The Treatment of Attention-Deficit Hyperactivity Disorder with Nonstimulant Medications

Between 25% and 30% of children diagnosed with attention-deficit hyperactivity disorder (ADHD) respond unsatisfactorily to stimulant medications. The indications for using nonstimulant drugs in the treatment of ADHD are reviewed, as well as pertinent studies. The use of tricyclic antidepressants and their potential cardiotoxicity are emphasized. In addition, the combined use of a nonstimulant medication and a stimulant for their synergistic effects or to augment an inadequate therapeutic response to a stimulant alone is discussed. Reliable criteria for identifying etiologically distinct subgroups of subjects and determining to which psychopharmacologic agent or agents they will have optimal responses remain for future research to elucidate.