Some adult professionals living with attention-deficit hyperactivity disorder (ADHD) manage their work tasks without much disruption. But others may face challenges like losing focus, struggling to stay organized, or feeling overwhelmed by competing priorities.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290aa4a576-0a05-40e1-baff-c8985d265c06 If ADHD symptoms are affecting your work or well-being, talking to your healthcare provider about treatment options is a good place to start. Medication is one of the main treatments for ADHD, but the choices can feel overwhelming.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e8194efd-4398-42d4-97ed-8ec5f11d4272 There are different classes, formulations, and brands, and they work in different ways. To help you feel more prepared when talking with your healthcare provider , we asked experts to explain the most commonly prescribed ADHD medications for adults, how they work, and what to consider when deciding what’s best for you.
Extended-Release Stimulants Extended-Release Stimulants Stimulants are the first-choice medication for ADHD.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296b923658-39e8-4847-9c52-cd74db3902e8 They fall into two main groups: amphetamine-based and methylphenidate-based, says Cooper Stone, DO , clinical assistant professor of psychiatry and behavioral science at Perelman School of Medicine at the University of Pennsylvania. These medications work by increasing neurotransmitters like dopamine and norepinephrine, which are chemical messengers that help with attention, focus, and impulse control.e60dc2a1-f33c-4a05-9b50-8e3e8e59762900e99a98-39d3-40d8-8317-79954d13dd21 Stimulants are available as short‑acting and extended‑release (ER) forms. Both forms start acting fast, generally within 30 to 60 minutes, but short‑acting options wear off after a few hours and typically need to be taken multiple times during the day to maintain their effectiveness.e60dc2a1-f33c-4a05-9b50-8e3e8e59762900e99a98-39d3-40d8-8317-79954d13dd21 Because of this, some people notice their symptoms returning between doses. Extended-release versions continue to release medication slowly over many hours, so symptoms stay more controlled throughout the day without the need for multiple doses.e60dc2a1-f33c-4a05-9b50-8e3e8e59762900e99a98-39d3-40d8-8317-79954d13dd21 Because they wear off more gradually, you’re less likely to experience sudden swings in energy or mood as the day progresses, says Erik Larson , a board-certified psychiatric mental health nurse practitioner based in Colorado. Stimulants are Schedule II controlled medications, which means they have a potential for addiction and dependence.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f18fb076-016e-4c89-8806-aaad6bcb4e4d Below are some extended-release stimulant medications used for ADHD. They’re generally taken once a day, preferably in the morning to prevent insomnia :e60dc2a1-f33c-4a05-9b50-8e3e8e5976296c22bea4-340a-4952-9de3-563d2c3571aae60dc2a1-f33c-4a05-9b50-8e3e8e597629e0453264-375b-487e-b3a5-2cdbf7f141d6e60dc2a1-f33c-4a05-9b50-8e3e8e597629cac11fbb-8165-4a04-87d5-8dab77f0f1ace60dc2a1-f33c-4a05-9b50-8e3e8e5976290b7a89f7-ab99-400f-b15f-d15a2520b0b0e60dc2a1-f33c-4a05-9b50-8e3e8e597629aa2941b3-f430-4273-8ec8-e59f44fd2df0e60dc2a1-f33c-4a05-9b50-8e3e8e59762943ae1d6a-99c3-4d7a-855e-5ef02359efa1e60dc2a1-f33c-4a05-9b50-8e3e8e597629b76aac66-227f-4b71-a05c-84953be2b661
Research shows that amphetamine- and methylphenidate-based options work well for many people, though some studies suggest amphetamines may have a slightly stronger effect.e60dc2a1-f33c-4a05-9b50-8e3e8e597629301d7e21-d7a6-4195-ae48-8a77705ac7fb Methylphenidate-based medications may feel gentler, but this varies widely from person to person, says Jeffrey Ditzell, DO , a psychiatrist specializing in adult ADHD, based in New York City. Many adults find that they respond better to one group of stimulants than the other. Your body’s metabolism and natural brain chemistry can influence which group works best for you, so it sometimes takes trying more than one option to find a good fit, explains Dr. Ditzell. Side Effects of Extended-Release Stimulants Like any medication, stimulants can cause side effects. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976290db7114c-6e3b-4508-bd2d-0925b6146585e60dc2a1-f33c-4a05-9b50-8e3e8e59762905fa9491-3a8d-4bde-b3e0-d1494d5359e4 Decreased appetite or weight loss Difficulty falling asleep or changes in sleep patterns Headaches Dry mouth Increased heart rate Increased blood pressure Nervousness or anxiety Jaw clenching Teeth grinding Nausea Constipation Feeling jittery, restless, or overstimulated Many people find that they have more noticeable side effects with amphetamines, while methylphenidate may cause fewer physical side effects, says Ditzell. Ongoing anxiety, significant increases in blood pressure, severe irritability, and sleep problems that interfere with your daily life warrant a visit with your healthcare provider. You may need a dose adjustment or a different medication altogether, says Larson. Because stimulants can be habit-forming, any signs of misuse or dependence should be discussed with your doctor right away, says Ditzell. Seek immediate medical attention