Non-Stimulant ADHD Medication: Every Option Explained

Stimulants get most of the attention when people talk about ADHD treatment. And for good reason--they work for about 70--80% of patients.

But what about the other 20--30%? Or the people who can't take stimulants because of heart conditions, substance use history, or side effects they can't tolerate?

That's where non-stimulant medications come in. They work differently, they feel different, and for some people, they work better. This guide covers every non-stimulant option available today so you can talk to your provider with real information.

How Non-Stimulants Work Differently

Stimulants like Adderall and Vyvanse boost dopamine quickly. You take a pill, and within an hour or two, your focus sharpens. When the medication wears off, the effect stops.

Non-stimulants take a different approach. Most of them work on norepinephrine (and sometimes dopamine) more gradually. They build up in your system over days or weeks. Once they reach steady state, they provide continuous, round-the-clock symptom relief.

The tradeoff is simple: non-stimulants take longer to kick in, but they provide smoother, more consistent coverage without the peaks and valleys that stimulants can cause.

For a broader look at how these fit alongside stimulant options, our guide to Adderall alternatives covers the full landscape.

Qelbree (Viloxazine)

Qelbree is the newest non-stimulant on the market. The FDA approved it for adults in 2022, and it's quickly becoming a go-to first-line non-stimulant for many providers.

How it works: Qelbree is a selective norepinephrine reuptake inhibitor with some additional serotonin modulating activity. Unlike older non-stimulants, it was designed specifically for ADHD from the start.

Timeline: Some patients notice improvements within the first week. Full effect usually takes 2--4 weeks.

Common side effects: Nausea, headache, fatigue, decreased appetite. These tend to be mild and often improve after the first couple of weeks.

Why providers like it: It's newer, the side effect profile is generally favorable, and early clinical data shows strong results for both inattentive and hyperactive symptoms.

We have a detailed breakdown of how Qelbree works and who it's best suited for if you want the deep dive.

Strattera (Atomoxetine)

Strattera was the first non-stimulant FDA-approved for ADHD, back in 2002. It has the longest track record of any non-stimulant option, which means there's a lot of real-world data on how it performs.

How it works: Strattera selectively blocks norepinephrine reuptake. It doesn't touch dopamine directly, which is why it has no abuse potential and isn't a controlled substance.

Timeline: This is the slowest-acting option. It takes 4--6 weeks to reach full therapeutic effect. Some patients see partial improvement in 1--2 weeks, but you need to give it time.

Common side effects: Nausea and stomach upset are the biggest complaints, especially in the first few weeks. Dry mouth, constipation, and decreased appetite are also common. Taking it with food helps significantly.

Best for: Patients who need 24-hour coverage (it works around the clock once at steady state), patients with co-occurring anxiety (it can help with both), and patients who need something with zero abuse potential.

Intuniv (Guanfacine ER)

Intuniv started life as a blood pressure medication. Doctors noticed it also improved attention, impulse control, and--importantly--emotional regulation in ADHD patients.

How it works: Guanfacine is an alpha-2A adrenergic agonist. It works in the prefrontal cortex to strengthen working memory and reduce distractibility. The mechanism is completely different from both stimulants and other non-stimulants.

Timeline: Effects begin within 1--2 weeks. Full optimization usually takes 3--4 weeks with dose titration.

Common side effects: Drowsiness is the big one, especially when starting. Fatigue, headache, and low blood pressure can also occur. Most patients adjust within a few weeks.

Best for: Patients with significant emotional dysregulation, rejection sensitivity, or impulsivity. It's also commonly used as an add-on to a stimulant rather than standalone--the combination can cover gaps that neither medication fills alone.

Wellbutrin (Bupropion)

Wellbutrin is FDA-approved for depression, not ADHD. But it's one of the most commonly prescribed off-label ADHD medications because of how it works in the brain.

How it works: Bupropion inhibits the reuptake of both dopamine and norepinephrine--the same two neurotransmitters targeted by stimulants. It just does it more gently and gradually.

Timeline: Mood effects typically appear within 1--2 weeks. ADHD symptom improvement usually takes 3--4 weeks.

Common side effects: Insomnia, dry mouth, headache, and mild agitation. It has a dose-dependent seizure risk, so it's not appropriate for everyone.

Best for: Patients with both ADHD and depression. If you're dealing with both conditions, Wellbutrin can address them simultaneously, which simplifies your treatment. It's also a reasonable option for patients who want to avoid both stimulants and the traditional non-stimulant side effects.

