ADHD, or attention deficit hyperactivity disorder, is characterized by inattention, hyperactivity, and impulsivity that often starts in childhood. Apart from behavior therapy, medications are used to manage the symptoms of ADHD. They are described below.
Stimulants: They enhance arousal in the prefrontal cortex of the brain. They include methylphenidate (Ritalin, Methylin, Concerta, Focalin) and amphetamines (Adderall, Evekeo, Dexedrine, Vyvanse). The active ingredient in Vyvanse is lisdexamfetamine, while Adderall contains a combination of amphetamine and dextroamphetamine. These drugs increase the concentration of dopamine and norepinephrine in the synaptic cleft in the brain. Methylphenidate is available in various forms, such as tablets, solutions, chewables, suspension, extended-release tablets and orally disintegrating tablets, etc. Adverse effects of stimulants include decreased appetite, nausea, weight loss, sleep disturbances, headache, tics, increased heart rate and blood pressure, irritability, seizures, psychosis, euphoria, mania, and depression. Stimulants have high abuse potential and are classified as DEA Schedule II drugs. Stimulants are contraindicated with MAOIs and in glaucoma. Caution should be used while prescribing in patients with cardiovascular disease, hyperthyroidism, and hypertension.
Non-stimulants: They include atomoxetine (Strattera), clonidine (Catapres, Onyda), and guanfacine (Intuniv). Atomoxetine is a norepinephrine reuptake inhibitor, which causes increased concentrations of norepinephrine and dopamine in the prefrontal cortex. Clonidine and guanfacine are alpha 2 agonists. Adverse effects include suicidal tendency (Strattera), decreased appetite, nausea, vomiting, diarrhea, fatigue, mood swings, dizziness, insomnia, liver damage, and prolongation of QT interval. They do not have abuse potential.