ADHD medicines

Medicine is one of the main treatments for ADHD (attention-deficit/hyperactivity disorder) in adults. For many people, the right medicine makes it easier to focus, plan, finish tasks and keep track of time.^1,2

ADHD medicines also have real risks. They can raise blood pressure and heart rate, and stimulants can be misused. This page explains the two main types, the safety checks that matter, the recent shortages, and what changes when you are older.

How ADHD medicines help

ADHD medicines do not cure ADHD. They ease symptoms while you take them. Stimulants make the brain more alert and help people focus. For people with real attention problems, this can make daily life much easier.¹

A large review pooled 52 short-term trials with more than 10,000 adults. Amphetamines helped core symptoms the most. Methylphenidate and atomoxetine helped a moderate amount. Bupropion, an antidepressant sometimes used for ADHD, had less certain benefit.²

Most of those trials lasted about 12 weeks. So we know much less about benefit and safety over years.²

Medicine often works best with other help, such as therapy and coaching and everyday strategies. Some people need to try more than one medicine before finding a good fit.

Stimulant medicines

Stimulants are the most common ADHD medicines. There are two families:^3,4,5

• Methylphenidate. Brand names include Ritalin and Concerta.
• Amphetamines. Brand names include Adderall, Dexedrine and Vyvanse (lisdexamfetamine).

Each family comes in short-acting and long-acting forms. Long-acting forms are usually taken once in the morning. Taking them later in the day can cause trouble sleeping.⁴

Stimulants are controlled substances. The U.S. Drug Enforcement Administration (DEA) puts Adderall and Ritalin in Schedule II. That is the strictest group for medicines that doctors can prescribe.¹⁵

Common side effects in adults include:^4,5

• Less appetite and weight loss
• Trouble sleeping
• Dry mouth
• Headache, nausea or dizziness
• Feeling anxious, jittery or irritable
• Faster heartbeat and more sweating

Less common but serious problems include:^4,5

• New or worse mania (very high, driven mood) in people with bipolar disorder, and rarely psychosis (losing touch with reality)
• Fingers or toes that turn pale, blue or painful in the cold (a circulation problem called Raynaud's)
• New or worse tics
• Higher pressure inside the eye, which matters for some types of glaucoma (methylphenidate label)
• A painful erection that will not go away. This needs care right away.

Tell your doctor about any history of bipolar disorder, psychosis, tics or glaucoma before you start.^4,5

Non-stimulant medicines

Non-stimulants work in other ways. Atomoxetine and viloxazine are not controlled substances.^6,7 Your doctor may suggest one if stimulants did not help, caused bad side effects, or are not safe for you. Ask how long to wait before deciding whether it works.

Mood warning. Atomoxetine has a boxed warning about suicidal thoughts in children and teens. A similar analysis in adults did not show this.⁶ Viloxazine has a boxed warning about suicidal thoughts and behaviors. The label asks doctors to watch all patients for worsening mood.⁷ Atomoxetine and viloxazine also call for screening for bipolar disorder before starting.^6,7

Do not stop guanfacine suddenly. Stopping all at once can cause a sharp rise in blood pressure. Your doctor will lower it slowly if you need to stop.⁸

Heart and blood pressure checks

All ADHD medicines can affect the heart and blood vessels. On average, stimulants raise blood pressure by a few points and heart rate by a few beats per minute. Some people have bigger increases.⁴ Atomoxetine and viloxazine can also raise blood pressure and pulse.^6,7 Guanfacine does the opposite and can lower them too much.⁸

Before you start, your doctor should ask about:^4,6

• Heart disease, heart rhythm problems, past heart attack or stroke
• High blood pressure
• Family members who died suddenly or had serious rhythm problems

Stimulant labels advise avoiding these medicines in people with serious heart disease. Sudden death has been reported in people with heart defects or other serious heart problems.^4,5

During treatment, your blood pressure and pulse should be checked after each dose change and from time to time after that.^6,7

What a large study found. A Swedish study looked at about 62,000 people aged 6 to 64. The longer people had used ADHD medicine, the more likely they were to have heart or blood vessel disease. Risk rose about 4% for each year of use, mostly in the first 3 years. The clearest link was with high blood pressure. People who had used ADHD medicine for 3 to 5 years were about 70% more likely to have a high blood pressure diagnosis.⁹

This kind of study shows a link, not proof that the medicine caused it. It also did not include people 65 and older. The authors advised weighing benefits and risks over time and checking heart health regularly.⁹ You can read about protecting your heart and brain on our blood pressure and the brain page.

Misuse, sharing and safe storage

Some people use stimulants without a prescription, to stay awake, study or get high. In 2023, the FDA required every prescription stimulant to carry the same boxed warning about misuse, addiction and overdose.³ Misuse risk is higher at high doses and when pills are crushed and snorted or injected.⁴

According to the FDA, most people who misuse stimulants get them from friends or family, often for free.³ To protect others:³

• Take your medicine only as prescribed. Do not take extra or take it more often.
• Never give or sell your pills to anyone.
• Keep them out of sight, ideally locked up, away from visitors and grandchildren.
• Do not mix them with alcohol or other controlled drugs.
• Get rid of unused pills promptly, for example at a drug take-back site.

Never buy stimulants from friends, social media or websites that do not require a prescription. Fake pills can look real but contain fentanyl or methamphetamine.^3,11

If you have ADHD and also have trouble with alcohol or drugs, tell your doctor. This can help guide the choice of medicine. See ADHD with anxiety, depression and substance use.

The stimulant shortages

In 2023, many people could not fill their ADHD prescriptions. In late 2023, a national CDC survey found that about 7 in 10 adults taking a stimulant (72%) had trouble getting it because it was out of stock.¹⁰

In June 2024, the CDC warned that shortages of several stimulants, including short-acting Adderall, were still going on. That same month, a large online ADHD company was charged with fraud. Tens of thousands of adults faced losing their prescriber.¹¹

As of October 2026, the FDA's shortage list still includes short-acting mixed amphetamine salts (generic Adderall), lisdexamfetamine capsules and some long-acting methylphenidate products.¹² Lisdexamfetamine capsules were first listed in July 2023. Many makers now report supply, but some strengths are still limited.¹³

Telehealth prescriptions. During COVID-19, temporary rules let doctors prescribe stimulants by video without an in-person visit. As of October 2026, those rules are extended through December 31, 2026.¹⁴ If you get your medicine through telehealth, ask your prescriber what will happen after that date. Read more on getting an adult ADHD diagnosis.

Older adults and ADHD medicines

Research on ADHD medicines mostly comes from children and younger adults.

• Few older people were studied. The labels for Vyvanse, Strattera and Qelbree say too few people 65 and older were in the trials to know whether they respond differently.^4,6,7 The Vyvanse label advises starting at the low end for older adults.⁴
• Some products have age limits. Concerta is approved for ages 6 to 65. It is not approved for people over 65.⁵ Guanfacine's safety in older adults has not been established.⁸
• Heart and blood pressure matter more. Heart disease and high blood pressure are more common with age. This makes the checks above even more important.
• Eyes and bladder. Ask about glaucoma before starting methylphenidate.⁵ Tell your doctor if you already have trouble passing urine, since atomoxetine can cause it.⁶
• Dizziness and falls. Guanfacine can lower blood pressure and cause fainting. Drink enough fluids and avoid overheating.⁸
• Medicine mix-ups. Older adults often take many medicines. Stimulants, atomoxetine and viloxazine must not be combined with an MAOI, an older type of antidepressant.^4,5,6,7 Amphetamines plus medicines that raise serotonin, including many antidepressants, can cause serotonin syndrome, a rare but dangerous reaction.⁴ Viloxazine and atomoxetine can change levels of other drugs.^6,7

Bring every medicine, vitamin and supplement you take to your doctor or pharmacist for a review.¹ Our page on medicines that can affect mood and memory explains how to do a "brown bag" review.

New memory or attention problems after 60 are not always ADHD. They can come from mild cognitive impairment, depression, sleep problems or other medicines. A full check comes first. See ADHD in later life.

Questions to ask your doctor

Is medicine a good choice for me?

• Which type do you suggest first, a stimulant or a non-stimulant? Why?
• How will we know whether it is working? How long should I wait?

Is it safe with my health and other medicines?

• Do I need a heart check or an ECG (heart tracing) before starting?
• How often should my blood pressure and pulse be checked?
• Does it mix safely with my other medicines, alcohol and supplements?
• I am over 65. Is this medicine approved and studied for my age?

What do I do if something goes wrong?

• Which side effects should make me call you?
• What should I do if my pharmacy is out of stock?
• How do I safely stop or switch, if I need to?

Never start, stop or change an ADHD medicine on your own, even if you feel better. Talk with your doctor or pharmacist before changing anything.¹ You can report a serious side effect to the FDA's MedWatch program at 1-800-332-1088.¹

When to get help

Call your doctor soon if you notice big mood changes, poor sleep that does not improve, ongoing weight loss, or rising blood pressure readings at home. For more ways to find care, see Get help or return to the ADHD in adults overview.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.