ADHD medications work on brain chemistry to relieve symptoms in children and adults.

Attention deficit hyperactivity disorder (ADHD) is a common condition in children and adults. Symptoms often include:

  • an inability to focus
  • persistent inattention
  • hyperactivity
  • impulsive behavior

Medications for ADHD help manage these symptoms by affecting the levels of chemicals in the brain responsible for these particular functions.

There are at least three different broad categories of ADHD medications: stimulants, nonstimulants, and off-label medications.

Not much is known about how exactly ADHD medications work. But there’s some speculation on how each type affects the brain and helps manage symptoms.

Studies have shown structural differences in the brain of people with ADHD.

Some research shows that the frontal lobe — the part of the brain responsible for attention, motivation, and memory — may mature later or be smaller in people with ADHD.

Another study found that children with ADHD had lower brain and total grey matter volumes. Differences were also found in the prefrontal cortex and other related areas.

Issues with neuron networks have also been noted in those living with ADHD. Neuron networks are the way signals travel through the brain. This is also the way neurotransmitters send messages to the brain to perform tasks.

The neurotransmitters involved in ADHD include:

If you live with ADHD, you may have an imbalance of these neurotransmitters, or your neuron networks may have trouble receiving messages from them.

Stimulant medications are usually the first line of treatment for ADHD. They work by increasing the levels of neurotransmitters in the brain, which improves symptoms and daily functioning.

There are two main types of stimulants for ADHD:

  • amphetamines (Adderall, Dexedrine, DextroStat)
  • methylphenidate (Ritalin, Focalin, Methylin, Concerta)

Stimulants are effective for up to 80% of children who take them, according to the Centers for Disease Control and Prevention (CDC).

These medications are available in short-acting (4 to 6 hours) or long-acting (10 to 12 hour) formulas.

A healthcare or mental health professional will likely monitor your progress on the medication, making adjustments as needed until the right one is found for you and your needs.

Since stimulants increase the brain’s levels of dopamine, the neurotransmitter responsible for reward, they do carry a chance of physical and psychological dependence. Repeated use of higher doses than prescribed may lead to substance use disorder or addiction.

Nonstimulant medications for ADHD are an alternative for people who prefer not to take a stimulant. They also are another line of treatment if stimulants don’t work or cause intolerable side effects.

There are three nonstimulant medications approved to treat symptoms of ADHD:

  • atomoxetine (Strattera)
  • guanfacine (Intuniv)
  • clonidine (Kapvay)

Each of these nonstimulant ADHD medications has a unique way of working.

Atomoxetine (Strattera) is a serotonin-norepinephrine reuptake inhibitor (SNRI). It increases brain concentrations of the neurotransmitters norepinephrine and serotonin, but acts differently than stimulants. Symptom improvement is slower than with stimulants, occurring over several weeks and up to 2 months.

Atomoxetine is the only nonstimulant that is a first-line treatment for ADHD.

Guanfacine (Intuniv) and clonidine (Kapvay) are alpha-2 receptor agonists. Both medications are alpha-2 adrenergic receptors, but clonidine works on all three subtypes of these receptors, while guanfacine only works on one.

Researchers are not sure how alpha-2 receptor agonists work to improve ADHD symptoms. One theory is that they regulate norepinephrine in the brain’s prefrontal cortex to help reduce inattention, hyperactivity, and impulsivity.

Alpha-2 receptor agonists are sometimes prescribed as an add-on therapy along with a stimulant ADHD medication. They may also serve as monotherapy, meaning they can be used alone.

Clonidine and guanfacine are currently only FDA approved for ADHD in long-acting forms. Short-acting forms — such as Catapres (clonidine) and Tenex (guanfacine hydrochloride) — are also available but not currently approved for ADHD.

There are other medications you might be prescribed for ADHD, even if they’re not specifically approved for the condition. These medications are called “off-label.“

Antidepressants are one off-label prescription medication for ADHD. They work by increasing neurotransmitters like norepinephrine. Examples of antidepressants sometimes used for ADHD include:

Children with ADHD often have coexisting conditions with symptoms that overlap with ADHD, such as:

A healthcare or mental health professional may use medications to manage symptoms of these conditions but also will try to limit the number of multiple medications.

ADHD medications help with the treatment and management of the condition in adults and children. There are stimulant and nonstimulant options that can help relieve symptoms and improve well-being.

Effective management might include trying different medications or dosages before finding the right combination for you and your needs.

You can find support groups and other information through Psych Central’s ADHD Resources page.