History of ADHD medications

ADHD (attention-deficit hyperactivity disorder) is a neurodevelopmental disorder. The Centers for Disease Control (CDC) estimates that about 11 percent of U.S. childrenopens in a new tab ages 3–17 have been diagnosed with ADHD. About 6 percent of adultsopens in a new tab have received a diagnosis.

ADHD can create major challenges for people who have it. Left untreated, ADHD symptoms like trouble focusing, impulsivity, difficulty with executive functions, and social and organizational challenges can be hard to manage. 

Research has shown that people with ADHD have higher rates of divorce, unemployment, unplanned pregnancies, self-harm, and substance use. A recent study also found that people with ADHD have lower life expectancies.

The good news is that ADHD is highly treatable. For decades, doctors have used a group of drugs known as stimulants to treat ADHD. These medications are effective and safe. But they’ve also been the source of controversy. And they’ve created some stigma around ADHD. Understanding their history is key to understanding how we view ADHD.

We’ve put together an interactive timeline charting key moments in the history of ADHD medications. Let’s look at where they began, what’s happened along the way, and where we stand today. 

Sir Alexander Crichton,opens in a new tab a Scottish physician, observes a disorder resembling ADHD. ADHD as we know it won’t be defined as a diagnosis until 1987, nearly two centuries later. 

Charles Bradley,opens in a new tab a psychiatrist, gives an amphetamine drug called Benzedrine sulfate to a group of children with behavioral issues. Benzedrine is a stimulant medication, which means it targets dopamine in the brain. A week in, Bradley notices improvements in school performance among many of the children.

The chemist Leandro Panizzonopens in a new tab makes a drug called methylphenidate. Ten years later, pharmaceutical company Ciba markets it as Ritalin — named for Panizzon’s wife, Marguerite, who went by Rita.

The FDA approves Ritalinopens in a new tab to treat a variety of conditions including depression, narcolepsy, and fatigue. Methylphenidate, the drug’s active ingredient, is a stimulant medication, similar to the one Bradley used nearly two decades earlier.

Ciba, Ritalin’s manufacturer, markets the drug widely to doctors and patients alike. Advertisementsopens in a new tab say it “brightens outlook and renews vigor” and tell doctors it can “bring patients ‘out of the corner’” when they’re depressed.

Ritalin gets FDA approval as a treatment for children with behavioral issues, including hyperactivity.opens in a new tab

The American Psychiatric Association releases the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).opens in a new tab Health care professionals use the DSM to diagnose and classify mental disorders. It lists a condition called “hyperkinetic reaction of childhood” that involves “overactivity, restlessness, distractibility, and short attention span, especially in young children; the behavior usually diminishes in adolescence.” Later, this would become known as ADD and, even later, ADHD. 

Congressopens in a new tab creates the Bureau of Narcotics and Dangerous Drugs, which later becomes part of the modern Drug Enforcement Administration (DEA), to control stimulants, among other drugs.opens in a new tab This comes amid national concerns over amphetamine-type stimulants being used for everything from dieting to treating mild depression. They were common among U.S. military members, too.opens in a new tab

President Richard Nixon declares his “war on drugs.”opens in a new tab Congress passes the Controlled Substances Act, creating a scheduling system for all federally regulated substances. Methylphenidate (generic Ritalin) becomes a Schedule II drug,opens in a new tab which means it has accepted medical use as well as a high potential for abuse and addiction. This change is prompted by concerns over stimulant abuse and makes it more difficult to get a Ritalin prescription. 

Several books come out, citing concerns about prescribing stimulant medications for children. One, The Myth of the Hyperactive Child, argues that medications like Ritalin are being used as “chemical straitjackets” on children. Media and public criticismopens in a new tab about the use of Ritalin to treat “hyperactive” children hits a high point.

The third edition of the DSMopens in a new tab lists “attention deficit disorder” (ADD) for the first time. It splits the disorder into two subtypes — with and without hyperactivity. And it notes that the primary features are “developmentally inappropriate inattention and impulsivity.” 

A revision to the third edition of the DSM combines both ADD subtypes into “attention-deficit hyperactivity disorder” for the first time. The criteria is largely based on young boys. ADHD as we know it officially becomes a disorder.opens in a new tab

The use of Ritalin and its generics (methylphenidate) to treat ADHD increases drastically. This leads to congressional hearings on the drug.opens in a new tab

Adderall gets FDA approvalopens in a new tab for treatment of ADHD and becomes a common ADHD medication. Like Ritalin, it is a stimulant. But Adderall is amphetamine-based, while Ritalin is made from methylphenidate. Both ingredients target dopamine.opens in a new tab Amphetamines work to release more dopamine. Methylphenidate blocks the reuptake of dopamine, producing a subtler effect.

Concerta gets FDA approvalopens in a new tab for treating ADHD. It uses the same medication as Ritalin (methylphenidate) but in an extended-release formula. The new, longer-acting formula can last throughout the day. This lets people take just one dose in the morning. 

The FDA approves the first non-stimulant drug for ADHD: Strattera.opens in a new tab It uses an ingredient called atomoxetine. Atomoxetine increases levels of the brain chemical norepinephrine, with the aim of improving attention while reducing impulsivity and hyperactivity. Unlike faster-acting stimulants like Ritalin and Adderall, Strattera takes a few weeks to take effect. 

ADHD is now a widely diagnosed condition. Several new drugs come onto the market. These include longer-acting formulas of methylphenidate-based drugs (Ritalin LA, Focalin XR) and amphetamine-based medications like Vyvanse. 

Three new non-stimulant drugs get FDA approvalopens in a new tab for ADHD treatment: Tenex, Intuniv, and Kapvay. These drugs are used to treat people with ADHD who can’t take or don’t respond well to stimulants. 

The fifth edition of the DSMopens in a new tab comes out. The diagnosis criteria for ADHD is updated again. This edition gives examples of how ADHD appears in adults.

In response to the pandemic, federal officials loosen telehealth rulesopens in a new tab so that ADHD medications can be prescribed without an in-person visit. Within the next year, stimulant prescriptions increasedopens in a new tab by more than 10 percent in certain age groups. 

ADHD diagnoses rise in all age groups, especially among women. One study finds that between 2020 and 2022, the percentage of women ages 23–49 who were newly diagnosed with ADHDopens in a new tab nearly doubled. Also this year, a Ritalin shortage hits U.S. markets and eventually impacts other stimulant medications. 

U.S. officials announce a response to widespread shortagesopens in a new tab of ADHD stimulant medications. Drugs affected by the shortage include Adderall, Ritalin, and Vyvanse. 

New international researchopens in a new tab shows that stimulants and atomoxetine (generic Strattera) are the most effective ADHD treatments for adults. It shows that these medications remain safe and useful.

The president establishes the “Make America Healthy Again Commission” in an executive order. The order mentions ADHD and the rise in diagnoses and medication use among children. A key task of the new commission is to “assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.”

The American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry, and others issue a joint statementopens in a new tab in response to the commission’s statements on stimulant medications. They reiterate existing data on ADHD medications, explaining that they are safe and effective. They warn that misinformation around medication increases stigma and can mean that people with ADHD will have less access to helpful, evidence-based medication.

Dr. Ari Tuckman answers some of the most common questions about ADHD treatments.