Treatments for ADHD/ADD in adults may include therapy and/or taking one or more types of medication. The information on this page is strictly about the different medications employed in the treatment of ADHD.
ADHD medication affects neurotransmitters, along with their pathways and receptors, in the human body and brain. A neurotransmitter is a chemical that transmits impulses from nerve cells to other nerve cells, gland cells, or muscle cells.
Some of the more important neurotransmitters include:
The neurotransmitters dopamine and norepinephrine, along with their pathways and receptors, are the main neurotransmitters associated with ADHD. Other neurotransmitters that may be involved include serotonin, glutamate, acetylcholine, GABA.
Dysfunction related to dopamine, as well as its neural pathways and receptors, is thought to have a major influence on matters related to focus and inattention. Dopamine and noradrenaline are thought to be primarily responsible for influencing impulsivity.
Most drugs for treating ADHD affect dopamine. They can increase the release of dopamine, bind to and triggering dopamine receptors, or inhibit the reuptake of dopamine. They may also affect other neurotransmitters, especially norepinephrine.
Medications that primary influence the focus and concentration aspects of ADHD may also aid in reducing the distractive or negative thinking that ADHD patients often experience.
The main method of action of most of these medications is increasing dopamine and/or norepinephrine receptor activity in the bodies of individuals who take them for the treatment of the disease.
The most well known medications for the treatment of attention deficit hyperactivity disorder are marketed under brand names like adderall and ritalin.
--- Amphetamines ---
Amphetamines are a group of central nervous system stimulant drugs that include methamphetamine and amphetamine. Amphetamine is equal parts levoamphetamine and dextroamphetamine (also utilized separately as ADHD drugs).
Amphetamines increase dopamine, norepinephrine, serotonin, monoamine levels that the human body can utilize. Brand names that amphetamines are sold under to treat ADHD include:
Amphetamines can improve attention, reduce impulsiveness and hyperactivity. They can reduce depression and calm people that experience physical hyperactivity. They are more effective than other drugs at increasing energy for people experiencing low levels.
--- Methylphenidate ---
Methylphenidate is a generic name for a central nervous system (cns) stimulant that is often employed in the treatment of ADHD. Methylphenidate is a dopamine reuptake inhibitor and a norepinephrine reuptake inhibitor.
After taking a dose, the amount of dopamine and norepinephrine available to the human body increases. Methylphenidate is marketed under brand names that include:
Methylphenidate can improve attention, reduce impulsiveness and hyperactivity. For some it can reduce depression. Methylphenidate can increase energy for people with low levels or calm people that experience physical hyperactivity.
--- Atomoxetine ---
Atomoxetine is a generic name for a monoamine reuptake inhibitor that primarily affects norepinephrine. The main benefit of atomoxetine in the treatment of ADHD is to improve attention, at the same time it can also reduce hyperactivity.
Atomoxetine inhibits norepinephrine, serotonin, dopamine transporters, and results in larger amounts of these neurotransmitters. In a majority of cases it does not act as a stimulant or sedative. It is marketed under brand names that include:
Atomoxetine is not as effective, for some patients, as some other ADHD treatments. It might not be as effective for treating problems related to focus, but be more effective at treating emotional problems and reducing hyperactive symptoms.
--- Clonidine ---
Clonidine is a generic name for a medication that is most commonly prescribed to treat people with high blood pressure. Clonidine is a centrally acting alpha-2 adrenergic receptor agonist.
Neurotransmitters like norepinephrine (aka noradrenaline) and epinephrine (aka adrenaline) signal through the alpha-2 adrenergic receptor. Clonidine is marketed under brand names that include:
For ADHD patients clonidine can be effective at treating distractibility, hyperactivity, impulsiveness. Clonidine has sedative properties and can reduce energy. It reduces blood pressure and sudden discontinuation can result in high blood pressure.
--- Guanfacine ---
Guanfacine is a generic name for a medication that is prescribed to treat people with ADHD, anxiety, high blood pressure, tics. It is a selective alpha-2A adrenergic receptor agonist that is mainly associated with norepinephrine (noradrenaline).
