Understanding Non-Stimulant ADHD Medications

If you're exploring ADHD treatment options, know that many adults feel uncertain. You're not alone, and there are effective ADHD medications for adults available to help manage your symptoms. Stimulants are usually the first choice medication for ADHD symptom management as they work fast, but not everyone can take stimulants.

There are ADHD alternatives to stimulants. Non-stimulants are FDA-approved medications that treat ADHD differently from stimulant drugs, but are still just as effective. Non-stimulants were rarely prescribed, but growth has taken off. Between 2019 and 2023, non-stimulant prescriptions for ADHD have gone up by over 60%.

Non-stimulant ADHD meds may be second-line options, but they're not "second best." Many patients on stimulants also use non-stimulants to help manage symptoms.

So let's dive into non-stimulant ADHD meds a bit more in-depth so you can see if these are a valid choice of treatment for you.

How Non-Stimulant Medications Work in Your Brain

Non-stimulant medications work in the brain by adjusting the neurotransmitters, mostly norepinephrine. The exact mechanism of action varies by class of medication, but they all act on the neurotransmitter norepinephrine. Norepinephrine plays a significant role in attention, focus, and hyperactivity. Unlike stimulants, non-stimulant ADHD meds do not really target dopamine levels directly.

Non-stimulant ADHD medication for adults works much more slowly and needs to build up in the body before you start to see significant symptom improvement. Typically, these medications take 2–6 weeks to build up in your system before you start to see real improvements. 

But this gradual buildup does tend to produce fewer "ups and downs" that some people experience with stimulants. Because they do not work immediately, non-stimulant medications are not typically associated with abuse, making them a great treatment option for people with substance use disorder or a past history of substance misuse.

The Main Difference Between Stimulants and Non-Stimulants

When comparing non-stimulant ADHD meds with stimulants, there are two major differences: speed and mechanism of action. Stimulants are designed to work right away for managing symptoms, and non-stimulants take weeks to build up in the body before you start to really see improvements in behaviors.

Stimulants primarily work by increasing dopamine and norepinephrine levels, while non-stimulants affect norepinephrine and can influence other neurotransmitters, including dopamine, as seen with Wellbutrin, which is sometimes used off-label.

Because stimulants affect dopamine directly and quickly, they are considered controlled substances due to their potential for abuse. Non-stimulant ADHD meds are not controlled substances. They also have different side effect profiles than stimulants do.

Neither stimulants nor non-stimulants are better than the other for treating ADHD, and some successfully take both. 

Types of Non-Stimulant ADHD Medications Available

There are two main types of non-stimulant ADHD meds available: medications specifically designed to treat ADHD symptoms and blood pressure meds that are used for ADHD.  All the following medications are FDA-approved and commonly prescribed to treat ADHD symptoms. Your healthcare provider will help you determine which non-stimulant ADHD medication is right for you.

Medications Specifically Designed for ADHD

Selective norepinephrine reuptake inhibitors (SNRIs) were created specifically for ADHD. Their main goal is to increase norepinephrine in the brain, which will gradually improve symptoms, such as better paying attention or focusing on one task at a time.

They work with norepinephrine differently than stimulants. SNRIs block the reuptake of norepinephrine, allowing the brain to use more of it.  SNRIs are usually the first non-stimulant medicine that doctors will prescribe for someone who isn't a good fit for stimulants or is having trouble with side effects. Let's look at some different SNRIs that are used to treat ADHD as a non-stimulant ADHD medication.

Viloxazine (Qelbree)

Qelbree, is the brand name for Viloxazine ADHD medication. It is an SNRI that indirectly increases norepinephrine and even dopamine in the prefrontal cortex, an area of the brain associated with impulsivity, inattention, organizational skills, and other executive functions. 

It is not a controlled substance, and Qelbree for ADHD is taken once a day, offering symptom improvement in a few weeks to 2 months.

Atomoxetine (Strattera)

Strattera, is the brand name for Atomoxetine ADHD medication. It's also an SNRI that blocks reuptake, increasing norepinephrine in the brain, mainly in the prefrontal cortex. 

Strattera can also indirectly regulate dopamine gradually over time to improve ADHD symptoms. Because Strattera is a non-stimulant ADHD medication, it is not a controlled substance, and it does not have much abuse risk. 

Strattera for ADHD is taken either once a day or divided into two doses, with improvements seen as early as a couple of weeks, but most results are after 1 to 2 months.

Blood Pressure Medications Used for ADHD

The second most common non-stimulant ADHD medications for adults are alpha-2 adrenergic agonists. These drugs were originally developed for high blood pressure but found to help with ADHD symptoms by targeting alpha-2 receptors in the prefrontal cortex.

Two specific Alpha-2 agonists are FDA-approved to treat ADHD: Guanfacine ER (Intuniv) and Clonidine ER( Kapvay). They are very helpful for people who have hyperactivity and impulsivity. Let's look at each one specifically.

Clonidine ER

Extended-release clonidine for ADHD is known as Kapvay and is FDA-approved to treat children and adolescents with ADHD. However, it is used "off-label" for adults, especially when stimulants are not a good fit. 

