Non-Stimulant ADHD Medications for Adults, Compared
Stimulants aren't the only option for adult ADHD. Four non-stimulant medications are commonly used for adults. Two are FDA-approved for adult ADHD and two are prescribed off-label. None are controlled substances. Here's how they compare.
At a glance
| Strattera (atomoxetine) | Qelbree (viloxazine ER) | Bupropion (Wellbutrin XL/SR) | Guanfacine ER (Intuniv) | |
|---|---|---|---|---|
| Type | Selective norepinephrine reuptake inhibitor | Selective norepinephrine reuptake inhibitor | Antidepressant (norepinephrine-dopamine reuptake inhibitor) | Alpha-2A agonist |
| FDA status for adult ADHD | Approved (adults and children 6+) | Approved (adults and children 6+) | Off-label (approved for depression and quitting smoking) | Off-label (ADHD approval is ages 6–17 only) |
| How it's taken | Capsule, once or twice daily | Extended-release capsule, once daily | Extended-release tablet, usually once daily | Extended-release tablet, once daily, swallowed whole |
| Time to full effect | Often several weeks | Often a few weeks | Often several weeks | Often a few weeks |
| Common side effects in adults | Nausea, dry mouth, decreased appetite, trouble sleeping, constipation, dizziness, sexual side effects, urinary hesitation | Trouble sleeping, headache, sleepiness, fatigue, nausea, decreased appetite, dry mouth, constipation | Dry mouth, trouble sleeping, headache, nausea | Sleepiness, fatigue, dizziness, low blood pressure, headache |
| Generic available | Yes | No (brand only) | Yes | Yes |
Strattera (atomoxetine)
The longest-established non-stimulant for ADHD, approved for adults since 2002. It works on norepinephrine and is taken every day, not as-needed.
It can raise heart rate and blood pressure, so your provider will check these and ask about heart history. It can't be combined with MAOI antidepressants. The label carries a boxed warning about suicidal thoughts in children and teens, and rare liver problems have been reported.
May suit: adults who want steady, all-day coverage, or who have anxiety alongside ADHD.
Qelbree (viloxazine extended-release)
Approved for children in 2021 and for adults later, Qelbree is the newest option. It's taken once daily, and the capsule can be opened onto applesauce if swallowing pills is hard.
It strongly affects how the body clears certain other medicines (the CYP1A2 pathway), so it can't be combined with some drugs such as tizanidine, duloxetine or ramelteon, and it can raise caffeine levels. It carries a boxed warning about suicidal thoughts, including in adults, and your provider will screen for bipolar disorder and check heart rate and blood pressure.
May suit: adults who didn't tolerate atomoxetine or want a once-daily option.
Bupropion
An antidepressant that is also used off-label for ADHD. A Cochrane review found low-quality evidence that it modestly reduces adult ADHD symptoms, with side effects similar to placebo.
It isn't used in people with a seizure history or an eating disorder, and like all antidepressants it carries a boxed warning about suicidal thoughts in young adults.
May suit: adults with ADHD and depression, or smokers who want to quit.
Guanfacine extended-release
Originally a blood-pressure medicine. The extended-release form is FDA-approved for ADHD in ages 6 to 17, so adult use is off-label.
It can cause sleepiness and lower blood pressure and heart rate, and it shouldn't be stopped suddenly. Sometimes it's used alongside another ADHD medication.
May suit: adults whose main struggles are impulsivity, irritability or trouble winding down at night.
How to choose
The right medication depends on your symptoms, other conditions (anxiety, depression, sleep, blood pressure), other medicines you take, and what you've tried before. That's what the first 60-minute evaluation with Affordable Psych is for.
See if a non-stimulant is right for you →
Educational information only, not medical advice. Don't start, stop or change a medication without talking to your prescriber.
Sources
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