Attention Deficit Hyperactivity Disorder (ADHD) in Teens

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: Roxanne Dryden-Edwards, MD
    Roxanne Dryden-Edwards, MD

    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

What non-stimulant medications are available to treat ADHD in teens?

Non-stimulant medications are generally considered to be second line in the treatment of ADHD. They are generally found to be more subtle in their effectiveness compared to stimulant-class medications. One of the primary non-stimulant medications prescribed is atomoxetine (Strattera). Other non-stimulant medications that have been found to be helpful in treating ADHD include those that are also used as cardiac medications like guanfacine (Tenex or Intuniv) and clonidine (Kapvay).

A disadvantage to such medications is that they may take up to six weeks for atomoxetine and one to four weeks for guanfacine and clonidine to achieve an effective dosage. As a consequence, taking "drug holidays" (for example, winter break) is not as feasible as it is when a patient is utilizing a member of the stimulant class of medications. Side effects of atomoxetine may include decreased appetite, upset stomach, and sleepiness. Side effects of guanfacine and clonidine may include sleepiness, dizziness, low blood pressure when taking the medication, and high blood pressure if the medication is stopped abruptly. In 2005, the FDA published a "black box" warning for atomoxetine and the risk for suicidal thoughts or attempts, especially in adolescents.

Pediatric behavior specialists may consider the use of antidepressants for ADHD patients who experience unreasonable side effects, do not effectively respond to stimulant/non-stimulant medications, or in those who also suffer from significant depression or anxiety.

Medically Reviewed by a Doctor on 10/22/2015
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