Which ADHD Medications Do I Choose? Jun 7 Written By Patricia Pop ADHD medication options: An Overview Amphetamine(3:1 d:l, Evekeo 50:50) Adderall IR/XR (G) Mydayis XR Adzenys XR-ODT, Dyanavel XR (liquid) Evekeo IR Dextroamphetamine(pure d-isomer) Dexedrine IR/ER (G), Zenzedi IR (G), ProCentra (G, liquid), Xelstrym (patch) Lisdexamfetamine prodrug → dextroamphetamine Vyvanse (G) Methylphenidate Concerta ER (G), Ritalin IR/LA (G) Methylin IR (G) Aptensio XR, Jornay PM, MPH patch (G) Quillivant XR (liquid), QuilliChew ER (chew), Cotempla XR-ODT Dexmethylphenidate(pure d-isomer) Focalin IR/XR (G) Serdexmethylphenidate prodrug → dexmethylphenidate Azstarys Amphetamine class Methylphenidate class Stimulants ADHD medications Nonstimulants Alpha-2 agonists NE modulators Guanfacine(alpha-2A selective) Intuniv ER (G) Clonidine(non-selective alpha-2) Kapvay ER (G), Onyda XR (liquid) Atomoxetine(selective NRI) Strattera (G) Viloxazine(NRI with 5-HT activity) Qelbree ER Bupropion(NDRI, off-label for ADHD) Wellbutrin SR/XL (G) bold = household · (G) = generic · dim = less common · dashed = prodrug · faded = off-label Stimulant duration of effect (approximate) 0h 4h 8h 12h 16h (school/work day) Amphetamine class Short-acting Adderall IR 4-6h Long-acting Adderall XR (biphasic) 10-12h Vyvanse (prodrug) 10-14h Mydayis XR 14-16h Methylphenidate class Short-acting Methylin/Ritalin IR 3-4h Focalin IR 3-5h Long-acting Ritalin LA (biphasic) 6-8h Focalin XR (biphasic) 8-12h MPH patch 2-9h wear, tail to 11h Concerta ER 10-12h Azstarys (prodrug) 12-13h Dot = approximate peak effect time · Two dots = biphasic IR + delayed release (Concerta uses smoother OROS) Short-acting (IR) typically dosed 2-3× daily · Long-acting (ER/XR/prodrugs) once daily Starting a stimulant: what to expect Usually eases in the first week or two Your body is adjusting - give it a little time Headache Feeling jittery or wired Mild stomach upset or nausea Lightheadedness Might stick around - tell me and we'll adjust Often fixable with timing or a dose change Less appetite (eat on a schedule, not just when hungry) Trouble falling asleep (usually about timing) Irritable or flat as it wears off (the rebound) Dry mouth Heart rate or blood pressure a little up (we'll keep watch) Call me or get care - don't wait on these Uncommon, but worth acting on Chest pain, fainting, or a racing heart that won't settle Big mood changes, or thoughts of harming yourself Seeing or believing things that aren't there Rash, swelling, or trouble breathing (allergic reaction) Everyone responds differently - this is a general guide, not a rule. Most people settle in fine. When in doubt, ask me. How stimulants rise and fall through the day Short-acting comes on fast and fades fast. Long-acting rises slower and rides longer. 0h 2h 4h 6h 8h 10h 12h 14h more less Hours after dose Effect Amphetamine IR Methylphenidate IR Amphetamine ER/XR Methylphenidate ER/XR Schematic shapes, not exact drug levels - your curve depends on the medication, dose, your body, and food. Heights show pattern and timing, not strength. What ADHD medication can and can't do Clear expectations make it easier to tell whether it's actually working What it can help with Getting started (the activation hump) Staying past the boring part Fewer careless mistakes Less mental restlessness Following through to the finish What it won't do on its own Build the habit or system Make you care about what you don't Replace sleep, food, or movement Fix anxiety or low mood directly Keep working once it's worn off Medication can open a window for focus. What fills it - habits, sleep, support - is the other half of the work. Patricia Pop Next Next A Working Menu for PTSD and Complex PTSD Care
