Hundreds of studies conducted since 1960s have consistently shown the efficacy of stimulant medication in improving symptoms associated with ADHD in children and adolescents.
The recommended initial psychopharmacological treatment of ADHD is atrial with one of the medications currently approved by FDA.
The FDA approved stimulant medications for the treatment of ADHD include dextroamphetamine, methylphenidate, mixed amphetamine salts, and lisdexamfetamine. The two non stimulant medications that are FDA approved for ADHD are atomoxetine and guanfacine.
It is believed that inattention and/ or hyperactivity may be the result of insufficient dopamine and norepinephrine activity.
Stimulant medications primarily increase synaptic concentration of dopamine whereas non stimulant medications such as atomoxetine increase norepinephrine synaptic concentration.
Some of the better known adverse effects associated with stimulant use are suppression of appetite, weight loss, insomnia, and headache.
Adverse effects which must be monitored when a patient is taking the norepinephrine reuptake inhibitor Atomoxetine include gastrointestinal distress, sedation, and decreased appetite.
The FDA has issued black box warnings for Atomoxetine , because of risks of hepatotoxicity and suicidality.
The literatures also support the use of alpha adrenergic agonist such as Clonidine and Guanfacine (both FDA approved) as second line treatment.
Other agents such as Bupropion, Desipramine, and Modafinil have shown efficacy and are recommended as second line treatment for ADHD.
When patients don't respond to either stimulant medication or Atomoxetine the two medications can be combined with good effect.