if you experience serious side effects, such as chest pain or shortness of breath. Who Shouldn’t Take Extended-Release Stimulants Your healthcare provider will consider your medical history and current health conditions before prescribing an extended-release stimulant. Our experts recommend avoiding these medications or using them with caution if you have:e60dc2a1-f33c-4a05-9b50-8e3e8e597629bae7c4ce-77d7-4394-82b2-f114be2f9142 Severe insomnia or significant sleep problems, as the long duration of these medications may affect or interfere with sleep Heart conditions or uncontrolled high blood pressure, since stimulants can slightly increase blood pressure and heart rate Hyperthyroidism , which can worsen symptoms like a rapid heart rate when combined with stimulants Glaucoma , as stimulants can increase pressure in the eye Severe anxiety, panic disorder, psychosis, or bipolar disorder A history of substance use disorder, as stimulants are controlled substances with potential for misuse Bariatric surgery, like gastric bypass, as extended-release formulations may not absorb properly Pregnancy, trying to get pregnant, or breastfeeding
Nonstimulants Nonstimulants Unlike stimulants, nonstimulants take about two to six weeks to start working, but they provide more steady, 24-hour coverage, rather than a sharp on-and-off effect, says Barbara Sparacino, MD , a triple board-certified psychiatrist based in Miami. These medications gradually increase norepinephrine levels and may be an option if stimulants aren’t working well or are causing unwanted side effects, she says. While they’re more effective at reducing hyperactivity and impulsivity, nonstimulants tend to have a weaker effect on attention, explains Larson. So, in adults, they’re often used as an add-on treatment. They also carry a much lower risk of misuse or dependence.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ccefbcc3-1c44-443a-ba16-1e95bc375621 And because they have a long, steady effect, nonstimulants don’t usually cause the rebound effects, like irritability or exhaustion, that some people feel when stimulants wear off, says Dr. Sparacino. You may still feel tired at the end of the day, but it tends to be a more natural fatigue, rather than a sudden crash, she adds. Nonstimulant medications for ADHD in adults include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ccefbcc3-1c44-443a-ba16-1e95bc375621e60dc2a1-f33c-4a05-9b50-8e3e8e597629c771f4b2-1243-42c4-88d6-a9353e9db4e8e60dc2a1-f33c-4a05-9b50-8e3e8e5976290fafed43-e0b0-4415-83dd-240be1e38b92e60dc2a1-f33c-4a05-9b50-8e3e8e597629aa585c2f-24f4-4390-b7c6-6b02a22b8092e60dc2a1-f33c-4a05-9b50-8e3e8e5976293167d3ad-8b72-4feb-9055-88ffdfd7dc2f
Atomoxetine and viloxazine can improve your ability to start tasks, stay focused, and block distractions, says Sparacino. Guanfacine ER and clonidine ER are often used to manage impulsive reactions like blurting or snapping. Larson notes that guanfacine ER and clonidine ER are officially approved for ADHD in children ages 6 to 17, but in adults they’re sometimes prescribed off‑label when stimulants aren’t a good option. Side Effects of Nonstimulants for ADHD Nonstimulants generally cause milder side effects than stimulants, and many of the side effects improve in a few weeks, says Larson. Common side effects include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d964caa5-860c-4004-a5ef-de15fd0c2cbbe60dc2a1-f33c-4a05-9b50-8e3e8e5976291dca0b7e-2826-4b6c-a809-4d1e51a26b0f Nausea Stomach upset Decreased appetite Sleep changes, including trouble falling asleep or feeling drowsy Dry mouth Dizziness or lightheadedness Fatigue or sedation, especially with guanfacine or clonidinee60dc2a1-f33c-4a05-9b50-8e3e8e5976292680f78a-ff50-40e8-bd34-68b98dc1ad53 Lower blood pressure or slower heart rate Mild increase in heart rate or blood pressure with atomoxetine or viloxazinee60dc2a1-f33c-4a05-9b50-8e3e8e5976294e7e1f0e-93c9-495c-a1be-024e6e5d6742 Constipation Sexual side effects in some adults Talk with your healthcare provider if side effects are persistent and bothersome, or if you notice significant changes in mood, like new or worsening depression or agitation, says Sparacino. Some people experience increased irritability or depressive symptoms while taking atomoxetine, says Larson. Any persistent worsening of mood or suicidal thoughts means it’s time to talk to your healthcare provider. Larson also notes that atomoxetine carries a rare risk of liver damage, which may appear as yellowing of the skin or dark urine, and it should be stopped right away if these symptoms occur. Who Shouldn’t Take Nonstimulants Providers may avoid or use nonstimulants cautiously in people who have:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d964caa5-860c-4004-a5ef-de15fd0c2cbb Significant cardiovascular disease, including serious heart rhythm problems, very low blood pressure, a recent heart attack, severe heart failure, or certain heart conditions Pheochromocytoma (a type of tumor in the adrenal glands) Bipolar disorder or psychotic disorders Severe liver disease Glaucoma “People with complex medical or mental health histories should work closely with a prescriber who can choose the safest medication and monitor symptoms over time,” says Sparacino.
