Consumer’s Guide | Nonstimulants for ADHD Treatment in Children

A fter your child is diagnosed with attention deficit hyperactivity disorder (ADHD), their pediatrician and other healthcare providers will recommend behavioral approaches that can help boost your child’s self-control and self-esteem. Next, they may recommend medication.

There are two classes of medication approved by the Food and Drug Administration (FDA) that can lessen ADHD symptoms: stimulants and nonstimulants. Both can help your child function better academically, at home, and among their family and peers.

Stimulant medications are the most commonly prescribed treatments and often prescribed first. But if your child doesn’t tolerate stimulants well, they may be a candidate for nonstimulants.

Here’s a look at how nonstimulants work inside the body.

In 2002 the FDA approved the first nonstimulant for kids with ADHD, and a handful of others followed. Now, a new drug has entered the mix: Viloxazine (Qelbree), a selective norepinephrine reuptake inhibitor (SNRI), also called a serotonin norepinephrine modulating agent (SNMA), which was approved by the FDA in April 2021 for use in children.

This guide can help you understand nonstimulants and when they might be worth considering for your child’s ADHD symptoms.

Stimulants have been used to treat ADHD in children since the first drug was approved almost 60 years ago, and they continue to be a standard treatment today. According to the Centers for Disease Control and Prevention (CDC), 70 to 80 percent of the approximately 6 million kids and teens diagnosed with ADHD get some relief from stimulant medications, which usually contain methylphenidate (Ritalin, Concerta) or amphetamine (Adderall).

It may seem strange to give your child something with a reputation for revving things up rather than calming things down, but stimulants are often paradoxically effective.

What aspects of the condition are causing the greatest problem for the child? Try to get a treatment that homes in on that.
— Jeffrey Newcorn, MD

That said, stimulants are controlled substances and carry a risk of addiction and abuse. This, along with other potential side effects, can be a deal breaker for some families. Other possible reactions include tics, anxiety, weight loss, and sleeplessness.

Many experts stress that ADHD treatment has to be individualized and work for your child’s situation right now, at this point in their life, with the recognition that it should be revisited several times as your child develops and issues rise or fall in importance.

“Number one,” says Jeffrey Newcorn, MD, director of the Division of Child and Adolescent Psychiatry at the Mount Sinai Medical Center in New York City, “What aspects of the condition are causing the greatest problem for the child? Try to get a treatment that homes in on that.”

Since as many as 6 in 10 children with ADHD have another behavioral, mental, or emotional health condition, such as depression or anxiety, according to the CDC, it’s extra important to adapt to changes in your child’s needs over time. Put another way: While certain stimulants or nonstimulants might work now, that could change.

A team of experts, including your child’s teacher, guidance counselor, doctor, psychiatrist, or therapist, can help you monitor your child’s condition and manage their treatment. (And if you don’t have a care team like this, consider assembling one!)

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