From the Guidelines
Atomoxetine is the most suitable alternative ADHD medication that does not suppress appetite, as it has been shown to have lower effects on decreased appetite and fewer growth/height problems compared to stimulants 1.
Non-Stimulant ADHD Medications
Several non-stimulant ADHD medications are available that do not typically suppress appetite like stimulants do. These include:
- Atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor that works by increasing norepinephrine levels in the brain without the appetite suppression commonly seen with stimulants 1.
- Guanfacine (Intuniv) and clonidine (Kapvay), alpha-2 adrenergic agonists that can help with ADHD symptoms while having minimal effects on appetite 1.
Key Considerations
When considering non-stimulant ADHD medications, it's essential to note that they generally take longer to show full effectiveness than stimulants (2-6 weeks versus hours/days) and may work better for some ADHD symptoms than others 1.
Administration and Dosage
Atomoxetine is usually started at 40mg daily and may be increased to 80-100mg daily for adults 1. Guanfacine and clonidine are generally administered in the evening due to the relatively frequent occurrence of somnolence/fatigue as an adverse effect 1.
Potential Benefits and Side Effects
Non-stimulant medications like atomoxetine, guanfacine, and clonidine have potential benefits, including their non-controlled status and "around-the-clock" effects 1. However, they may also have side effects like initial drowsiness, dry mouth, or potential blood pressure changes 1.
Consultation with a Healthcare Provider
It's crucial to discuss these options with a healthcare provider, as effectiveness varies between individuals, and some may have other side effects or interactions 1.
From the FDA Drug Label
Atomoxetine capsules are indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) The efficacy of atomoxetine capsules was established in seven clinical trials in outpatients with ADHD
- Alternative ADHD medication: Atomoxetine
- Appetite suppression: The provided drug label for atomoxetine does not mention appetite suppression as a side effect.
- Based on the information from the drug label for viloxazine, which mentions decreased appetite as a side effect, atomoxetine may be considered as an alternative ADHD medication that does not suppress appetite 2.
From the Research
Alternative ADHD Medications
Alternative Attention Deficit Hyperactivity Disorder (ADHD) medications that do not suppress appetite include:
- Non-stimulant agents such as tricyclic antidepressants (TCAs) 3
- Bupropion, which has a more favorable side-effect profile than TCAs 3
- Atomoxetine, a selective norepinephrine reuptake inhibitor that has been shown to be efficacious in the treatment of ADHD 3, 4
- Alpha-2-adrenergic agonists such as clonidine and guanfacine, which have been used as alternative agents in ADHD 3
- Viloxazine, a selective norepinephrine reuptake inhibitor that has been approved for the treatment of ADHD in pediatric and adult patients 5, 6, 7
Mechanism of Action
These alternative medications work by:
- Inhibiting the uptake of norepinephrine, which has been shown to be decreased in patients with ADHD 5
- Increasing the levels of dopamine and norepinephrine in the brain, which can help to improve attention and reduce impulsivity 4
- Having a more favorable side-effect profile compared to stimulants, with fewer reports of appetite suppression and other adverse effects 3, 5, 6, 7
Efficacy and Safety
The efficacy and safety of these alternative medications have been established in several studies, including:
- Placebo-controlled trials that have demonstrated significant improvements in ADHD symptoms 5, 6, 7
- Studies that have compared the efficacy and safety of these medications to stimulants, with mixed results 6
- Reviews of the literature that have highlighted the potential benefits and limitations of these alternative medications 3, 4