Table 3.

Pharmacotherapeutic Agents for the Treatment of ADHD in Adults.^*

Drug and Formulation	Trade Name	Dose	Common Adverse Effects
Stimulant medications
Immediate-release
Methylphenidate	Ritalin, Methylin, Metadate	10–60 mg/day in divided doses	Nervousness, insomnia, hypersensitivity, anorexia, nausea, dizziness, headache, dyskinesia, drowsiness, blood-pressure and pulse changes, tachycardia, weight loss, abdominal pain, decreased appetite
Dexmethylphenidate	Focalin IR†	Initial dose, 5 mg/day (2.5 mg twice daily); can be increased weekly in increments of 2.5 to 5 mg/day to a maximum of 20 mg/day	Abdominal pain, fever, anorexia, nausea, nervousness, insomnia
Amphetamine	Adderall	Initial dose, 10 mg/day; can be increased by 10 mg/day every week; usual dose, 5–60 mg/day	Dry mouth, loss of appetite, insomnia, headache, weight loss, nausea, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, urinary tract infections
Dextroamphetamine	Dexedrine, Dextrostat	Initial dose, 10 mg/day; can be increased by 10 mg/day at weekly intervals until best response is obtained; usual dose, 5–60 mg/day in divided doses	Blood-pressure elevation, tachycardia, palpitations, dizziness, insomnia, tremor, diarrhea, constipation, dry mouth, urticaria, impotence, changes in libido, euphoria, dyskinesia, headache
Sustained-release
Methylphenidate	Concerta, Metadate CD, Metadate ER, Ritalin LA	Concerta: 18–72 mg/day; Metadate CD, Metadate ER, and Ritalin LA: 10–60 mg per day	Decreased appetite, headache, dry mouth, nausea, insomnia, anxiety, dizziness, decreased weight, irritability, upper abdominal pain, hyperhidrosis, palpitations, tachycardia, depressed mood, nervousness
Dexmethylphenidate	Focalin XR	Initial dose, 10 mg; can be increased weekly in 10-mg increments to a maximum of 40 mg/day	Dyspepsia, headache, anxiety, insomnia, anorexia, dry mouth, pharyngolaryngeal pain, jittery feeling, dizziness, decreased appetite, vomiting
Amphetamine	Adderall XR	Typically, 20 mg every morning; for persons switching from immediate-release amphetamine, the total daily dose should be the same; the dose can be adjusted at weekly intervals as indicated	Dry mouth, loss of appetite, insomnia, headache, abdominal pain, weight loss, agitation, anxiety, nausea, vomiting, dizziness, tachycardia, nervousness, asthenia, diarrhea
Dextroamphetamine	Dexedrine Spansule	5–60 mg/day in divided doses	Blood-pressure elevation, tachycardia, palpitations, dizziness, insomnia, tremor, diarrhea, constipation, dry mouth, urticaria, impotence, changes in libido, euphoria, dyskinesia, headache
Lisdexamfetamine dimesylate	Vyvanse‡	Initial dose, 30 mg; can be increased in increments of 10 or 20 mg/day at weekly intervals to a maximum of 70 mg/day	Appetite decreased, insomnia, upper abdominal pain, irritability, nausea, vomiting, weight decreased, dry mouth, dizziness, affect lability, rash, diarrhea, anxiety, anorexia, jittery feeling
Nonstimulant medications
Atomoxetine (selective norepinephrine-reuptake inhibitor)	Strattera	Initial dose, 40 mg/day; can be increased to maximum of 100 mg/day	Abdominal pain, nausea, vomiting, fatigue, decreased appetite, somnolence, increased heart rate, headache, dry mouth, insomnia, constipation, hot flushes, urinary hesitancy and retention, erectile dysfunction

^*Typical doses in published studies of medications to treat ADHD in adults are shown. Data are from Wilens et al.²⁸

^†This agent contains only the D-isomer, unlike Ritalin, which contains both the D- and L-isomers.

^‡This prodrug of dextroamphetamine lasts longer and may be less addictive when misused than other stimulants.