Whether you’ve already had a diagnosis of ADHD in adulthood or are in the process of being assessed, you’ve probably read about stimulants, like Vyvanse or Adderall, already. Stimulants are a highly effective category of drugs prescribed and are the most widely used type of drug for excessive activity in children with ADHD. However, they’re not suitable for all people.
Adults who feel that stimulants are not worth the side effects, are worried about their heart or circulatory system, have had addiction problems, have high levels of anxiety or do not tolerate the drugs may not be able to take them. Prescription shortages have made it impossible for others to have regular access to stimulants, which are in short supply for patients across New York and New Jersey. For others, stimulants aren’t equally effective and there is always the possibility of providing non-stimulant alternatives.
Being a NYC and New Jersey adult ADHD psychiatrist working virtually (telehealth), I regularly lead adults through the entire spectrum of ADHD medication management. This guide includes all the significant non-stimulants that are available in 2026, what they do, who they work for and what to expect.
Why Some Adults with ADHD Need Non-Stimulant Options
Before reaching the specifics of the medications, it may help if we review the rationale behind why treatment for ADHD is more pertinent to adults today.
Stimulant shortages are ongoing. The United States has been under the shortfall of amphetamine-based drugs like Adderall and generics since 2022. Our supply chain problems are ongoing in 2026, with some pharmacies in Massachusetts still rationing their stock of vaccines.Supply chain problems plague pharmacies around the state in New York and New Jersey – and for many patients, the only solution is to find another way to get their vaccination.
ADHD and anxiety frequently co-occur. About half of people with ADHD have a corresponding anxiety disorder. Some people find that stimulants may accentuate anxiety reactions, so non-stimulant medications are medically preferable for these people.
Cardiovascular history matters. People who have a history of heart arrhythmia or high blood pressure, or those with high blood pressure as adults, may not be appropriate candidates for stimulants, which increase blood pressure and heart rate.
Substance use history. It is important to remember that stimulants are Schedule II controlled drugs with abuse potential, so adults with a history of substance use disorder might respond better to medical treatments of ADHD that do not include stimulants.
Preference and tolerance. Some adults may experience side effects from stimulants that they don’t want, such as suppressing their appetite, disrupting sleep patterns, dulling their emotions or “crashing” in the afternoon and opting for a quieter day.
Non-Stimulant ADHD Medications: A Complete Overview for 2026
1. Atomoxetine (Strattera)
Atomoxetine is the first non-stimulant drug approved specifically by the FDA for ADHD in adults (under the name Strattera). It is thought to act by blocking the re-uptake of norepinephrine (noradrenaline) from the brain, enhancing attentive control and impulse control and working memory over time.
Who it works best for: Adults who have anxiety issues as well, as well as those who have had substance use disorders before or anyone who can’t stand stimulants because of heart issues. It can also be a solid treatment choice if a child has mood disorders, such as ADHD and anxiety, because it provides treatment for both conditions without any stimulating properties.
What to expect: Strattera is not a “quick fix”. The therapeutic effects of this generally arise after four to eight weeks, in contrast to the few hours that stimulants take. The gradual onset is in fact a feature and actually means there is no daily on/off cycle, there is no afternoon crash and there are no risks of misuse.
Common side effects: These are normal – nausea (especially at the beginning, usually reduced by eating it), diminished appetite, slight changes in blood pressure, and up to early fatigue with the medication in some adults. Most of the side effects go away in the first couple of weeks.
2026 update: Atomoxetine is readily available as a generic medication in New York and New Jersey pharmacies, as a reasonable alternative during the current stimulant shortage.
2. Viloxazine (Qelbree)
Viloxazine (name: Qelbree) is a newer drug (2026) that has been approved as an ADHD drug for adults. It used to be an antidepressant medication prescribed in Europe; the FDA approved it for ADHD in 2021 and is an increasingly used medication in adults.
How it works: Viloxazine works like atomoxetine, as a selective norepinephrine reuptake inhibitor, but also affects serotonin which may explain why some people feel more of a lift in mood along with an increase in concentration.
