What’s the Difference Between Stimulant vs. Non Stimulant ADHD Meds?

Discover the key differences between stimulant and non-stimulant ADHD medications, including how they work, benefits, side effects, and which option might be best for you.

How do you treat ADHD?

If you have attention-deficit/hyperactivity disorder (ADHD)—or think you might—you’re not alone. ADHD is a common neurodevelopmental condition that can make it challenging to focus, manage impulses, and regulate energy levels. But ADHD is more than just being easily distracted or restless; the condition affects everyone living with ADHD differently.

The good news? Effective treatments are available to help you navigate daily life with more ease if you receive an ADHD diagnosis. Whether you’re considering ADHD medication for the first time or reevaluating your current treatment plan, working with a healthcare provider can help you find an approach that fits your unique needs.

Stimulant vs non stimulant ADHD medication

The two primary categories of ADHD medications are stimulants and non-stimulants. Both aim to enhance concentration, improve attentiveness, and reduce impulsivity, but one may be more suitable than the other, depending on the individual. Stimulants are generally considered the most effective treatment for ADHD symptoms and are often the first-line option.

The key differences between these medication types include their mechanisms of action, potential side effects, and interactions with other medications. Read on to learn more about the difference between these treatment options.

How stimulant medication works for ADHD

Stimulant ADHD medication increases the levels of neurotransmitters in the brain, including dopamine, norepinephrine, and serotonin. They also help prevent these chemicals from being degraded. Stimulants are the first-line medical treatment for ADHD but are typically not recommended for children under six years old before attempting behavioral therapy, or some other form of mental health intervention.

Common stimulant medications include:

• Ritalin (methylphenidate hydrochloride)
• Concerta (methylphenidate)
• Adderall (amphetamine/dextroamphetamine)
• Vyvanse (lisdexamfetamine)

Stimulants are effective in managing common adult ADHD symptoms like restlessness and hyperactivity. However, they are classified as controlled substances due to their potential for misuse. As a result, federal and state-controlled substance laws regulate their prescription, limiting the quantity that can be dispensed at one time. Some states also have restrictions on obtaining stimulant prescriptions via telehealth.

Side effects of stimulants

Common side effects of stimulants include:

• Appetite suppression
• Nausea/vomiting
• Insomnia/sleep disturbances
• Dry mouth
• Weight loss
• Potential for abuse

Rare but serious side effects of stimulants include cardiac side effects, serotonin syndrome, and stimulant overdose, which require emergency intervention.

How quickly do stimulants work?

Stimulants are available in short-acting (e.g., Adderall, Ritalin) and long-acting forms (e.g., Concerta, Adderall XR, Vyvanse). Research indicates that they take effect within an hour, with short-acting stimulants lasting 3 to 4 hours and long-acting stimulants lasting up to 10 hours.

How non-stimulant ADHD medication work

Non-stimulant medications include antidepressants and former antihypertensive drugs. These are often prescribed when stimulants are ineffective or unsuitable. They work by increasing neurotransmitter levels through reuptake inhibition.

Common non-stimulant medications include:

• Strattera (atomoxetine)
• Intuniv (guanfacine)
• Wellbutrin SR & XL (bupropion hydrochloride)

Side effects of non-stimulants

Common side effects include:

• Nausea/vomiting
• Headaches and dizziness
• Abdominal pain

Serious side effects include serotonin syndrome, particularly when combined with other antidepressants, and increased suicidal ideation in teens.

How quickly do non-stimulants work?

The onset of non-stimulant medication effectiveness varies as follows:

• Atomoxetine: may take several weeks to show full effects
• Bupropion: typically takes about a month to work

Benefits and risks of stimulant vs non-stimulant ADHD meds

Each ADHD medication option has its own advantages and potential risks, and the best choice depends on individual needs, medical history, and a doctor’s guidance. Below is a breakdown of the benefits and risks associated with both types of medications to help patients and caregivers make informed decisions in collaboration with a healthcare provider.

Benefits of stimulants

Clinical trials suggest that 70% of ADHD patients experience improved concentration and reduced distractibility with stimulant treatment. Children receiving stimulant therapy also show enhanced decision-making skills and academic performance.

Risks of stimulants

Severe risks include stimulant overdose, cardiac complications, and serotonin syndrome, particularly when combined with antidepressants. Symptoms such as rapid heart rate, sweating, tremors, and high blood pressure require immediate medical attention.

Benefits of non-stimulants

Unlike stimulants, non-stimulants are not controlled substances and do not pose a risk of abuse. They are a viable alternative for the 10-30% of ADHD patients who do not respond well to stimulants.

Risks of non-stimulants

Patients should be aware of serotonin syndrome risks when combining non-stimulants with other antidepressants. Additionally, children and teens should be closely monitored for suicidal thoughts during the first month of treatment, especially if managing other mental health conditions concurrently.

Stimulant vs. non-stimulant medication: which works best?

Choosing between stimulant and non-stimulant ADHD medications should be done in consultation with a healthcare provider. While stimulants are generally more effective for managing ADHD symptoms, a doctor may recommend non-stimulant options for individuals who experience intolerable side effects, have a history of substance abuse, or have medical conditions that contraindicate stimulant use. A healthcare professional can help assess individual needs and determine the most appropriate treatment plan.

Factors to consider when choosing non-stimulants over stimulants:

• Ineffectiveness of stimulant treatment
• Low risk of substance abuse
• Unmanageable side effects from stimulants (insomnia, anxiety, etc.) 
• Potential interactions with other medications

Questions to ask your doctor about ADHD medication

Before starting ADHD medication, patients should ask:

• How does this medication work?
• What are the common and serious side effects?
• How will these medications interact with other mental health treatments?
• What is the appropriate dosage and schedule?
• How long before I notice symptom improvement?

ADHD treatment is multifaceted, and medication efficacy varies by individual. A comprehensive treatment plan—including behavioral therapy—can enhance symptom management. Consulting with a healthcare provider can help determine whether stimulant or non-stimulant medication is the best option for treating ADHD symptoms.

How Charlie Health can help

If you or a loved one are struggling with choosing between stimulant vs non-stimulant ADHD meds, Charlie Health is here to help. Charlie Health’s Virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for dealing with serious mental health conditions, including ADHD, childhood trauma, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With treatment, managing ADHD is possible. Fill out the form below or give us a call to start healing today.