|How they work|
Mainly target receptors of the brain chemical dopamine.
Very effective at improving attention and reducing hyperactivity and impulsivity.
Atomoxetine (Strattera): Targets the brain chemical norepinephrine. Can improve attention and reduce impulsivity and hyperactivity.
Alpha-2 adrenergics: How they work in the brain to help with ADHD is not clear. But they reduce hyperactivity and impulsivity. They may also improve attention.
|How quickly they start and stop working|
Fast acting. A child will feel effects within 30 to 90 minutes of the first dose, depending on the drug and individual sensitivity.
These drugs — and their effects — leave the system within three to 12 hours, depending on whether they’re short-acting or long-acting.
Atomoxetine (Strattera): Takes two to four weeks for the drug to have full effect. Kids can be tapered off quickly, usually within a few days.
Alpha-2 adrenergics: Takes two weeks to know if the drug is effective. Kids on high doses over a long term may need to be tapered off slowly to avoid side effects when the drug is discontinued.
Extended-release pills last six to 12 hours — enough to cover the school day.
Atomoxetine (Strattera): Once, sometimes twice, a day
Alpha-2 adrenergics: From one to three times a day
|Common side effects|
Loss of appetite, trouble sleeping
(Uncommon side effects include increased anxiety, agitation, headaches, tics, psychosis.)
Atomoxetine (Strattera): Moodiness
(Uncommon side effects include nausea, loss of appetite, sluggishness.)
Alpha-2 adrenergics: Sleepiness, fatigue
(Uncommon side effects include loss of appetite, drop in blood pressure, nausea.)
Could cause weight loss and possibly impact height. (Weight and height should be monitored.)
Use with caution in kids with pre-existing heart conditions because these drugs can, in rare instances, cause complications. A cardiologist should approve the child taking it.
Atomoxetine (Strattera): Very rare incidence of liver complications.
Alpha-2 adrenergics: May cause dizziness and fainting if it greatly impacts blood pressure.
Improves attention and reduces impulsivity and hyperactivity in 70 to 80 percent of patients.
Atomoxetine (Strattera): Improves attention and reduces impulsivity and hyperactivity in about 50 percent of patients.
Alpha-2 adrenergics: Reduces impulsivity and hyperactivity in 60 percent of patients.
|When doctors might prescribe these drugs|
Generally, this is the first line of drug treatment for children with ADHD and ADD.
Atomoxetine (Strattera): May be prescribed if a child can’t tolerate the side effects of stimulants. May also be an alternative for teens and young adults who might benefit from 24-hour coverage.
Alpha-2 adrenergics: Most often used in addition to stimulants to help kids with severe symptoms.