When compared to stimulants like adderall and ritalin, guanfacine can be more effective at treating the emotional component of ADHD. As a treatment for ADHD, guanfacine is marketed under brand names that include:
Guanfacine can be effective with ADHD patients as a treatment for hyperactivity, and those with Tourette's. It may also help with problems related to aggression, behavior, memory. However, its sedative properties that can reduce energy.
Other ADHD Medications For Adults
--- Adrafinil ---
Adrafinil is a prodrug of modafinil (listed below). This means the human body converts adrafinil to modafinil. Because of this adrafinil takes more time to work and has to be taken in larger doses than modafinil.
Adrafinil produces medical effects that are similar to modafinil and is also a dopamine reuptake inhibitor. After taking a dose, the amount of dopamine available to the human body increases. It is not currently marketed under any brand names.
Adrafinil improves attention, reduces impulsiveness and hyperactivity. At the same time it can also reduce depression and increase energy, making the patient feel better mentally and physically.
--- Armodafinil ---
Armodafinil is the enantiopure of modafinil (listed below), it consists of just the (-)-(R)-enantiomer. It produces effects that are similar to modafinil, but armodafinil can take longer to work.
Armodafinil is a dopamine reuptake inhibitor. After taking a dose, the amount of dopamine available to the human body increases. Armodafinil is marketed under brand names that include:
Armodafinil improves attention, reduces impulsiveness and hyperactivity. At the same time it can also reduce depression and increase energy, making the patient feel better mentally and physically.
--- Bupropion ---
Bupropion is categorized as an NDRI (norepinephrine-dopamine reuptake inhibitor). It has nicotinic antagonist properties that inhibit the action of the neurotransmitter acetylcholine on nicotinic acetylcholine receptors.
Most adults will find bupropion is fairly mild compared to more popular ADHD medication. However, there are a minority who can obtain enough benefit to take bupropion as a stand alone medication.
Bupropion is marketed under brand names that include Wellbutrin, for treating depression. Bupropion is also marketed under the brand name Zyban, as well as other brand names, to aid as a smoking cessation medication.
--- Cannabis ---
Cannabis products like marijuana, hashish, hash oil affect dopamine and other neurotransmitters. They serve as effective ADHD medications for some individuals. When smoked they can increase the potency of other drugs, especially those that increase dopamine activity.
When eaten in the form of edible food, they can be a stand alone treatment for ADHD. A limited number of patients will benefit, but for those that do, cannabis can be a safer alternative to other more commonly employed medications.
The main benefit of cannabis products in the treatment of ADHD is to improve attention and reduce hyperactivity, at the same time it can also reduce pain and alleviate depression, but for some individuals it may impair thinking, increase anxiety, reduce energy.
--- Modafinil ---
Modafinil is a generic name for a drug that is categorized as a wakefulness promoting agent that has stimulant properties. It is a dopamine reuptake inhibitor.
After taking a dose, the amount of dopamine available to the human body increases. Modafinil is marketed under brand names that include:
Modafinil improves attention, reduces impulsiveness and hyperactivity. At the same time it can also reduce depression and increase energy, making the patient feel better mentally and physically.
--- Opioids ---
Opioids are a class of drugs that bind to opioid receptors in the human body and produce effects comparable to morphine. Although opioids are most commonly prescribed to treat pain they can be very effective as a treatment for ADHD.
The main benefit of opioids in the treatment of ADHD is to improve attention, reduce impulsiveness and hyperactivity. They affect dopamine and other neurotransmitters. Opioids will decrease pain and can reduce anxiety, depression, or other symptoms.
Opioids to treat symptoms of ADHD include hydrocodone, oxycodone, tramadol. Tramadol is more effective at treating depression when compared to most other opioids. Because of the chances of tolerance and addiction, it is best to limit intake of opioids to once every 3-4 days, or less often.
--- Reboxetine ---
Reboxetine is a generic name for a medication that is most commonly prescribed as an antidepressant to treat people with major depressive disorder. Reboxetine acts as a norepinephrine reuptake inhibitor.
It is sometimes prescribed off label to treat ADHD as well as panic disorder. Reboxetine is marketed under brand names that include:
For ADHD patients reboxetine can be effective at treating various symptoms of ADHD. It may be especially helpful for treating pain, depression, migraine that are related to ADHD. Many find it sedating and it reduces energy levels.
