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

Adderall + Thomas Jefferson =

“When Ben Franklin gives you some of his Adderall and you write the whole Declaration of Independence in one night.”

Source: adapted from a joke found on the internet. The original joke-writer said the Adderall was from John Locke but that would be anachronistic. Jefferson drafted the Declaration in 1776; John Locke died in 1704.

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.