Non-Stimulant ADHD Medication: A Complete Guide to Treatment Options
Author:
Blossom Editorial
Jan 14, 2026
Non-stimulant medications offer an alternative option for treating attention-deficit/hyperactivity disorder (ADHD), particularly for people who don't respond well to stimulants or have concerns about abuse potential. Research shows that non-stimulant medications can reduce ADHD symptoms for some children and adults, though responses may vary.
The FDA has approved several non-stimulant medications for ADHD treatment. Understanding these options can help you make informed decisions about ADHD treatment alongside your healthcare provider.
Key Takeaways
FDA-approved options: Several non-stimulant medications are approved for ADHD. These include atomoxetine (Strattera), viloxazine (Qelbree), guanfacine (Intuniv), and clonidine extended-release formulations (Kapvay and Onyda XR).
Different timeline than stimulants: Non-stimulant medications often take several weeks to reach full benefit, compared to stimulants, which often work within hours. Some people notice gradual improvement within the first few weeks of non-stimulation usage, while others may require 6–8 weeks
Not controlled substances: Unlike stimulants, FDA-approved non-stimulants are not controlled substances and have low abuse potential, making them valuable options for people with substance use concerns.
What Are Non-Stimulant ADHD Medications?
Non-stimulant medications treat ADHD symptoms through different mechanisms than stimulants like methylphenidate or amphetamines. According to research published in the journal Psychiatry, approximately 30% of patients don't respond adequately to stimulants, creating a need for alternatives.
The American Academy of Pediatrics notes that non-stimulants can be used alone or combined with stimulants.
Note: Details of non-stimulant ADHD medications, including dosage and effectiveness, are provided for general understanding and are not a prescription recommendation. Always consult a licensed healthcare provider before starting, changing, or discontinuing any medication.
FDA-Approved Non-Stimulant Medications
Atomoxetine (Strattera)
Atomoxetine was the first non-stimulant approved by the FDA in 2002. As a selective norepinephrine reuptake inhibitor, it works around the clock, unlike stimulants. Clinical trials involving over 3,000 children and adolescents showed consistent ADHD symptom improvement, with around 1,200 of them continuing treatment for over a year.
Key details: Takes 4-6 weeks for full effect. Atomoxetine may help with co-occurring anxiety or tic disorders in some individuals. Common side effects include decreased appetite, nausea, fatigue, and mood swings. The FDA requires monitoring for suicidal thinking in youth, though the risk is very low.
Viloxazine (Qelbree)
Approved in 2021 for children and 2022 for adults, Qelbree is a serotonin-norepinephrine modulating agent taken once daily. It may help with comorbid anxiety and depression.
Key details: Common side effects among children (6-17 years) include drowsiness, decreased appetite, and nausea. For adults, common side effects include insomnia, fatigue, nausea, and headaches. Qelbree shows significant improvements in ADHD symptoms after two weeks of treatment, potentially working faster than atomoxetine. Similar suicidal thinking warning as atomoxetine.
Guanfacine Extended-Release (Intuniv) and Clonidine (Kapvay, Onyda XR)
These alpha-2 adrenergic agonists were originally blood pressure medications. FDA approved for ADHD in 2009-2010, they may help with tics, sleep problems, and aggression.
Key details: Intuniv may take 3-4 weeks for full effect. The main side effects of these medications are drowsiness and low blood pressure. Both need to be tapered off gradually. Onyda XR (2024) is the first liquid formulation with nighttime dosing.
Who Should Consider Non-Stimulant Medications?
Non-stimulant medications may be particularly appropriate in several situations:
People who don't respond to stimulants: Approximately 30% of people with ADHD don't achieve adequate symptom control with stimulant medications. For these individuals, non-stimulants offer an important alternative.
Those with substance use concerns: Because non-stimulants have low abuse potential and aren't controlled substances, they're often preferred for people with current or past substance use disorders or those with a family history of substance misuse.
