Stimulants

• Amphetamines

  • Short acting = Dexamfetamine

  • Long acting = Lisdexamfetamine (Vyvanse)

• Methylphenidate

  • Short acting = Ritalin

  • Long acting = Concerta

Benefits

• Improvement in daily functioning

Adverse effects

• Dry mouth, poor sleep, irritability, less appetite, weight loss, headaches

• Euphoria or elevated mood

• Motor or verbal tics

• Psychosis

• Mania is concurrent Bipolar

• Increase in blood pressure by 3 to 5 points

Alternative to Stimulants

• Atomxetine

  • 40mg once daily in the morning or evening

  • Increase to 80mg after three or four days if tolerated

  • Monitor for 4 weeks

Antidepressant medications

• Buproprion

  • 100mg in the morning

  • Increase to 100mg twice daily after 1-2 weeks

• Nortriptyline

  • 10mg at night

  • Increase by 25mg weekly to effect (50 to 150mg)

Specific situations