If you are forced to treat ADHD yourself because you have no health insurance or for any other reason, substances that increase, or produce results similar to increasing, dopamine levels are a good option. These include dopamine precursors.
A limited number of individuals with ADHD may respond to substances that affect neurotransmitters and neuroreceptors associated with acetylcholine and glutamate. Noopept may be one of the better options for this purpose.
--- 5-HTP ---
5-HTP is a precursor to serotonin, after consuming it orally, it is converted to serotonin in the body. People with reduced natural levels of 5-HTP may not be able to synthesize adequate levels of serotonin.
Reduced levels of serotonin can result in various maladies that include depression. 5-HTP can increase focus, reduce anxiety, reduce depression, reduce pain, but it may reduce energy and cause sedation.
5-HTP starting doses around 20 mg are recommended. If necessary, raise the dose size slowly on subsequent attempts. Most people find doses around 50-400 mg optimal, but there are those who require more or less to produce satisfactory results.
--- Coenzyme Q10 ---
Some individuals find coenzyme Q10 (CoQ10) helps with some symptoms of ADHD. It is not a stimulant in itself, but for those that have reduced natural levels in their body, a CoQ10 supplement can increase blood flow and energy levels.
Increasing coenzyme Q10 levels can reduce depression, treat symptoms of fibromyalgia, treat symptoms of hypertension, treat symptoms of cardiovascular issues, treat symptoms of chronic fatigue syndrome. It should be taken with a bit of fatty food.
Coenzyme Q10 doses of 50-100 milligram dose taken 1-3 times a day (at regular intervals) is a good starting point. Dividing up the dose into 2-3 smaller amounts, instead of 1 large dose, can help keep levels steady and reduce side effects. Dose can be adjusted as needed.
--- D-phenylalanine ---
D-phenylalanine (DPA) can reduce the breakdown enkephalins. Enkephalins have pain reducing and antidepressant qualities similar to endorphins.
Those who report positive results say D-phenylalanine helps with:
--- Various Types Of Chronic Pain.
--- Chronic Fatigue Syndrome.
--- Increasing Energy Levels.
--- Bipolar Disorder.
DPA doses in the range of 350 milligrams are a good starting point. Take on an empty stomach for better absorption. Some people find it becomes more effective over time if it is taken daily. Others can't take it everyday or it becomes less effective.
--- Lithium ---
Lithium in small doses can reduce symptoms of physical and mental hyperactivity. Taking it when you are already calm may result in reduced energy, lethargy, sleep. Best to take only when needed, rather than everyday.
Limit intake of lithium aspartate or lithium orotate to 1-5 milligrams doses, 1-3 times per day at equally spaced intervals if taken more than once a day, when you first try it.
Lithium in small doses can produce positive, but mild results. You can increase the dose size in 5 mg increments. Do not take more than 30-45 milligrams a day unless a qualified medical practitioner advises it.
--- Muira Puama ---
Muira Puama can improve attention, reduce impulsiveness and hyperactivity. It can also reduce anxiety and ease symptoms of depression, helping ADHD patients feel better mentally and physically. Larger doses tend to be more sedating.
For individuals with no tolerance to stimulants, at low dose levels it can act as a mild stimulant that increases physical and mental energy. This results of which induce mental relaxation and improved cognition, while helping keep you awake and alert.
Muira Puama may increase, or produce results similar to increasing, levels of the neurotransmitters dopamine, norepinephrine, serotonin. It is a mild pain reliever and a mild GABA antagonist, slightly reducing the effect of GABA.
--- NADH ---
NADH can increase energy and improve focus. Some individuals find it reduces anxiety and depression. It is sometimes utilized as a treatment for chronic pain and chronic fatigue syndrome.
Combined with coenzyme q10 (listed above), it can increase energy and other positive effects of both substances. It may also increase the potency of adderall as well as other amphetamine or methamphetamine based ADHD medications.
NADH can be effective in doses as small as 5 mg, on an empty stomach. Some find it work best when taken daily. For others it becomes less effective over time when taken daily, and only take it every 3-4 days or less often.
--- Tianeptine ---
Tianeptine can increase focus and matters related to cognition. Most people find it effective at treating mild to moderate pain. It is utilized as a treatment for anxiety and various anxiety related disorders. As well it can be effectual at treating many types of depression.
