Date of Award

2027

Document Type

Capstone

Degree Name

Master of Science (MS)

Department

Physician Assistant Studies

Committee Chair

LaDonna Clark

Abstract

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults with ADHD.

Results: Stimulants and atomoxetine improved short-term ADHD symptoms; clinician-rated effects were numerically larger with stimulants, while self-rated effects were similar. Both classes had treatment-limiting adverse effects. In indirect comparisons, centanafadine had fewer specific adverse effects than lisdexamfetamine, methylphenidate, and atomoxetine but less symptom improvement than lisdexamfetamine; differences versus methylphenidate and atomoxetine were not statistically significant. Amphetamines, methylphenidate, and atomoxetine improved quality of life versus placebo.

Discussion: Non-stimulants are effective options for adults with ADHD, but current evidence does not show they are consistently as effective as stimulants or always better tolerated. Treatment should be individualized based on symptom response, adverse effects, medical history, misuse concerns, access, and patient preference. Additional long-term, head-to-head studies are needed to directly compare stimulant and non-stimulant medications in adults.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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