Current Pharmacological Treatments for ADHD

Curr Top Behav Neurosci. 2022:57:19-50. doi: 10.1007/7854_2022_330.

Abstract

Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition associated with impaired function and increased risk of poor outcomes in children, young people and adults with the condition. Currently approved pharmacological treatments for ADHD include a range of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, guanfacine, clonidine) medications. All have been shown to be effective in treating the symptoms of ADHD and improving other functional outcomes including quality of life, academic performance, rates of accidents and injuries, and do not appear to be associated with significant adverse outcomes or side effects. In this chapter, we review medications for ADHD by summarising the mechanisms of action of each of the two main classes of compounds (stimulants and nonstimulants), the formulations of the most commonly prescribed medications within each class, their efficacy in treating ADHD symptoms and other outcomes, and other factors that influence treatment decisions including side effects and tolerability, comorbidities and medical history. We conclude with a summary of the treatment decisions made by clinicians and suggest some next steps for research. Further research is needed to understand the mechanisms of action of these medications and how exactly they improve symptoms, and to examine their effects on commonly occurring comorbidities.

Keywords: ADHD; Amphetamine; Clonidine; Comorbidity; Efficacy; Functional outcomes; Guanfacine; Methylphenidate; Nonstimulant; Stimulant; Tolerability; Treatment.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Atomoxetine Hydrochloride / pharmacology
  • Atomoxetine Hydrochloride / therapeutic use
  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Central Nervous System Stimulants* / adverse effects
  • Child
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • Methylphenidate* / pharmacology
  • Methylphenidate* / therapeutic use
  • Quality of Life

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride