Pharmacological treatment for ADHD is mainly classified into 2 categories – stimulants and non-stimulants. The commonly used stimulant medication in HK is methylphenidate, while the non-stimulant medication commonly indicated for ADHD is atomoxetine.
The typical approaches for treatment are to start off with stimulants, and if stimulants are not the best option (no/ inadequate response, or patient has no tolerance for stimulants), non-stimulant options are often considered as the second choice.
Stimulants are the most studied type of medical interventions and are typically the first-line treatment for ADHD.
Dopamine (a neurotransmitter i.e. chemical messengers that transmit signals) in the brain has been found to be associated with ADHD. Dopamine allows us to regulate attention, behaviour, and emotional responses. However, studies have suggested that people with ADHD usually have lower levels of dopamine, leading to symptoms of inattention, impulsivity, and emotional regulation, which are all symptoms found in ADHD.
Stimulants are used to increase dopamine levels in individuals with ADHD, which oftentimes allows enhanced self-regulation and improved symptoms associated with ADHD.
Methylphenidate is the most commonly prescribed stimulant and is often considered as the first-line treatment for ADHD.
*Please refer to the Patient Toolkit for more information on methylphenidate.
Miscellaneous drugs studied in ADHD are termed as non-stimulants, which are often considered as the second or third-line treatment for ADHD.
Non-stimulant drugs work by preventing the removal of neurotransmitter norepinephrine/ noradrenaline, this action is linked to enhancing working memory and ability to concentrate. The drug does not affect other neurotransmitters (e.g. serotonin and dopamine) which can affect mood, happiness and functioning to think and plan.
Non-stimulants generally have lower effectiveness in comparison with stimulants, and are often used as an adjunct or medication for those who have no or inadequate response, or no tolerance to stimulants.
Atomoxetine is a common long-acting non-stimulant used to treat ADHD.
*Please refer to the Patient Toolkit for more information on Atomoxetine.