Medications for ADD
A number of medications have proven effective in treating Attention Deficit Disorder. The list below describes each one and explains briefly how it works. The medications are listed by their generic names with the brand names in parentheses.
Methylphenidate (Ritalin, Concerta, Methylin, Focalin) – One of the first medications
used to treat ADD. Methylphenidate is
in the class of medications called
“psychostimulants.” Why would a stimulant drug be helpful in ADD? It is
theorized that by making the brain more excited, stimulants paradoxically calm
people down. Part of the problem in ADD is that the individual’s environment
doesn’t stimulate their brain sufficiently, as it does in people without the
illness. As a result ADD-sufferers often feel bored and look for ways to feel more
excited – often by rapidly shifting their attention to something new,
engaging in thrill-seeking or being constantly on the move. By providing the missing
stimulation to the brain, these medicines help people calm down and stay
focused.
Dextroamphetamine (Adderall, Adderall XR, Dextrostat, Dexedrine) – This is another psychostimulant. Adderall is a combination of four different amphetamine molecules. Adderall XR is the extended release form of the drug. Whereas Adderall is usually taken twice or three times a day, Adderall XR only needs to be taken once a day. Both Methylphenidate (Ritalin) and Dextroamphetamine (Adderall) work equally well. For reasons that are not fully understood, sometimes one works when the other doesn’t. If you’ve tried one medication and have not seen your ADD symptoms get better, you shouldn’t conclude that these are not the right medications for you. It may just be that you haven’t found the right one yet or gotten on the right dose.
Bupropion (Wellbutrin) – Bupropion is an antidepressant that is also useful in ADD. Its effects are similar to the psychostimulants. However, most people find it somewhat less effective than these medications. The side-effects are also similar: occasional difficulty with sleep, decrease in appetite, potential for increased blood pressure.
Atomoxetine (Strattera) – Although this medication is marketed as effective for ADD, most patients and clinicians have been disappointed with its results. At best it can be beneficial to some patients when combined with psychostimulants, but it rarely offers much benefit alone. Its primary drawback is that it has an unpleasant side effect profile, leading many patients to discontinue use.
Modafinil (Provigil) - This drug was originally developed to help fighter pilots stay awake on long missions. It stimulates the part of the brain responsible for increasing wakefulness. Because it has this stimulating effect, it has been proposed as useful for ADD. Although some early research indicates that it may be helpful, experience has yet to demonstrate this conclusively. At this point use of Modafinil in ADD patients can only recommended on a case-by-case basis.
Clonidine (Catapres) – Clonidine is a medication used to treat high blood pressure. It acts primarily on norepinephrine, a neurotransmitter. One advantage of Clonidine as an ADD drug is that, unlike the psychostimulants, it can help people fall asleep. For this reason people with ADD sometimes use it for their evening ADD symptoms, since using Adderall or Ritalin later in the day can cause insomnia. Clonidine’s main side effect is a drop in blood pressure. This is usually not a problem at the doses ADD patients use it. However, it can occasionally lead to some lightheadedness.
Tricyclic antidepressants (Desipramine, Nortriptyline) – These are older antidepressants that also treat ADD symptoms. Because of their difficult side effects they are not used much any more. However, they may be good treatment options, especially when the person also has depression.
[About Nicholas Schwartz, M.D.] [What Makes ADD Worse?]
Dr. Schwartz does not accept gifts, contributions or sponsorship from the pharmaceutical industry.
© copyright 2006 Nicholas Schwartz, M.D.