Explore Non-stimulant ADHD medications like Strattera, Intuniv, Qelbree, and Kapvay. Learn their benefits, side effects, and when they are preferred over stimulants.

Non-stimulant ADHD Medications

Attention-deficit/hyperactivity disorder (ADHD) is a mental disorder particularly among children (affecting approximately 7 million US children aged 3 to 17). It also affects adolescents and adults. ADHD is difficulty paying attention, hyperactivity, or impulsivity.

Some medications are used to help manage ADHD symptoms. These include:

• Stimulants
• Non-stimulants

Stimulants are controlled substances and are most effective in reducing ADHD symptoms. However, stimulants are not always the best option for everyone. If the child does not respond well to the stimulant treatment or experiences side effects, a non-stimulant may be a better option for ADHD medications.

Your healthcare provider will guide you in selecting the most appropriate medications. It is important to consult with your doctor to understand the benefits and side effects. Book your online appointment at Therapy Fleet to discuss your medication options.

What Are Non-stimulant ADHD Medications?

Life with ADHD is like operating a computer with dozens of applications running simultaneously, each demanding attention and focus. Consequently, it makes it difficult to concentrate on a task at hand. Approximately 6 in 10 children with ADHD struggle with moderate to severe symptoms.

Non-stimulant medications for ADHD are prescription drugs that boost communication between brain cells. They activate the prefrontal cortex (the part of the brain responsible for decision-making, emotions, and attention). Unlike stimulant medications, non-stimulant medications are not controlled substances, and people are less likely to become dependent on them.

Non-stimulants are a second-line treatment when people don’t respond well to the stimulants or cause side effects. 

There are some non-stimulant medications used for children with ADHD and coexisting conditions. Your child may take longer to feel the effect because non-stimulants take longer to start working. The FDA has approved a non-stimulant medication. Some of the common non-stimulant medications are:

Most Common Non-stimulant ADHD Medications

Atomoxetine (Strattera)

Atomoxetine (Strattera) is one of the most commonly prescribed FDA-approved medications. Many studies have shown that Atomoxetine may be an effective non-stimulant alternative for reducing ADHD symptoms. Atomoxetine (Strattera) is available in capsule and liquid form (Liquid form is not widely available). It is taken orally. Atomoxetine (Strattera) belongs to a class of selective norepinephrine reuptake inhibitors (NRIs). Atomoxetine may take a few weeks to work.

Off-label Uses

Off-label uses of Atomoxetine are:

• ADHD in adults with co-occurring partially responsive major depressive disorder (MDD)
• Neurogenic orthostatic hypotension

Possible Side Effects of Atomoxetine (Strattera)

• Nausea
• Decrease appetite
• Fatigue
• headache
• Insomnia
• Constipation
• Stomach pain
• Sweating
• Decreased sex drive

Severe side effects may include

• Faintness
• Shortness of breath
• Rash
• Dark urine
• Numbness of an arm or a leg
• Chest pain

Talk to your doctor about the risks of using Atomoxetine for your child, alternative treatment options, and the possible outcomes of not treating the condition.

Guanfacine (Intuniv)

Guanfacine (Intuniv) is a non-stimulant and not a controlled substance. It is available in tablet and capsule form. Guanfacine is FDA-approved and belongs to the class of medications known as central alpha 2A adrenergic receptor agonists. Guanfacine was developed for high blood pressure treatment, but it is also used for children with ADHD. For children or adults who struggle with restlessness or have difficulty concentrating for a long time, guanfacine may help improve focus and increase attention. 

Off-Label Uses

Off-label uses of Guanfacine (Intuniv) are Tic disorder or Tourette syndrome, anxiety disorder, PTSD, traumatic brain injury, pervasive developmental disorders, substance use disorder, and sleep disorder.

Possible Side Effects of Guanfacine

• Dry mouth
• Nausea
• Stomach pain
• Loss of appetite
• Constipation
• Irritability
• Decrease sexual ability
• Headache
• Tiredness

Severe side effects may include:

• Itching or Rash
• Fainting
• Slow heartbeat
• Breathing problem
• Joint pain
• Blurred vision
• Hallucinations

Talk to your doctor about the risks of using Guanfacine for your child, alternative treatment options, and the possible outcomes of not treating the condition.

Viloxazine (Qelbree)

Viloxaine (Qelbree) is an FDA-approved non-stimulant medication used to treat ADHD in children and adolescents aged 6-17 years. It belongs to a class of drugs known as selective norepinephrine reuptake inhibitors. Veloxazine (Qelbree) works by increasing the levels of norepinephrine in the brain by inhibiting its reuptake. It is available by prescription only.

• Qelbree has a box warning of suicidal thoughts (Like Strattera)

Off-Label Uses

• Depression
• Narcolepsy (sleeping disorder)
• Alcohol dependence

Possible Side Effects of Viloxaine (Qelbree)

• Loss of appetite
• Tiredness
• Nausea
• Headache
• Insomnia

Serious side effects may be:

• Severe allergic reaction
• Suicidal thoughts
• Increased heart rate
• Extreme tiredness
• Manic episode

Talk to your doctor about the risks of using Viloxazine (Qelbree) for your child, alternative treatment options, and the possible outcomes of not treating the condition.

Clonidine (Kapvay)

Clonidine (Kapvay) is a commonly used non-stimulant medication for ADHD (age 6 to 17). It is an alpha agonist. The immediate release is mainly used for high blood pressure. Clonidine is an FDA-approved medication that helps to improve focus and reduce impulsivity. It can be used alone or with the stimulant medications.