Clonidine ER (Kapvay)

Like guanfacine, clonidine was originally a blood pressure medication that showed ADHD benefits. It's less commonly used in adults than Intuniv, but it has a role for certain patients.

How it works: Similar to guanfacine, clonidine is an alpha-2 adrenergic agonist. It's less selective than guanfacine, which means it affects more receptor subtypes.

Best for: Patients who also struggle with sleep (clonidine has stronger sedating effects than guanfacine), patients with co-occurring tic disorders, or as an add-on to stimulants for patients who need help with hyperactivity and impulsivity specifically.

When Do Non-Stimulants Make Sense?

Your provider might recommend starting with a non-stimulant if:

• You have a history of substance use disorder (stimulants carry abuse potential)
• You have cardiovascular concerns (high blood pressure, heart arrhythmia, structural heart issues)
• You've tried stimulants and couldn't tolerate the side effects
• You experience severe anxiety that stimulants make worse
• You want 24-hour coverage without dosing multiple times per day
• You simply prefer to avoid controlled substances

Non-stimulants are also commonly paired with stimulants. If a stimulant handles your focus well but doesn't help with emotional regulation or impulsivity, adding guanfacine or another non-stimulant can fill that gap.

Non-Stimulant vs Stimulant: Head-to-Head

Let's be direct about the data:

Response rates: Stimulants work for about 70--80% of patients. Non-stimulants work for about 50--60%. Stimulants win on average--but averages don't prescribe medication. Individual response varies dramatically.

Speed: Stimulants work within hours. Non-stimulants take weeks. If you need immediate relief, stimulants are faster.

Duration: Most stimulants wear off by evening. Non-stimulants like Strattera provide 24-hour coverage once at steady state.

Side effect profile: Stimulants tend to cause appetite loss, insomnia, and cardiovascular effects. Non-stimulants tend to cause nausea, fatigue, and drowsiness. Different trade-offs for different people.

Abuse potential: Stimulants are Schedule II controlled substances. Non-stimulants have zero abuse potential and are not controlled.

You can see every medication compared in our full chart for a side-by-side view.

How to Find the Right Non-Stimulant

There's no blood test or brain scan that tells you which medication will work. Finding the right non-stimulant requires a proper evaluation, an honest conversation with your provider about your symptoms and history, and often some patience during the titration period.

What matters is working with a provider who knows these medications well and won't give up after one try. If the first option doesn't work, there are others. You can get started with an evaluation today.

Frequently Asked Questions

Do non-stimulant ADHD medications actually work?

Yes. Non-stimulants have been proven effective in clinical trials and real-world use. Response rates are about 50--60%, compared to 70--80% for stimulants. They work through different brain mechanisms and can be highly effective for the right patient, especially those who can't tolerate stimulants.

The key is giving them enough time. Unlike stimulants, non-stimulants take weeks to reach full effect. Many patients who think a non-stimulant isn't working simply haven't waited long enough.

What is the best non-stimulant medication for ADHD?

There's no single "best" option--it depends on your specific symptoms, medical history, and what side effects you can tolerate. Qelbree and Strattera are the two FDA-approved non-stimulants designed specifically for ADHD. Intuniv is excellent for emotional dysregulation. Wellbutrin is often used when depression co-occurs with ADHD.

Your provider will recommend the best starting point based on your individual check-up.

Can you take a non-stimulant and stimulant together?

Yes, and it's actually quite common. Many providers prescribe a stimulant for core focus symptoms and add a non-stimulant like guanfacine for emotional regulation, impulsivity, or evening coverage. This combination approach can provide more complete symptom management than either medication alone.

How long do non-stimulant ADHD medications take to work?

It varies by medication. Qelbree may show initial effects within 1 week, with full benefit at 2--4 weeks. Strattera is the slowest at 4--6 weeks for full effect. Guanfacine typically takes 2--4 weeks. Wellbutrin usually takes 3--4 weeks for ADHD symptom improvement.

This is very different from stimulants, which work within hours. Patience during the dose adjustment period is essential.

Are non-stimulants safer than stimulants?

"Safer" depends on context. Non-stimulants have no abuse potential and are generally better for patients with cardiovascular concerns or substance use history. But they have their own side effects--Strattera carries a black box warning about suicidal thinking in young people, and guanfacine can cause significant drowsiness and blood pressure changes.

Both categories are safe when prescribed and monitored by a qualified provider. The right choice depends on your individual risk factors.