It stimulates alpha-2 adrenergic receptors in the prefrontal cortex. It also helps to relax the CNS. Therefore, clonidine can help manage symptoms of ADHD, including hyperactivity, impulsivity, and attention. 

Kapvay ADHD medication is often taken twice a day or once a day at bedtime to reduce feelings of tiredness.

Guanfacine ER (Intuniv)

Intuniv is the brand name of guanfacine ADHD medication. Guanfacine is selective and target-specific alpha-2A receptors that help to enhance the prefrontal cortex, which is why it helps to improve ADHD symptoms. 

 Intuniv for ADHD can also reduce the fight or flight response, which calms down the nervous system, so you can be less reactive to stimuli. It typically takes 2 to 4 weeks to start showing improvements. Guanfacine ER is prescribed once a day, often at bedtime, as it can cause some drowsiness.

Gunafacine is more selective than clonidine, which could make it a little less sedating than clonidine, though everyone's experience is different.

When Non-Stimulant Medications Might Be the Right Choice

No two people are going to experience ADHD the same way. Therefore, everyone will respond to medication differently.  

We're going to look at some possible reasons that you might be a good fit for non-stimulant ADHD medication options. It's ultimately a decision you and your doctor will make together. 

You may be looking for ADHD medication without stimulants. Many people start with stimulants, but they may not be what works best for them. So let's go over some reasons why non-stimulant ADHD meds might be a good part of your treatment.

You Have Concerns About Stimulant Medications

If you have any concerns about stimulant medications, then you may want to start with non-stimulants first. 

If you have a history of substance use disorder, you may not feel comfortable trying out stimulants because of their risk for dependence, so you could try non-stimulants. Non-stimulants are non-addictive ADHD medications. 

Non-stimulants take a little longer to start working, but they are certainly a valid option for treating ADHD symptoms without some of the worries that can come with stimulant drugs.

If You Have Certain Medical Conditions

There are some health conditions that make taking stimulant medications too risky. For example, if you have serious heart conditions, high blood pressure, glaucoma, Tourette's syndrome, hyperthyroidism, or specific mental health conditions like paranoia or bipolar disorder, you may not be a great fit for stimulant medications. 

Having any of these existing conditions does not mean that you can treat your ADHD. It makes you a prime candidate for ADHD non-stimulant options instead of stimulants.

If Stimulants Haven't Worked Well for You

If you have tried stimulants in the past and they didn't work well for you, then you could potentially be a good candidate for non-stimulant ADHD meds. Just because you tried stimulants, and they didn't work well for you, does not mean you should get discouraged. 

On the contrary, there are so many options for treating ADHD symptoms in adults now that your provider can try one or two of these non-stimulant options. Trial and error is a common theme for ADHD treatment, and doctors will work with you until you find what fits with your life to reduce your symptoms.

What to Expect When Taking Non-Stimulant ADHD Medications

Patience is needed when taking non-stimulant medication for ADHD. Generally speaking, these medications can take up to 2 months before you really start to see improvements. 

Just because non-stimulants build up gradually in your body doesn't mean that they are any less effective than the rapid effects of stimulants. It is just that they have a different mechanism of action and require a bit more time to build up.

The First Few Weeks: Starting Your Medication

When you first start taking a non-stimulant medication for ADHD, your doctor will start off with a low dose and gradually increase it as needed. The reason for this approach is that it helps to minimize unwanted side effects. 

You probably won't notice any improvements right away, as these medicines take time to build up in your system. Some people do see a little improvement after a couple of weeks, but it really takes between 4 and 8 weeks to see major symptom improvements in most areas of your day-to-day life. 

The actual timeline does depend on the medication. Unlike stimulants, which provide daytime relief for symptoms right away, non-stimulants will offer you 24-hour improvements since the medicine builds and stays in the system, reducing rebound effects that tend to come with stimulants.

Potential Side Effects

The ADHD medication side effects that you experience will differ depending on what type of non-stimulant drug you are taking. Also, each person experiences side effects differently, so this is just a general list. 

If you do experience any of these ADHD medication side effects, be sure to let your doctor know, and there are some ways to manage some side effects. Some potential side effects that can arise from taking non-stimulant ADHD meds include:

• Nausea
• Fatigue/drowsiness
• Dry mouth
• Headaches
• Appetite changes
• Blood pressure changes
• Mood changes

Finding the Right Dose for You

It's important to note that what dose your provider starts you on will most likely not be your final dose. Your doctor will consider your side effects and response to the medication before finding the best long-term dose for you. 

Long-Term Use: What Happens After You Find the Right Medication

Non-stimulants are safe for long-term use. So once your provider finds a good dose, you are well on your way to maintaining your ADHD symptoms for the long run. Ongoing treatment for ADHD when taking non-stimulants will consist of regular follow-up appointments and check-ups, where your blood pressure may be monitored, as well as discussing symptom improvement and side effects.

How to Get Started With Non-Stimulant ADHD Medications

Let's take a look at the easy steps that you can take to get your ADHD under control.

