Beyond Adderall: The Lesser Known, Non-Stimulant Treatments for ADHD

By La Lune Integrative Psychiatry

Medically Reviewed by Elita Wong PMHNP-BC

For many people, medications like Adderall, Vyvanse, or Ritalin are the first things they hear about when they’re diagnosed with ADHD. And for a valid reason: stimulants work. They’re fast, well-studied, and often very effective. But they’re not right for everyone.

Some people can’t take stimulants because of side effects like mood swings, anxiety, appetite loss, insomnia, or rarely, risk of serious cardiac events. Others have medical reasons (i.e. irregular heart beats, history of personal or familial cardiac events, peripheral vascular health issues), substance-use history, medication interactions, or simply don’t want to be on a controlled medication. 

Federally-controlled medications that have the potential for dependence (withdrawal symptoms when you take a break from stimulants) or tolerance (needing higher doses over time) also come with a lot of responsibility for both the patient and provider. Risks and benefits of treatment should always be discussed with your provider.

Even if stimulants don’t end up being the right fit, that doesn’t mean you’re out of options. Your provider might recommend non-stimulant ADHD treatments instead.

At La Lune Integrative Psychiatry, we help patients explore all alternatives and match the medication to the whole person, not just the diagnosis.

Why would a provider recommend a non-stimulant?

A prescriber might recommend a non-stimulant ADHD medication if:

• you’ve had side effects from multiple trials of stimulants (jittery, irritable, can’t sleep)

• you have co-occurring anxiety or mood shifts and stimulants made it worse

• there’s a history of substance use that negatively impacted quality of life (some people are more genetically susceptible to dependence and tolerance risks)

• you have cardiovascular or blood pressure concerns, or other medical conditions where your specialist provider recommends avoiding stimulants

• you need 24-hour coverage and struggle with taking break days or low-dose days from stimulants (some non-stimulants last all day and into evening)

• you’re looking for options with less appetite suppression

Non-stimulants might not give you the “switch flipped on” feeling that stimulants can. They work more quietly, in the background, and can take a few weeks to reach full effect. But for the right person, they’re steady, predictable, and easier to stay on.

1. Atomoxetine (Strattera)

Atomoxetine (Strattera) is one of the best-known non-stimulant ADHD meds. It works by increasing norepinephrine in specific parts of the brain, which supports attention, impulse control, and cognitive regulation. It can also indirectly increase availability of dopamine, another neurotransmitter involved in ADHD presentation,  in the prefrontal cortex, a region involved in planning, focus, and executive functioning. Strattera isn’t a controlled substance and is taken consistently every day, which can be helpful for patients who need steady symptom coverage across both work and personal life.

Pros: Good for people with ADHD and low mood (often linked); no rebound; not known to be addictive.
Things to know: Can take 2–4 weeks to feel benefits; some people notice nausea, dry mouth, fatigue, or lower appetite at first. Increase in blood pressure and heart rate is also possible with this medication as with stimulants, so monitoring is recommended.

For more information about Strattera, the National Institute of Mental Health has published a full medication guide which can be accessed here. 

2. Viloxazine ER (Qelbree)

Qelbree is a newer, non-stimulant ADHD medication approved for kids, teens, and adults. Like atomoxetine, it targets norepinephrine, but it also affects serotonin pathways, which may contribute to a different side-effect profile for some patients. It is taken once daily and is not a controlled substance.

Pros: A non-stimulant, once-daily option that may be helpful for attention, impulsivity, and emotional regulation in some patients.
Things to know: Like other non-stimulants, Qelbree may take a few weeks to show full benefit. Some people experience sleepiness, headache, or increases in blood pressure or heart rate, so routine monitoring is recommended. At this time, it is only available as a brand-name medication, which means insurance coverage and out-of-pocket cost can vary. Access Quelbree guide here.

3. Guanfacine ER (Intuniv)

Guanfacine ER is an extended-release form of a medication originally used for blood pressure, now widely used as a non-stimulant option in ADHD treatment. It works by reducing sympathetic nervous system activity and supporting regulation in brain areas involved in attention, impulse control, and emotional responses.

Pros: Great for impulsivity, irritability, and inattentive symptoms of ADHD. Also useful when ADHD comes with tics or sleep problems.

Things to know: Guanfacine ER can cause sleepiness, dizziness, or drops in blood pressure, especially when starting or increasing the dose. Because of this, treatment is typically started at a low dose and adjusted gradually.

For a full list of possible side effects and Intuniv medication guide, visit NAMI’s website.

4. Clonidine ER (Kapvay)

Clonidine ER is an extended-release form of a medication originally used for blood pressure. Like guanfacine, it reduces sympathetic nervous system activity and can support attention, impulse control, and overall regulation. It tends to be more sedating than guanfacine and is sometimes chosen when ADHD symptoms occur alongside restlessness, nighttime difficulty settling, or heightened arousal.

Pros: May be helpful for people with ADHD who struggle with sleep difficulties, restlessness, or irritability. It can be used alone or alongside other ADHD medications.
Things to know: Clonidine ER can cause drowsiness, dizziness, or drops in blood pressure, especially early in treatment or with dose changes. Slow and careful dose adjustments are important.

Full side effect guide here.

5. Bupropion (Wellbutrin) — off-label

Wellbutrin isn’t FDA-approved for ADHD, but many prescribers use it off-label, especially for adults. It boosts dopamine and norepinephrine similarly to stimulants, but is not known to be habit-forming.

Best for: May be considered when ADHD occurs alongside depression, seasonal mood patterns, or when someone prefers to avoid stimulant medications.
Things to know: Bupropion can be activating for some individuals, so providers typically monitor anxiety, sleep, and irritability. It is not recommended for people with a seizure history or certain eating disorders, as it can lower the seizure threshold. For detailed prescribing information and a full list of possible side effects, the official Wellbutrin medication guide is available here.

A quick word on safety

This post is for general education only and isn’t meant to guide self-diagnosis or self-treatment. All ADHD medications—stimulant or non-stimulant—require a proper evaluation, individualized dosing, and ongoing monitoring for things like blood pressure, heart rate, sleep, mood, and medication interactions.

If you have a personal or family history of heart conditions, fainting, seizures, bipolar disorder, or if you are pregnant or postpartum, share that with your prescriber before starting or changing any medication. A licensed clinician can help determine what is safe and appropriate for your specific situation.

Getting ADHD care that fits you

ADHD is not one-size-fits-all, and neither is ADHD medication. If stimulants haven’t been the right fit, or you’ve been told “that’s all there is,” there are alternatives to Adderall available.

At La Lune Integrative Psychiatry, our providers in Arizona, Colorado, Oregon, Washington, and New Hampshire can help you explore non-stimulant ADHD treatment, look at co-occurring anxiety or depression, and build a plan that actually works in real life. Our personalized online care is designed for adults 18+ that are interested in solutions beyond medication that consider the whole story. 

If you’re ready to explore your options, we make it easy to get started with no waitlist and a simple 4-step intake process.