Off-Label Medications for Adults With ADHD Off-Label Medications Some medications, including antidepressants , are prescribed “off-label” when standard treatments don’t work well, aren’t tolerated, or when someone has ADHD along with conditions like depression or anxiety, says Larson. “‘Off-label’ doesn’t mean ‘experimental with no evidence.’ It simply means the medication isn’t approved [by the U.S. Food and Drug Administration] for ADHD specifically, even if there’s decent data and experience supporting its use in some cases,” explains Sparacino. The most common off-label option for ADHD is bupropion (Wellbutrin), says Dr. Stone. It’s an antidepressant that can help with focus, motivation, and co-occurring depression, and it’s often used when someone wants a single medication to address both depression and ADHD, explains Sparacino. Bupropion may also be combined with stimulants to extend their effect. Other off-label options include venlafaxine (Effexor), which may help with attention and mood when anxiety or depression are present.e60dc2a1-f33c-4a05-9b50-8e3e8e59762910d91db3-95d1-4593-9aae-44617235bb52 Modafinil (Provigil) or armodafinil (Nuvigil), which are wakefulness-promoting medications, are also used off-label when someone has both attention problems and significant daytime sleepiness.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b63285cc-c64a-442c-8d16-5b53100a2265 Ditzell notes that nonmedication tools such as cognitive behavioral therapy , coaching, mindfulness, exercise, and good sleep habits can also help manage ADHD symptoms.
Talking With Your Doctor Talking With Your Doctor When starting a conversation about ADHD medication with a healthcare provider, Sparacino recommends being as specific as possible about what daily life and your workday look like. Instead of saying “I’m distracted,” try describing the patterns you notice, such as missed deadlines, losing track of time, constantly switching tasks, feeling overwhelmed, or hitting a wall every afternoon. It’s also important to share your health history, including past medications, family history, substance use, and any supplements you’re taking. Sparacino suggests using the questions below as a starting point when talking with your healthcare provider: Given my health history, which options would you consider: stimulants, nonstimulants, or a combination? What improvements should I expect, and how long will it take to know if it’s working? What are the most common side effects, and how would we handle them? How will we monitor things like blood pressure, heart rate, mood, and sleep? If this medication isn’t a good fit, what’s our next step? Still, finding the right ADHD medication is a collaborative process, says Sparacino.
The Takeaway Stimulants act quickly — often within an hour — and are the first-line treatment for many adults with ADHD. They can help improve focus, attention, and impulse control, and they come in short-acting and extended-release forms. Nonstimulants take longer to work, typically two to six weeks, and they provide steadier all-day support. They may be helpful for adults who don’t tolerate stimulants well or prefer a slower, more even effect. Off-label options like bupropion and other antidepressants may be considered when approved treatments aren’t effective or when ADHD occurs alongside conditions such as depression or anxiety. When talking to your healthcare provider about medications, share examples of how ADHD affects your daily life, and ask specific questions. Contact your healthcare provider if your symptoms significantly change after starting treatment or if you have any concerns.
Resources We Trust Cleveland Clinic: ADHD MedicationMayo Clinic Health System: Navigating ADHD in Adulthood National Institute of Mental Health: ADHD in Adults: 4 Things to KnowAmerican Academy of Family Physicians: Treatment and Management of ADHD in AdultsChildren and Adults With Attention-Deficit/Hyperactivity Disorder: Workplace Issues
What Are the Best ADHD Medications for Adults — and How Do You Know What’s Right for You?