Tianeptine starting doses of around 15 mg, 1-3 times daily, are recommended. Some people find tianeptine can be addictive. In order to reduce chances of addiction, limit intake to once or twice a week, with 3-4 days off in between, or less often.--- Tyrosine ---
In addition to the stimulation most people experience after taking tyrosine, it can increase the potency of other stimulants when they are taken together. If you try this, start with a low doses to see how you respond, increase the dose size gradually.
Tyrosine starting doses around 100-150 milligrams are recommended. Most will find 150-500 milligrams, 1-3 times daily, produces satisfactory results. Take on an empty stomach, some people prefer with a small amount of carbohydrates.
--- Vitamin B6 ---
B6 might be major contributing factor to ADHD in some cases. It is very important in the synthesis of dopamine, norepinephrine, epinephrine, serotonin, GABA. Low levels of dopamine and norepinephrine are common with ADHD.
Low levels of vitamin B6 may reduce the quantity of these important neurotransmitters. The recommended dose of vitamin B6 for treating ADHD is between 30-100 milligrams. The P-5-P form of B6 is absorbed by the body more easily than pyridoxine.
Vitamin B6 can be taken with a bit of food to aid in absorption. In combination with magnesium, it may be more effective. The maximum recommended daily intake is 100 mg, but some people take larger amounts. Too much can increase anxiety and may cause numbing or tingling sensations in the hands or feet.
--- Vitamin B9 ---
Vitamin B9 is closely associated with depression, up to half the people with ADHD and depression may have reduced levels of vitamin B9. Deficiency may also result in things like anemia, heart palpitations, tiredness.
The MTHFR gene mutation is associated with ADHD. It can reduce the ability of your body to metabolize vitamin B9 and those with the mutation should supplement B9.
Vitamin B9 is critical to many important bodily processes. The recommended dose for treating ADHD is 800-1000 µg (micrograms) daily. Larger doses may increase cancer risk and hide symptoms of vitamin B12 deficiency.
--- Vitamin B12 ---
Low levels of vitamin B12 are fairly common with ADHD and can result in depression and lack of energy, both are frequent symptoms of ADHD. In addition it can result in impaired thinking, memory loss, irritability, personality changes, other problems.
B12 deficiency may be the result of genetics or poor absorption, and can occur even if you think you get more than enough through diet or supplements. Those over 50 have a greater chance of vitamin B12 deficiency than younger individuals.
The recommended dose size of vitamin B12 for treating ADHD is 750-1000 µg (micrograms) daily. B12 is often available as cyanocobalamin or methylcobalamin. Methylcobalamin is a form of B12 found in the body and may be absorbed more easily.
Additional ADHD Medications For Adults
Some patients may respond well to a single daily ADHD medication, while others may require several medications per day in order to manage the different symptoms. The additional medications may also help treat other symptoms of ADHD.
--- Anxiety: To treat anxiety related to ADHD, benzodiazepines including alprazolam, diazepam, lorazepam may be prescribed.
--- Chronic Pain: To treat chronic pain associated with ADHD, analgesics (pain relievers) may be prescribed.
--- Depression: Antidepressants may be prescribed to treat depression, as well as other ADHD symptoms.
--- Low Energy: Stimulants like amphetamines, methylphenidate, modafinil will increase energy.
--- Insomnia: Various sleep inducing medications may be utilized to treat insomnia.
With addictive medications and those where a tolerance can build, restricting intake to 4-7 days between dose days may be the best treatment option. For example when some form of amphetamine or opioid is utilized.
Restricting intake to 4-7 days between dose days does not mean only taking ADHD medication only once every 4-7 days. It can be achieved by alternating the medications that are ingested on a daily basis. For example:
An amphetamine medication like adderall on day 1.
A medication like adrafinil or modafinil on day 2.
A methylphenidate based drug like ritalin on day 3.
An opioid medication like tramadol on day 4.
On day 5 the cycle can be restarted with the same medication taken on day 1. This way individual drugs would only be ingested every 4th day, but if required the patient would receive ADHD medication daily. If you take vitamins, do so daily.
1 --- Some physicians will combine stimulants with atomoxetine or guanfacine because stimulants like adderall and ritalin will help better with issues related to focus, while atomoxetine and guanfacine can be better at treating symptoms associated with emotions.