Table 3. Approved substances in Germany for the treatment of attention-deficit/hyperactivity disorder.

	Substance class	Typical dose range	Effect strength	Number needed to treat	Adverse effects	Remarks
Methylphenidate (MPH)	Psychostimulant	0.3–1.0 mg/kg BW	0.8–1.0	ca. 2.5 (e81)	On average. mild increase in blood pressure and heart rate; appetite suppression. weight loss. abdominal pain. headache. difficulty falling asleep. insomnia. emotional irritability. intensification of tic manifestations if already present	Drug of first choice; sustained-release preparations are available (e81, e82)
Dexamfetamine	Psychostimulant	0.1–0.5 mg/kg BW	0.8–1.0	ca. 2 (e82)		Efficacy and tolerability comparable to that of MPH; approved if MPH is not sufficiently effective (e81, e82)
Lisdexamfetamine	Psychostimulant	30–70 mg	Ø  1.0			Prodrug with prolonged effect; approved in Germany if the response to MPH is inadequate (e83)
Atomoxetine	Selective norepinephrine reuptake inhibitor (SNRI)	1.2 mg/kg BW	0.5–0.7	ca. 4 (e84)	On average. mild increase in blood pressure and heart rate; mild shortening of QTc. dry mouth. appetite suppression. weight loss. gastrointestinal symptoms. dizziness. headache. drowsiness. fatigue. sedation	Drug of first choice in the presence of a comorbid tic. anxiety. or substance disorder; otherwise. drug of second choice (e84)
Guanfacine	Central α2-agonist	1–5 mg	0.6	ca. 4 (e85)	Fatigue. sedation. somnolence. mild lowering of blood pressure and heart rate. mild QTc prolongation	Sustained-release preparation available as a drug of second choice if MPH is ineffective or poorly tolerated; metabolized by CYP3A4 (e85, e86)

BW. body weight