Who it works best for: Adults who want a non-stimulant ADHD medication and want to use a medication that also treats low mood, fatigue, or emotional dysregulation as well as ADHD.
What to expect: Qelbree is taken every day. A few people may need a little more time for Strattera to work. Usually begins to be evident within 2 to 4 weeks.
Common side effects: Somnolence (drowsiness), decreased appetite, nausea, and irritability early in treatment. For some adults, sleeping at night can help reduce the amount of sleepiness in the daytime.
3. Guanfacine Extended-Release (Intuniv)
Guanfacine ER is a member of a group of medications called alpha-2A adrenergic receptor agonists. Unlike atomoxetine and viloxazine, it is not an inhibitor of norepinephrine reuptake, but rather it activates receptors in the prefrontal cortex that are known to regulate attention and impulse control.
Who it works best for: When emotional dysregulation and impulsivity/hyperactivity are marked while inattention is less severe, especially for adults with serious difficulties in emotional self-control and impulse reactions. It is also a very good adjunct drug, making it a good add-on agent for adults requiring extra treatment for emotional symptoms when receiving a low dose stimulant.
What to expect: Guanfacine ER has a soothing, sedative effect. Many adults report that it helps quiet the inner frenzy and irritability of ADHD and that its benefits are there even though attention isn’t necessarily established. The effects usually appear within 2-3 weeks.
Common side effects: Most commonly, sedation and fatigue, which occur as the initial side effects and tend to abate over time; lowered blood pressure, dizziness, drowsiness, dry mouth. The lengthened release version minimizes the peak level of sedation associated with the previous immediate release version of Guanfacine.
4. Clonidine Extended-Release (Kapvay)
Clonidine ER, known as Kapvay, is also classified as an alpha-2 adrenergic agonist and works the same way as guanfacine. It is also sedating to a greater extent and is sometimes prescribed when sleep disruption and hyperarousal symptoms are strong in concert with ADHD symptoms.
Who it works best for: Adults with ADHD who struggle with sleep, hyperactivity and inner restlessness. It is often used as an evening dose for adults who are taking a main medication for ADHD (but it is not enough to improve sleep) as a supplement to the nighttime.
What to expect: Clonidine ER is extremely sedative and must be with dose titration. It is important not to stop abruptly as this may lead to the blood pressure rising again.
Common side effects: Sedation, dry mouth, constipation and blood pressure changes. Regular checks of blood pressure are suggested during treatment.
5. Bupropion (Wellbutrin)
Bupropion is technically an antidepressant (neither a serotonin nor a noradrenergic), but is used more and more off-label in adults who have ADHD, especially if they are also depressed or have low motivation.
Who it works best for: Adults with ADHD and comorbid depression, adults attempting to quit smoking in addition to ADHD (counselling and bupropion are indicated for smoking cessation), and patients who wish for a once daily broad spectrum antiemetic effect.
What to expect: It may take 2-4 weeks for Bupropion to be effective for ADHD. There are many adults who state that they have seen a positive improvement in their motivation, mood stability and mild attention gains. In general it’s not as effective for attention disorders as stimulants or atomoxetine, but for an appropriate patient profile it’s helpful in several respects.
Common side effects: Sensations of insomnia, dry mouth, and headache are common, and a higher risk of seizures at extremely high doses in rare instances. Well tolerated in general.
How Non-Stimulant ADHD Medications Are Prescribed in New York and New Jersey
There is one major distinction between non-stimulant and stimulant drugs for ADHD: prescribing guidelines. The NJ 2026 telehealth rules classify stimulants as a Schedule II controlled substance, meaning that a written prescription for a stimulant must always be made in person, with quarterly visits after that.
Non-stimulant drugs for ADHD (atomoxetine, viloxazine, guanfacine, clonidine and bupropion) are not controlled drugs. This means that they can usually be launched and administered via telehealth in both New York and New Jersey without the identical requirements which are expressed for in-person treatment, making them much more available for grownup patients who choose virtual therapy for their ADHD.
For those looking for an adult ADHD medication management in New Jersey or NYC, non-stimulant medications might prove to be an easier route to beginning therapy.
Which Non-Stimulant ADHD Medication Is Right for You?