Getting an ADHD Diagnosis

If you are ready to get your ADHD under control and possibly receive non-stimulant medication, you will first need to get a formal diagnosis from a medical provider. You have to have a professional evaluation before you can receive any medication.

Diagnosis will involve a complete evaluation by a medical doctor or psychiatrist, not just a quick questionnaire, so be prepared to go over your medical and symptom history as completely as you can.

Talking to Your Doctor About Non-Stimulant Options

Once you have a formal ADHD diagnosis, it's time to discuss treatment options with your doctor. Let them know that you are interested in starting out with non-stimulant medication, if medication is going to be a part of your treatment plan. 

Be honest and direct with them. Share your hesitation about stimulants or any relevant medical conditions you have. Your provider will appreciate your honesty and help you decide which non-stimulant option is best for you.

Insurance and Cost Considerations

We know that the costs of medications are a real concern for most people, but the good news is that most insurance plans will cover ADHD treatment. Even if you do not have insurance or your insurance won't cover a specific medication, there are websites with discount codes and other discounts that you can check into to get your medicine.

Generics are often cheaper than brand-name drugs, so if cost is a concern, be sure to discuss this with your provider, and they can help you find a pharmacy with lower prices or try you on a non-stimulant that has a lower out-of-pocket cost.

Taking the Next Step in Your ADHD Treatment Journey

If you are tired of losing important documents for work, getting lost on your phone when you should be cleaning, or any other ADHD-related disruption, know that you can reach out for help. 

Taking the first step towards treating your ADHD can be scary, especially when it comes to discussing sensitive topics like your mental health with a new doctor. However, it's crucial to open up about these issues if you want to manage your symptoms effectively.

Effective treatment is now more accessible than ever. With telehealth options, you no longer have to drive out of your way or spend months waiting to see a doctor to get treated. You can get same-day appointments with ADHD Advisor.

You Don't Have to Figure This Out Alone

Having professional support makes treatment so much easier. Starting ADHD treatment can be overwhelming, but healthcare providers are there to make it easier and support you. They will guide you through the process; all you need to do is take the first step.

Start Your ADHD Evaluation Today

ADHD Advisor can help you right now. We offer same-day virtual appointments, and you don't even have to leave your house! Our licensed clinicians can give you a proper ADHD evaluation and online prescriptions from the comfort of your own home. They can help determine if non-stimulant ADHD meds are right for you.

Using online care is not only easy and convenient, but private and discreet, using HIPAA-approved technology to ensure your healthcare data is safe and secure on our platform. 

So what are you waiting for? Don't let another day go by wondering whether your faulty organizational skills or impulse shopping sprees will ever ease up; get the help you need. Take our free online ADHD screening now to get started.

Frequently Asked Questions

What are non-stimulant ADHD medications and how do they work?

Non-stimulant ADHD medications are any medicine that is used to treat ADHD that isn’t considered a stimulant. These medications increase norepinephrine levels in the brain, reducing impulsiveness and hyperactivity while improving focus.

Are non-stimulant ADHD medications as effective as stimulants?

Yes, non-stimulant medications are effective at treating ADHD symptoms, just not as quickly as stimulants.

What are the side effects of non-stimulant ADHD medications?

Side effects of non-stimulants vary by medication. However, some common side effects can include:

• Drowsiness
• Dry mouth
• Stomach upset
• Dizziness
• Mood problems

How long does it take for non-stimulant ADHD medication to work?

Non-stimulant ADHD medication needs to build up in the body before it really starts to work. So it can take anywhere from a few weeks to a couple of months for symptoms to improve effectively.

What is the most effective non-stimulant ADHD medication?

There is no single “most effective” non-stimulant medication, as people respond to medications differently. Alpha-2 agonists and SNRIs are the two most commonly prescribed non-stimulants.

What are the FDA-approved non-stimulant ADHD medications available?

The following are FDA-approved non-stimulant ADHD medications available for adults:

• Guanfacine ER (Intuniv)
• Clonidine ER (Kapvay)
• Atomoxetine (Strattera)
• Viloxazine (Qelbree)

Can you take non-stimulant and stimulant ADHD medications together?

Yes, taking both non-stimulant and stimulant ADHD medications is common, and they can work synergistically to manage ADHD symptoms, especially when stimulants alone are not working well or to address co-occurring mental health issues like anxiety or depression.

What is the difference between Strattera and Qelbree for ADHD treatment?

The difference between Strattera and Qelbree for ADHD treatment is mainly their onset of action. Strattera can take up to 12 weeks to reach its full effect, while Qelbree can show results in as little as a month.

Which non-stimulant ADHD medications are best for adults?

There is no best non-stimulant for ADHD in adults. The most common non-stimulant ADHD medications for adults are Qelbree, Strattera, Intuniv, and Kapvay.

Do non-stimulant ADHD medications help with anxiety?

Yes, some non-stimulant medications can help co-occurring anxiety because they can promote a sense of calm by boosting norepinephrine in the brain. ADHD meds for anxiety would include SNRIs like viloxazine and atomoxetine.