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ADHD treatment: Stimulant vs. non-stimulant options

Stimulants aren’t the only way to treat ADHD. Here’s how we choose, what to expect, and how to personalize your plan.

Updated this week

Medication can make a huge difference for people with ADHD — but there’s no one-size-fits-all solution.

At Fishtown Medicine, we help you understand:

  • Whether medication makes sense

  • Which type might fit best

  • What we’re actually targeting

  • How to evaluate whether it’s working

We also offer tools beyond meds to improve focus, motivation, and daily flow — but if meds are helpful, we prescribe with clarity and caution.


💊 Two main categories of ADHD medications:

✅ Stimulants

These are the most commonly prescribed and often most effective for core ADHD symptoms.

How they work:
They increase dopamine and norepinephrine in the brain — which improves focus, attention, and task initiation.

Examples:

  • Amphetamine-based: Adderall, Vyvanse, Evekeo

  • Methylphenidate-based: Ritalin, Concerta, Focalin

What they help:

  • Distractibility

  • Task switching

  • Mental fatigue

  • Slowed start-up (executive dysfunction)

What to watch for:

  • Sleep disruption

  • Appetite changes

  • Anxiety or overstimulation

  • Elevated blood pressure or heart rate

  • Rebound symptoms when medication wears off

We always start low and monitor closely — stimulants are controlled substances, so we take safety, state law, and medical context seriously.


✅ Non-Stimulants

These may be helpful if you’ve had side effects from stimulants, have coexisting conditions (like anxiety), or need longer 24-hour support.

How they work:
Different mechanisms — some regulate norepinephrine levels; others work through dopamine modulation or emotional regulation.

Examples:

  • Atomoxetine (Strattera)

  • Guanfacine (Intuniv)

  • Bupropion (Wellbutrin) — also used for mood and nicotine withdrawal

  • Clonidine (Kapvay) — often used in children or for sleep-related ADHD symptoms

What they help:

  • Focus and attention

  • Emotional impulsivity

  • Sleep, irritability, and anxiety in some patients

What to watch for:

  • Fatigue or low energy (especially early on)

  • Dry mouth, nausea, or low mood in some

  • Slower onset of benefits (can take several weeks)


🧠 How we choose:

We consider:

  • Your top symptoms (focus? motivation? mood?)

  • History of sensitivity to medications or stimulants

  • Sleep and anxiety patterns

  • Cardiovascular health

  • Hormones, iron levels, thyroid function, and more

  • Whether you’ve responded to certain meds in the past


⚖️ Our philosophy:

  • Meds are a tool, not a crutch

  • If we prescribe, we monitor closely and review regularly

  • We combine meds with nutrition, sleep, therapy/coaching, and structure

  • We don’t medicate just to meet productivity — we medicate to support your function, self-regulation, and sense of self

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