Non-Stimulant Medications for ADHD

Adderall and Ritalin are proven medications for managing attention deficit in adults.

Unfortunately, these two drugs — both stimulants — can also amp up blood pressure, which can be extremely hazardous for many adults who are already at risk from hypertension.

Several non-stimulant meds are available for adult ADHD. Atomoxetine (generic Stratera) is specifically intended for ADHD and is extremely affordable. Guanfacine and Clonidine are anti-hypertension meds that help some adults with hyperactivity and (less so) with attention deficit. Buproprion (generic Wellbutrin) is an anti-depressant that helps some adults with hyperactivity and attention deficit.

Here is a nice summary article from WebMD: Nonstimulant Therapy and Other ADHD Drugs

Toolkit: Biochemical/Pharmaceutical

A partial list of biochemical tools to manage ADHD:

  1. Diet (more protein and complex carbs, less sugar and simple carbs)
  2. Caffeine, carefully dosed (not too much, not too little; not too early, not too late)
  3. Eating schedule (tuned for your body)
  4. ADHD pharmaceuticals: stimulants (e.g. adderall, ritalin, Vyvanse, Concerta) and non-stimulants (e.g., Intuniv)
  5. non-ADHD pharmaceuticals that may also help ADHD: e.g., imipramine (Tofranil), buproprion, or armodafinil (Nuvigil)(
  6. non-pharmaceuticals that may help ADHD: e.g., fish oil, ginkgo biloba, and others

More to come…

Steering first. Gas second.

“If I have a clear set of tasks to do, a big cup of coffee in the morning is a great productivity-enhancer. I get straight to work and stay focused for hours. But if I don’t have a clear set of tasks in mind before I have the coffee, I’m just wired and rudderless.”
— Anonymous Reader

There’s often an order to doing things. We ADHDexecs have spent many years ignoring the steps and sometimes that’s fine. But sometimes we really need to know the 1, 2, 3…

Assembling “a clear set of tasks” can be hard if you’re working on a big, complex project. In fact, it’s impossible to write your whole list of tasks! So break it down. A day’s worth if you can do it. Or a half-day’s worth. Or half-hour‘s worth. Whatever you can do — as long as it’s steering first, gas second.


ADHD and Depression, Anxiety, etc.

Depression, anxiety, and other conditions often accompany ADHD in adults.

If you have ADHD, consider screening for common co-morbid traits.

Some statistics:

ADHD occurs in 3% to 5% of the US population. The risk for comorbidity is high, and the presence of comorbid disorders warrants special consideration in the treatment of patients with ADHD. For example, a comorbid diagnosis of ADHD and depression occurs in approximately 20% to 30% of patients, and ADHD and anxiety in more than 25% of patients.

from What Are Common Comorbidities in ADHD (Psychiatric Times); Julie Sherman, PhD and Jay Tarnow, MD (July 26, 2013)


It estimated the prevalence of ADHD to be 4.4% in 18- to 44-year-olds. Comorbidity rates were significantly elevated in this group compared to adults without ADHD. Respective rates were: mood disorders 38 and 11% (p < 0.05); anxiety disorders, 47 and 19% (p < 0.05); SUD, 15 and 6% (p <0.05), and intermittent explosive disorder, 29 and 6% (p < 0.05). Among the mood and anxiety disorders, all the individual component disorders were significantly elevated in the ADHD adults. Not so in the case of SUDs – only drug dependence was significantly higher in the adults with ADHD (4.4 vs. 0.6%, p < 0.05). There were no significant differences in alcohol abuse, alcohol dependence, and drug abuse.

from Attention-Deficit Hyperactivity Disorder (ADHD) in Adults. Key Issues in Mental Health; Rachel G. Klein, ed. (2010)

Take Your Assistant to Therapy

I brought my assistant to a few of my psychiatric appointments so she could share her observations about how I work.

My psychiatrist and I both learned some new things about me, like:

  • I cheat at the reward game (“You can have a snack after you finish Task X”. Apparently I’m really good at redefining Task X midstream.).
  • If I’m successful on one day, the next day can be harder.
  • Etc.

In sum: the experience was shocking, useful, and highly recommended.