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    ADHD medication guide: stimulants, non-stimulants and the evidence

    ADHD medicines fall into two groups: stimulants such as methylphenidate and amphetamines (including lisdexamfetamine), and non-stimulants such as atomoxetine and guanfacine.[1][2][3] NICE recommends methylphenidate first for children aged 5 and over and lisdexamfetamine or methylphenidate for adults, and trials show stimulants reduce core symptoms in the short term.[4][5][6] FDA labels carry a boxed warning on abuse, misuse and addiction, and long-term evidence is thinner than short-term evidence.[7][8]

    Editor reviewedStrict sourcingUpdated ExplainerMental health, Health and medicine

    This guide explains the main types of ADHD medicine, what guidelines recommend, and what trials and regulators say about benefits and risks. It names medicines and summarises official labels and guidelines, such as NICE’s and the AAP’s; it does not give doses.[4][9]

    This page is not medical advice. ADHD medicines must be prescribed and monitored by a clinician; do not start, stop or change a medicine without talking to your prescriber. If you or someone you know is struggling or having thoughts of suicide, help is available now: in the US call or text 988 (Suicide & Crisis Lifeline); in the UK and Ireland call Samaritans on 116 123; elsewhere, find a local line at findahelpline.com.

    The two main groups

    Stimulants are the medicines NICE lists first for children and adults.[4][5] They include methylphenidate (for example Concerta) and amphetamines (for example Adderall XR and Vyvanse, whose active ingredient is lisdexamfetamine).[10][11][3] Non-stimulants work differently: atomoxetine (Strattera) and extended-release guanfacine (Intuniv) are FDA-approved for ADHD.[1][2] Guidelines usually try stimulants first and non-stimulants when stimulants are not tolerated or do not work.[12]

    Medicine (example brand)TypeFDA-labelled ADHD use
    Methylphenidate ER (Concerta)StimulantAges 6 to 65[10]
    Mixed amphetamine salts ER (Adderall XR)StimulantAdults and children 6+[11]
    Lisdexamfetamine (Vyvanse)Stimulant (prodrug)Adults and children 6+; also binge eating disorder in adults[3]
    Atomoxetine (Strattera)Selective norepinephrine reuptake inhibitorAdults and children 6+[1]
    Guanfacine ER (Intuniv)Alpha-2A agonistAlone or with a stimulant[2]

    The AAP rates evidence as particularly strong for stimulants and sufficient but weaker for atomoxetine, extended-release guanfacine and extended-release clonidine, in that order.[13]

    What guidelines recommend

    • Children under 5 (NICE) and 4 to 5 (AAP): behavioural approaches first. NICE recommends group parent training; the AAP recommends parent training and/or classroom behavioural interventions, with methylphenidate considered if these do not help enough.[14][15]
    • School-age children: NICE recommends methylphenidate first for children aged 5 and over; the AAP recommends FDA-approved medicine plus behavioural support for ages 6 to 11.[4][9] If methylphenidate and lisdexamfetamine are not tolerated or do not work, NICE recommends atomoxetine or guanfacine.[12]
    • Teenagers: the AAP recommends FDA-approved medicine with the teenager’s agreement, plus behavioural support where available.[16]
    • Adults: NICE recommends lisdexamfetamine or methylphenidate first, offered only when symptoms still cause significant problems after practical changes.[5][17]

    Benefits: what the trials show

    Many randomised trials show ADHD medicines reduce core symptoms over weeks to months.[6] What is less certain is the long run: reviewers found too few long trials to judge effects at six months or a year.[8] Large observational studies, which cannot prove cause and effect, have linked starting medicine to fewer transport accidents, less substance misuse and less crime.[18]

    • Randomised evidence, short term: a 2018 network meta-analysis of 133 double-blind trials supported methylphenidate in children and amphetamines in adults as first choices for short-term treatment.[6] A 2025 adult analysis of 113 trials found stimulants and atomoxetine were the only treatments to improve both self- and clinician-rated symptoms, but medicines did not improve quality of life.[19][20]
    • Long term, observational: in the MTA follow-up, extended medication use was not associated with lower symptom severity in early adulthood.[21] A 2025 Swedish register study emulating target trials in 148,581 people linked starting medicine with lower rates of substance misuse, transport accidents and criminality over two years.[18] Both designs are observational and vulnerable to confounding.