Which ADHD Medications Do I Choose? Jun 7 Written By Patricia Pop ADHD medication options: An Overview Amphetamine(3:1 d:l, Evekeo 50:50) Adderall IR/XR (G) Mydayis XR Adzenys XR-ODT, Dyanavel XR (liquid) Evekeo IR Dextroamphetamine(pure d-isomer) Dexedrine IR/ER (G), Zenzedi IR (G), ProCentra (G, liquid), Xelstrym (patch) Lisdexamfetamine prodrug → dextroamphetamine Vyvanse (G) Methylphenidate Concerta ER (G), Ritalin IR/LA (G) Methylin IR (G) Aptensio XR, Jornay PM, MPH patch (G) Quillivant XR (liquid), QuilliChew ER (chew), Cotempla XR-ODT Dexmethylphenidate(pure d-isomer) Focalin IR/XR (G) Serdexmethylphenidate prodrug → dexmethylphenidate Azstarys Amphetamine class Methylphenidate class Stimulants ADHD medications Nonstimulants Alpha-2 agonists NE modulators Guanfacine(alpha-2A selective) Intuniv ER (G) Clonidine(non-selective alpha-2) Kapvay ER (G), Onyda XR (liquid) Atomoxetine(selective NRI) Strattera (G) Viloxazine(NRI with 5-HT activity) Qelbree ER Bupropion(NDRI, off-label for ADHD) Wellbutrin SR/XL (G) bold = household · (G) = generic · dim = less common · dashed = prodrug · faded = off-label Stimulant duration of effect (approximate) 0h 4h 8h 12h 16h (school/work day) Amphetamine class Short-acting Adderall IR 4-6h Long-acting Adderall XR (biphasic) 10-12h Vyvanse (prodrug) 10-14h Mydayis XR 14-16h Methylphenidate class Short-acting Methylin/Ritalin IR 3-4h Focalin IR 3-5h Long-acting Ritalin LA (biphasic) 6-8h Focalin XR (biphasic) 8-12h MPH patch 2-9h wear, tail to 11h Concerta ER 10-12h Azstarys (prodrug) 12-13h Dot = approximate peak effect time · Two dots = biphasic IR + delayed release (Concerta uses smoother OROS) Short-acting (IR) typically dosed 2-3× daily · Long-acting (ER/XR/prodrugs) once daily Starting a stimulant: what to expect Usually eases in the first week or two Your body is adjusting - give it a little time Headache Feeling jittery or wired Mild stomach upset or nausea Lightheadedness Might stick around - tell me and we'll adjust Often fixable with timing or a dose change Less appetite (eat on a schedule, not just when hungry) Trouble falling asleep (usually about timing) Irritable or flat as it wears off (the rebound) Dry mouth Heart rate or blood pressure a little up (we'll keep watch) Call me or get care - don't wait on these Uncommon, but worth acting on Chest pain, fainting, or a racing heart that won't settle Big mood changes, or thoughts of harming yourself Seeing or believing things that aren't there Rash, swelling, or trouble breathing (allergic reaction) Everyone responds differently - this is a general guide, not a rule. Most people settle in fine. When in doubt, ask me. How stimulants rise and fall through the day Short-acting comes on fast and fades fast. Long-acting rises slower and rides longer. 0h 2h 4h 6h 8h 10h 12h 14h more less Hours after dose Effect Amphetamine IR Methylphenidate IR Amphetamine ER/XR Methylphenidate ER/XR Schematic shapes, not exact drug levels - your curve depends on the medication, dose, your body, and food. Heights show pattern and timing, not strength. What ADHD medication can and can't do Clear expectations make it easier to tell whether it's actually working What it can help with Getting started (the activation hump) Staying past the boring part Fewer careless mistakes Less mental restlessness Following through to the finish What it won't do on its own Build the habit or system Make you care about what you don't Replace sleep, food, or movement Fix anxiety or low mood directly Keep working once it's worn off Medication can open a window for focus. What fills it - habits, sleep, support - is the other half of the work. Patricia Pop
