Non-stimulants may be prescribed for people with ADHD who don’t respond to stimulants or can’t tolerate them. Non-stimulants work by altering chemical messengers in your brain to help improve ADHD symptoms.

Some of the most common medications for attention deficit hyperactivity disorder (ADHD) include stimulants such as methylphenidate (Ritalin) and amphetamines (Adderall).

These medications alter levels of neurotransmitters, chemical messengers found in the brain, such as dopamine and norepinephrine, to help improve impulse control and attention.

Non-stimulants are usually considered second-line options, meaning they’re often the second choice if stimulants aren’t effective or you’re unable to take them. Some options include atomoxetine (Strattera) and guanfacine (Intuniv).

Learn more about non-stimulant ADHD medications, including how they work, potential benefits, and what your options may be.

Non-stimulants may be used by themselves or in combinations with stimulants. Stimulants such as methylphenidates and amphetamines are generally the first-line treatment for ADHD.

Non-stimulant ADHD medications are prescription drugs that help manage ADHD symptoms without directly stimulating your central nervous system in the same way traditional stimulants do. They’re prescribed to help improve the symptoms of ADHD, such as low concentration and restlessness.

Non-stimulants are typically prescribed when:

  • you don’t achieve significant improvement with stimulants.
  • stimulants cause significant side effects, such as insomnia, loss of appetite, or increased anxiety
  • you have a history of substance misuse or a high risk of substance misuse
  • you have a health condition that may be made worse by stimulants

The three main classifications of ADHD medications are stimulants, nonstimulants, and antidepressants. Antidepressants are sometimes included in the nonstimulant category.

These medications are all prescribed to help control ADHD symptoms, but the key difference in these types of medications is how they affect your brain.

Stimulants increase levels of the neurotransmitters dopamine and norepinephrine. They tend to act rapidly and can be short- or long-acting.

Non-stimulants also modify the levels of neurotransmitters in your brain, but the way they achieve this is different. They take longer to act, and many people see symptoms improve between four and eight weeks after initiating their medication.

The two main categories of non-stimulants are selective norepinephrine reuptake inhibitors (SNRI) and alpha-2 adrenergic agonists.

SNRIs

SNRIs work by increasing levels of dopamine and norepinephrine in your brain by inhibiting your body’s ability to remove these neurotransmitters from the spaces between neurons in your brain called synapses.

Some of the most common drugs in this class include atomoxetine (Strattera) and viloxazine (Qelbree).

Alpha-2 adrenergic agonists

Alpha-2 adrenergic agonists can help improve ADHD symptoms by mimicking the effects of norepinephrine in your brain. Common medications in this class include guanfacine (Tenex, Intuniv) and clonidine (Catapres).

Non-stimulants have some benefits that make them a good second-line choice for people who don’t have a satisfactory response to stimulants.

Non-stimulants may be options for people who:

  • develop too many side effects on stimulants
  • don’t have an effective response from stimulants
  • have a risk of substance misuse
  • have pre-existing symptoms such as insomnia or anxiety that may be heightened by stimulants

Additionally, non-stimulants may benefit people with severe early morning or evening symptoms since these periods may not be optimally covered by stimulants.

Like all medications, non-stimulants can cause side effects. Some side effects may include:

Not everyone is a good candidate for non-stimulant medications. It’s important to speak with a healthcare professional about potential side effects before starting new medications and communicate if you develop any concerning side effects while taking them.

Although rare, some people may develop allergic reactions to some of the components of guanfacine.

Certain groups of people may need to take precautions before taking non-stimulants, such as those with pre-existing conditions, including:

  • low blood pressure
  • slow heart rate (bradycardia)
  • dizziness
  • heart disease
  • kidney disease

Healthcare professionals often advise people taking non-stimulants to avoid becoming dehydrated or overheated, since this might exacerbate side effects.

Non-stimulant ADHD medications offer an alternative to stimulants. They may make an option for people who don’t respond well to stimulants or have a condition that prevents them from taking them. Like stimulants, non-stimulants alter neurotransmitter levels in your brain to manage ADHD symptoms, but the underlying mechanism is different.

If you or your child has ADHD and you’re wondering whether non-stimulant medications might be a good fit, it’s best to talk with a healthcare professional. Together, you can weigh the benefits and potential side effects to find a treatment plan that best supports your needs.