    Risks and warnings

    • Misuse and addiction: FDA labels for stimulants carry a boxed warning that they have a high potential for abuse and misuse, which can lead to a substance use disorder.[7] NICE advises caution where medicine might be diverted, for example to boost studying or suppress appetite.[22]
    • Dependence and stopping: the Vyvanse label says stimulants may produce physical dependence and lists withdrawal symptoms, such as low mood, fatigue and sleep changes, after abrupt stopping following prolonged use. Talk to the prescriber before stopping.[23]
    • Young children: Adderall XR and Concerta labels say use is not recommended under age 6, because younger children had higher drug levels and more side effects such as weight loss.[24]
    • Heart rate and blood pressure: short-term trials show small rises with stimulants and some non-stimulants, and reviewers advise monitoring for all ADHD medicines.[25]
    • Growth: in the MTA follow-up, children with consistent or inconsistent stimulant use were on average 2.55 cm shorter as adults than those with negligible use.[21]
    • Atomoxetine: the Strattera label has a boxed warning to watch children and teenagers closely for suicidal thoughts and behaviour, especially early in treatment or after dose changes.[1]

    Getting medicine in 2026

    Shortages of immediate-release amphetamine salts, lisdexamfetamine and extended-release methylphenidate were still listed by FDA in October 2026.[26][27][28] Telehealth prescribing of stimulants without an in-person visit is allowed until 31 December 2026 under a temporary DEA rule.[29] See the shortage and telehealth tracker for updates, and the ADHD explainer for the wider picture.

    Next in the crash course

    Questions readers ask

    What is the first-choice ADHD medicine?

    NICE recommends methylphenidate as the first-line medicine for children aged 5 and over and young people, and lisdexamfetamine or methylphenidate for adults. A 2018 network meta-analysis supported methylphenidate in children and amphetamines in adults for short-term treatment.[4][5][6]

    Are there non-stimulant ADHD medicines?

    Yes. Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor, and extended-release guanfacine (Intuniv) is an alpha-2A agonist that can be used alone or with a stimulant. The AAP rates the evidence for non-stimulants as sufficient but weaker than for stimulants.[1][2][13]

    Should young children take ADHD medicine?

    For children under 5, NICE recommends group parent training first. The AAP recommends behavioural treatment first for children aged 4 to 5, with methylphenidate considered if that is not enough. Labels for Adderall XR and Concerta say they are not recommended under age 6.[14][15][24]

    Do ADHD medicines raise blood pressure?

    A 2025 network meta-analysis of short-term trials found stimulants, atomoxetine and viloxazine raised blood pressure and pulse slightly, and recommended monitoring for any ADHD medicine.[25]

    Do stimulants affect children's height?

    In the observational follow-up of the MTA study, children who used stimulants consistently or inconsistently were on average 2.55 cm shorter as adults than those with negligible use.[21]

    Can ADHD stimulants be misused?

    Yes. FDA labels for stimulants carry a boxed warning that they have a high potential for abuse and misuse, which can lead to addiction, and NICE advises caution where there is a risk of diversion.[7][22]

    Sources

    · 29 claims from 10 publishers

    Each numbered claim is a statement we checked against the sources listed with it. Tap a number in the text to see its sources in place.

    1. [1]

      Strattera (atomoxetine) is a selective norepinephrine reuptake inhibitor, not a stimulant, indicated for ADHD in adults and children aged 6 and older; its label carries a boxed warning to monitor children and teenagers closely for suicidal thoughts and behaviour. confirmedas of 2026-06-30

      • Strattera (atomoxetine) prescribing information · US Food and Drug Administration (openFDA drug label; Eli Lilly) · 2026-06-30 · 1 Indications and Usage; boxed warning: "All STRATTERA-treated pediatric patients 6 years of age or older should be monitored and observed closely for suicidal thoughts and behavior, clinical worsening, or unusual changes in behavior, especially during the initial months of therapy or at times of dosage changes." (retrieved 2026-10-11)
    2. [2]

      Intuniv (extended-release guanfacine) is a non-stimulant alpha-2A agonist indicated for ADHD on its own or added to stimulant medication. confirmedas of 2025-06-23

    3. [3]

      Vyvanse (lisdexamfetamine) is FDA-approved for ADHD in adults and children aged 6 and older, and for moderate to severe binge eating disorder in adults. confirmedas of 2026-04-30

    4. [4]

      NICE recommends methylphenidate as the first-line medicine for children aged 5 and over and young people with ADHD. confirmedas of 2019-09-13

    5. [5]

      NICE recommends lisdexamfetamine or methylphenidate as first-line medicines for adults with ADHD. confirmedas of 2019-09-13

    6. [6]

      A 2018 network meta-analysis of 133 double-blind randomised trials concluded that, weighing efficacy and safety, methylphenidate in children and adolescents and amphetamines in adults are preferred first-choice medicines for short-term ADHD treatment. confirmedas of 2018-08-07

    7. [7]

      FDA labels for stimulants such as Vyvanse, Adderall XR and Concerta carry a boxed warning that they have a high potential for abuse and misuse, which can lead to substance use disorder including addiction. confirmedas of 2026-04-30

    8. [8]

      The 2018 network meta-analysis did not find sufficient data to assess ADHD medicines at 26 and 52 weeks and called for funding of research on long-term effects. confirmedas of 2018-08-07

    9. [9]

      For children aged 6 to 11 with ADHD, the AAP recommends FDA-approved medication together with parent training and/or behavioural classroom interventions. confirmedas of 2019-10-01

    10. [10]

