The first-line medication used to treat ADHD are mostly stimulants, which work by stimulating the areas of the brain responsible for focus, attention, and impulse control. The use of stimulants to treat a syndrome often characterized by hyperactivity is sometimes referred to as a paradoxical effect. The stimulants used include:
* Methylphenidate -- Available in:
o Regular formulation, sold as Ritalin, Metadate, Methylin. Duration: 4-6 hours per dose. Usually taken morning, lunchtime, and in some cases, afternoon.
o Long acting formulation, sold as Ritalin SR, Metadate ER. Duration: 8 hours per dose. Usually taken twice daily.
o All-day formulation, sold as Ritalin LA, Metadate CD, Concerta. Duration: 10-12 hours per dose. Usually taken once a day.
* Amphetamines --
o Dextroamphetamine -- Available in:
+ Regular formulation, sold as Dexedrine. Duration: 4-6 hours per dose. Usually taken 2-3 times daily.
+ Long-acting formulation, sold as Dexedrine Spansules. Duration: 8-12 hours per dose. Taken once a day. Also known as dexamphetamine in Australia.
o Adderall, a trade name for a mixture of dextroamphetamine and laevoamphetamine salts. -- Available in:
+ Regular formulation, Adderall. Duration: 4-6 hours a dose.
+ Long-acting formulation, Adderall XR. Duration: 12 hours. Taken once a day.
o Methamphetamine -- Available in:
+ Regular formulation, sold as Desoxyn by Ovation Pharmaceutical Company. Usually taken twice daily.
* Atomoxetine. A Selective Norepinephrine Reuptake Inhibitor (SNRI) introduced in 2002, it is the newest class of drug used to treat ADHD, and the first non-stimulant medication to be used as a first-line treatment for ADHD. Available in:
o Once daily formulation, sold by Eli Lilly and Company as Strattera. Duration: 24 hours per dose. Taken once a day.
Second-line medications include:
* benzphetamine -- a less powerful stimulant. Research on the effectiveness of this drug is not yet complete.
* Provigil/Alertec/modafinil -- Research on this drug is not yet complete.
* Cylert/Pemoline -- a stimulant used with great success until the late 1980s when it was discovered that this medication could cause liver damage. Although some physicians do continue to prescribe Cylert, it can no longer be considered a first-line medicine. In March 2005 the makers of Cylert announced that it would discontinue the medication's production.
* Clonidine -- Initially developed as a treatment for high blood pressure, low doses in evenings and/or afternoons are sometimes used in conjunction with stimulants to help with sleep and because Clonidine sometimes helps moderate impulsive and oppositional behavior and may reduce tics.article
Because most of the medications used to treat ADHD are Schedule II under the U.S. DEA schedule system, and are considered powerful stimulants with a potential for diversion and abuse, there is controversy surrounding prescribing these drugs for children and adolescents. However, research studying ADHD sufferers who either receive treatment with stimulants or go untreated has indicated that those treated with stimulants are in fact much less likely to abuse any substance than ADHD sufferers who are not treated with stimulants