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Nonstimulant Treatments for ADHD.

Jeffrey H Newcorn1, Beth Krone2, Ralf W Dittmann3

  • 1Department of Psychiatry, Division of ADHD, Learning Disabilities, and Related Disorders, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1230, New York, NY 10029, USA; Department of Pediatrics, Division of ADHD, Learning Disabilities, and Related Disorders, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1230, New York, NY 10029, USA.

Child and Adolescent Psychiatric Clinics of North America
|June 13, 2022
PubMed
Summary

Nonstimulant medications offer crucial alternatives for attention deficit hyperactivity disorder (ADHD) treatment when psychostimulants are ineffective or poorly tolerated. This review details approved and emerging nonstimulant options for personalized ADHD care.

Keywords:
ADHD treatmentNonstimulantsPsychopharmacology

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Area of Science:

  • Pharmacology
  • Neuroscience
  • Psychiatry

Background:

  • Nonstimulant medications are vital for attention deficit hyperactivity disorder (ADHD) management.
  • They are indicated for patients with poor response or tolerability to psychostimulants, comorbid conditions, or personal preference.
  • This review focuses on nonstimulant therapies for ADHD.

Purpose of the Study:

  • To review the mechanism of action, pharmacokinetics, efficacy, tolerability, and safety of approved, off-label, and pipeline nonstimulant medications for ADHD.
  • To provide detailed information on FDA-approved nonstimulants, including atomoxetine, viloxazine extended release, clonidine XR, and guanfacine XR.
  • To discuss the nuanced treatment approach for individuals with complex ADHD presentations and comorbid disorders.

Main Methods:

  • Comprehensive review of existing literature on nonstimulant ADHD medications.
  • Analysis of data on FDA-approved nonstimulants: atomoxetine, viloxazine extended release, clonidine XR, and guanfacine XR.
  • Examination of evidence for off-label nonstimulant medication use in ADHD treatment.

Main Results:

  • Four FDA-approved nonstimulants include norepinephrine reuptake inhibitors (atomoxetine, viloxazine XR) and α-2 adrenergic agonists (clonidine XR, guanfacine XR).
  • Evidence for the off-label use of various other medications is also reviewed.
  • Variability in drug classes allows for personalized ADHD treatment strategies.

Conclusions:

  • Nonstimulant medications provide essential options for ADHD treatment, complementing psychostimulants.
  • The availability of diverse nonstimulant options facilitates personalized treatment approaches for ADHD across the lifespan.
  • Tailoring treatment based on individual response, tolerability, and comorbidities is key for effective ADHD management.