD by increasing attention span and reducing impulsive behavior and hyperactivity.

Intuniv and Kapvay have an effect on receptors in the brain. Studies show that they reduce distractibility and improve attention, working memory, and impulse control. Intuniv is an extended release medicine that contains the same active ingredient as Tenex, a drug that lowers blood pressure that has been used as an off-label ADHD treatment for years. Kapvay contains clonidine, the same active ingredients used in Catapres, a medication used to lower high blood pressure. 

Nonstimulants  have some advantages over many stimulants used for ADHD. For instance, nonstimulants:

• Don’t cause agitation or sleeplessness
• Are not controlled substances and don’t pose the same risk of abuse or addiction
• Have a longer-lasting and smoother effect than many stimulants, which can take effect and wear off abruptly

What Are the Side Effects of Nonstimulants?

Of course, nonstimulants do have some potential side effects of their own.

Strattera Side Effects. The most common side effects of Strattera are:

• Upset stomach
• Decreased appetite, which may cause weight loss
• Nausea
• Dizziness
• Fatigue
• Mood swings

Other, less common risks from Strattera include:

• Jaundice and liver problems. If you develop yellowing of the skin or whites of the eyes, contact your doctor right away.
  
• Suicidal thinking. There’s a possibility that Strattera - like many antidepressantdrugs - may slightly increase the risk of suicidal thinking in teenagers.
  
• Slowed growth in children. Your doctor will probably keep a close eye on your child’s height and weight.
  
• Priapism, or erections that last more than four hours.
  
• Serious allergic reactions. While rare, some people develop rashes, hives, or swelling.

Intuniv Side Effects include:

• Headache
• Fatigue
• Abdominal pain
• Sleepiness and sedation

Since Intuniv can cause drowsiness, make sure you know how it affects you before you try driving or operating heavy machinery.

Rarer and more serious side effects include:

• Low blood pressure
• Heart rhythm changes

Kapvay contains the same active ingredients seen in some types of blood pressure medications known as clonidine. 

Kapvay's common side effects include sleepiness, tiredness, trouble sleeping (insomnia), and nightmares. Side effects may also include symptoms of upper respiratory infection, such as:

• Cough
• Runny nose
• Sneezing
• Irritability
• Sore throat