Off-Label Uses

Off-label uses of Clonidine (Kapvay) are Anxiety, Tics associated with Tourette syndrome, Insomnia, Management of withdrawal symptoms, Restless leg syndrome, and migraine prophylaxis.

Possible Side Effects of Clonidine (Kapvay)

• Headache
• Fatigue
• Nausea
• Constipation
• Abdominal pain
• Diarrhea
• Sedation
• Sexual dysfunction
• Hypotension

Serious side effects include:

• Depression
• Hypersenstivity
• Fainting (rare)
• Allergic reaction
• Difficulty swallowing or breathing

Talk to your doctor about the risks of using Clonidine (Kapvay) for your child, alternative treatment options, and the possible outcomes of not treating the condition.

Benefits of Non-stimulant Medications

• Non-stimulant medications are helpful for children, adolescents, and adults who experience side effects from stimulant medications.
• They have a low risk of abuse, as they are not classified as controlled substances. This makes them a safer option for individuals with a history of addiction or substance abuse.
• Non-stimulant medications provide a sustained effect throughout the day, offering more consistent control.
• Non-stimulant medications may help to manage co-morbid conditions such as anxiety, sleep issues, Tics, or Tourette’s syndrome.
• Non-stimulant medications may be a better choice for those who do not respond well to the stimulants, experience severe side effects, or are sensitive to stimulant medications.

When Are Non-stimulants Preferred Over Stimulants?

Stimulant medications are often considered as first-line treatment due to proven efficacy for ADHD. There are some circumstances when non-stimulant medications may be a preferred option.

The main reason is that when a person experiences significant side effects from stimulant medications,non-stimulants may be a suitable alternative. They are not controlled substances and have a low risk of abuse.

In some cases, a combination of stimulants and non-stimulants is prescribed for better results. A study on combined medications found that a combination of stimulants and non-stimulants may offer benefits, but are less commonly prescribed. Further research is needed to understand the efficacy of combined (stimulants and non-stimulants) medications.

How Do You Know Which Non-stimulant Medication Is Right for You?

Choosing the most suitable non-stimulant medication requires collaboration with your doctor, as Individual responses can vary. Your doctor may consider several important factors, such as:

• Medical history
• Previous treatment
• Overall health profile
• Co-existing conditions (mental or physical)

Together, you and your doctor can determine the right option through 

• Comprehensive clinical evaluation
• Consideration of your needs and concerns
• Monitoring of side effects
• Adjustment based on your response to the treatment

Conclusion

Non-stimulant medications offer a valuable alternative for treating Attention-Deficit/Hyperactivity Disorder, especially when stimulant medications pose a risk of abuse or are not well tolerated.  Choosing the most suitable non-stimulant medication involves comprehensive evaluation, close collaboration, and ongoing monitoring to ensure safety and effectiveness. 

If you or your loved ones are exploring non-stimulant treatment options for ADHD, consider reaching out to qualified mental health practitioners.

At Therapy Fleet, our experienced professionals provide thorough assessments and personalized care to help you make informed decisions about ADHD treatment. Book your online consultation today and get expert guidance you can trust.

Medical Disclaimer:

At Therapy Fleet, we strive to enhance the quality of life for those dealing with mental health issues. Our licensed medical professionals meticulously research, edit, and review all content before publication. Nonetheless, this information should not replace professional medical advice, diagnosis, or treatment. For medical guidance, please consult your physician or reach out to Therapy Fleet’s qualified staff.

Behind the restlessness and distraction is a brain trying hard to keep up; it deserves understanding, not judgment.

FAQs

1. What is the new non-stimulant medication?

Qelbree is a relatively new non-stimulant medication. It is used to treat ADHD and is FDA-approved for children in 2021 and adults in 2022.

2. Is therapy still needed if I am on non-stimulant medication?

Yes, Therapy continues to play an important role in the effective treatment of ADHD.

3. Do non-stimulant adhd medications cause withdrawal symptoms?

Yes, some non-stimulant medications can cause withdrawal symptoms if suddenly stopped. For example, abruptly stopping medications like clonidine can raise blood pressure or cause other issues. It is always important to consult a healthcare provider before stopping any medication. 

Sources

• https://www.psychiatry.org/patients-families/adhd/what-is-adhd#
• https://www.cdc.gov/adhd/data/index.html
• https://www.healthychildren.org/English/health-issues/conditions/adhd/Pages/Non-Stimulant-Medications-Available-for-ADHD-Treatment.aspx
• https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/21-411_Strattera.cfm#
• https://www.ncbi.nlm.nih.gov/books/NBK493234/
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021411s004s012s013s015s021lbl.pdf
• https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/022037s009lbl.pdf
• https://pmc.ncbi.nlm.nih.gov/articles/PMC3733520/

Additional Sources

• https://www.therapyfleet.com/strattera-vs-adderall/
• https://www.therapyfleet.com/adhd-meds-how-to-get-rid-of-adderall-tongue/
• https://www.therapyfleet.com/qelbree-for-adhd-side-effects-dosage-and-interactions/
• https://www.therapyfleet.com/efficacy-of-clonidine-for-anxiety-disorders/
• https://www.therapyfleet.com/adhd/
• https://www.therapyfleet.com/ssri-vs-snri-how-to-get-an-online-prescription-for-anxiety/
• https://www.therapyfleet.com/adhd-mood-swings-in-adults-and-children/
• https://www.therapyfleet.com/which-is-the-best-adhd-medication-for-adults-with-anxiety/
• https://www.therapyfleet.com/ptsd/
• https://www.therapyfleet.com/anxiety/
• https://www.therapyfleet.com/insomnia/