      Concerta (extended-release methylphenidate) is indicated for ADHD in patients aged 6 to 65. confirmedas of 2026-04-20

    11. [11]

      Adderall XR is an amphetamine stimulant indicated for ADHD in adults and children aged 6 and older. confirmedas of 2026-04-30

    12. [12]

      NICE recommends atomoxetine or guanfacine for children aged 5 and over and young people who cannot tolerate methylphenidate or lisdexamfetamine, or whose symptoms have not responded to separate six-week trials of both. confirmedas of 2019-09-13

    13. [13]

      The AAP guideline says the evidence is particularly strong for stimulant medications and sufficient but less strong for atomoxetine, extended-release guanfacine and extended-release clonidine, in that order. confirmedas of 2019-10-01

    14. [14]

      For children under 5 with ADHD, NICE recommends an ADHD-focused group parent-training programme as first-line treatment. confirmedas of 2019-09-13

    15. [15]

      The American Academy of Pediatrics recommends parent training in behaviour management and/or behavioural classroom interventions as first-line treatment for preschool children aged 4 to 5 with ADHD, with methylphenidate considered if these do not help enough. confirmedas of 2019-10-01

    16. [16]

      For adolescents aged 12 to 17, the AAP recommends FDA-approved ADHD medication with the adolescent's assent, and encourages evidence-based training or behavioural interventions where available. confirmedas of 2019-10-01

    17. [17]

      NICE says medication should be offered to children aged 5 and over, young people and adults only if ADHD symptoms still cause significant impairment after environmental changes have been made and reviewed. confirmedas of 2019-09-13

    18. [18]

      A 2025 Swedish register study emulating target trials in 148,581 people with ADHD found that starting ADHD medication was associated with lower rates of substance misuse, transport accidents and criminality over two years, but not of first accidental injuries. confirmedas of 2025-08-13

    19. [19]

      A 2025 network meta-analysis of 113 randomised trials in adults found that stimulants and atomoxetine were the only treatments with short-term benefit on core ADHD symptoms on both self-reported and clinician-reported scales; CBT, mindfulness and psychoeducation improved clinician-rated symptoms only. confirmedas of 2025-01-01

    20. [20]

      The 2025 adult network meta-analysis found ADHD medicines were not efficacious on outcomes such as quality of life, and that longer-term evidence is under-investigated. confirmedas of 2025-01-01

    21. [21]

      In the observational long-term follow-up of the MTA study, children who used stimulants consistently or inconsistently were on average 2.55 cm shorter as adults than those with negligible use, and extended medication use was not associated with lower symptom severity in early adulthood. confirmedas of 2017-03-10

    22. [22]

      NICE advises caution in prescribing stimulants where there is a risk of diversion for cognitive enhancement or appetite suppression. confirmedas of 2019-09-13

    23. [23]

      The Vyvanse label says it may produce physical dependence, and lists withdrawal symptoms after abrupt stopping or dose reduction following prolonged use of stimulants, including low mood, depression, fatigue, vivid unpleasant dreams, sleep changes and increased appetite. confirmedas of 2026-04-30

    24. [24]

      The labels for Adderall XR and Concerta say use is not recommended in children younger than 6 because they had higher drug exposure and more adverse reactions such as weight loss than older children at the same dose. confirmedas of 2026-04-30

    25. [25]

      A 2025 network meta-analysis of 102 short-term randomised trials found that stimulants and the non-stimulants atomoxetine and viloxazine raised blood pressure and pulse slightly, and its authors advised monitoring for any ADHD medicine, not stimulants only. confirmedas of 2025-04-06

    26. [26]

      FDA's drug shortage list has carried immediate-release amphetamine mixed salts tablets (Adderall and generics) since 12 October 2022, and the shortage was still listed as current in data updated on 9 October 2026. confirmedas of 2026-10-09

    27. [27]

      FDA has listed a shortage of lisdexamfetamine capsules and chewable tablets since 14 July 2023; as of 9 October 2026 it remained current, with 33 of 108 product records showing limited availability and 1 unavailable. confirmedas of 2026-10-09

    28. [28]

      FDA has listed a shortage of extended-release methylphenidate tablets since 26 July 2023 and of a methylphenidate extended-release film since 28 February 2025; as of 9 October 2026 both remained current, with 6 tablet products unavailable and 9 limited. confirmedas of 2026-10-09

    29. [29]

      On 31 December 2025 DEA and HHS published a fourth extension of the telemedicine flexibilities, effective 1 January 2026 through 31 December 2026. confirmedas of 2025-12-31

    Revision history (1)
    1. Page created.

    Created Oct 11, 2026. Last reviewed by an editor on Oct 11, 2026. Next scheduled review: Jan 11, 2027.

    Cite this page

    "ADHD medication guide: stimulants, non-stimulants and the evidence." ContentLora, updated Oct 11, 2026. https://contentlora.com/explain/adhd-medications-guide

    Spotted an error? Suggest a correction or emailcorrections@contentlora.com.

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