Individuals with certain medical conditions: People with heart conditions, high blood pressure, depression, bipolar disorder, or anxiety disorders that might be worsened by stimulants may benefit from non-stimulant options.
Children with tic disorders or Tourette’s syndrome: Alpha agonists like guanfacine and clonidine may actually help reduce tics while treating ADHD symptoms, whereas stimulants can sometimes worsen tics in susceptible individuals.
People experiencing severe stimulant side effects: If stimulants cause significant appetite suppression, sleep problems, or emotional changes that don't improve with adjustments, non-stimulants may be better tolerated.
Those seeking 24-hour coverage: Atomoxetine and viloxazine provide continuous symptom coverage throughout the day and night, unlike most stimulants, which wear off after several hours.
How Effective Are Non-Stimulant Medications?
Research shows that non-stimulant medications are effective for many people with ADHD, though response rates and effect sizes differ somewhat from stimulants.
According to a review of atomoxetine studies, the medication shows good efficacy in improving ADHD symptoms in both children and adults. Effect sizes for atomoxetine in children range from 0.6 to 1.3, which are comparable to stimulants, while in adults, effect sizes are around 0.40-0.41.
Research published in the American Academy of Pediatrics notes that atomoxetine has been found to be about two-thirds as likely to be effective as stimulant medications for the average person. However, individual responses vary greatly — some people respond well to atomoxetine while not responding to stimulants, highlighting the importance of individualized treatment.
For alpha agonists, response rates range between 50% and 60% according to available research. These medications often work best when combined with stimulants for comprehensive symptom coverage.
Managing Side Effects
Most side effects of non-stimulant medications are mild and often improve with time. Strategies that may be discussed with a healthcare provider include:
For nausea or upset stomach (atomoxetine, viloxazine): Taking the medication with food, starting at a low dose and increasing gradually, or splitting the dose into twice daily can help. The side effect often diminishes after the first few weeks.
For drowsiness (guanfacine, clonidine): Taking the medication at bedtime when possible, allowing time for tolerance to develop, or adjusting the dose may reduce daytime sleepiness. The drowsiness often improves significantly after the first few weeks.
For decreased appetite: While less common than with stimulants, some people experience reduced appetite with atomoxetine or viloxazine. Eating before taking the medication and maintaining consistent meal times can help.
For sleep problems: If viloxazine causes insomnia, taking it earlier in the day may help. If Strattera causes sleep issues, evening dosing might be better than morning dosing.
Note: If you are already on non-stimulant medication, discuss options with your healthcare provider before making any changes to dosage or timing.
Making the Decision: Is a Non-Stimulant Right for You?
Deciding whether to try a non-stimulant medication involves several considerations:
Talk with your healthcare provider about:
Your specific ADHD symptoms and how they impact daily functioning
Any previous responses to ADHD medications
Co-occurring conditions that might influence medication choice
Your lifestyle and whether the slower onset of non-stimulants is acceptable
Any concerns about controlled substances or abuse potential
Your willingness to wait several weeks for full benefits
For some people, non-stimulants are the first choice due to medical contraindications to stimulants or personal preference. For others, they're a second-line option after stimulants prove ineffective or intolerable.
In some cases, for children with ADHD, non-stimulants may be prescribed as a first line of treatment to avoid the side effects associated with stimulants. Ultimately, the right choice depends on individual circumstances and must be made under the guidance of a healthcare provider.
Getting Started with Treatment
If you're considering non-stimulant medication for ADHD, Blossom Health offers virtual psychiatry appointments with board-certified providers who can evaluate your symptoms and develop a personalized treatment plan. Our psychiatrists work with you to identify appropriate treatment options based on your symptoms and medical history, whether that's a stimulant, non-stimulant, or combination approach, all covered by your in-network insurance.
Schedule your first appointment to discuss whether non-stimulant ADHD medication might be right for you.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
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