No one formula – the choice of the right medication depends on your overall clinical picture, or your specific ADHD presentation, any co-occurring conditions such as anxiety or depression, your cardiovascular history, your sleep patterns and your lifestyle.
The first step is a comprehensive evaluation of the adult ADHD by a qualified psychiatrist. Assessment includes taking the history of your symptoms, completing valid ADHD questionnaires, obtaining information about a history of treatment and excluding other factors that may be contributing to your symptoms.
In my practice, I see adults throughout the NYC and New Jersey areas, and work with them to tailor a treatment plan that is uniquely theirs for ADHD, either by beginning with a non-stimulant or by weaning off a stimulant that isn’t working, or a combination of the two done carefully.
Ready to Explore Your ADHD Treatment Options?
If you are an adult in New York or New Jersey, and are having problems focusing, impulse control, or emotional regulation, and you are considering stimulant medicine or not, let me help you.
Dr. John C. Shershow, MD, is a board-certified psychiatrist who concentrates on ADHD evaluation and medication management in adults, practising via telehealth in New York and New Jersey.
Call us at (212) 265-4310 or contact us online at drjohnshershow.com/contact-us/ to schedule your adult ADHD evaluation.
Frequently Asked Questions (FAQ)
Q: Are non-stimulant ADHD medications as effective as Adderall or Vyvanse?
For many grownups, non-stimulants are useful and have, on average, slightly lower effect sizes for attention, but are meaningfully effective for attention. Effectiveness, though, is subject to personal choice: some adults do very well on atomoxetine, or guanfacine (often in combination with other medications that address anxiety and emotional regulation), especially if anxiety and emotional regulation are involved. For an individual, that will be the best medicine that doesn’t cause more harm than good.
Q: How long do non-stimulant ADHD medications take to work?
Most non-stimulant drugs for this disorder become effective after several weeks, but stimulants are effective for the first hour or two after they’re taken. Only about 4-8 weeks is the time it takes to see the effects of atomoxetine and viloxazine. Guanfacine and clonidine take 2 to 3 weeks to have an effect. It’s crucial to allow the titration phase to run its course and your prescribing psychiatrist will probably be with you to manage and adjust the dose during the initial months.
Q: Can I take a non-stimulant ADHD medication alongside a stimulant?
Yes. Combination therapy is a standard treatment for adults suffering with ADHD. Guanfacine is commonly combined with a stimulant to help curb stubborn impulsivity, emotional reactivity or sleep problems. A stimulant is sometimes added to Bupropion if depression occurs. Any drug combination should be carefully monitored by a psychiatrist who is aware of drug interactions.
Q: Do non-stimulant ADHD medications cause dependence or withdrawal?
The medications listed here – atomoxetine, viloxazine, guanfacine, clonidine, and bupropion – are not controlled substances, and none have abuse potential or a risk of dependence. Clonidine and guanfacine should be weaned over several days but this is physiologic, not addictive, and is a rebound response when discontinuing these drugs.
Q: Can I get non-stimulant ADHD medication through telehealth in New Jersey?
In most cases, yes. Unlike stimulants such as Adderall or Vyvanse, non-stimulant ADHD medications are not controlled substances and do not have the New Jersey regulations for the in-person visit prior to prescribing them in 2026. A licensed psychiatrist in NJ and/or NY can readily prescribe a non-stimulant medication during an adult ADHD evaluation without a face-to-face appointment first.
Q: I have ADHD and anxiety – which non-stimulant is best?
At times, atomoxetine (Strattera) will be the first drug suggested when a child has both ADHD and anxiety because it is an anti-norepinephrine drug that works for both conditions, but does not have the anxiogenic effects of the stimulants. Guanfacine can also be used to help calm nervousness and anxiety. Your psychiatrist will determine which one best fits you due to your complete history.
Q: What if I tried a non-stimulant ADHD medication and it did not work?
Medication from the non-stimulant class doesn’t always have to be the not-so-good fit if your first medication trips – it could be a need for the right dose, a need for a different medication class, or perhaps a co-occurring condition needs to first be addressed. Before you eliminate the class, it is vital to re-evaluate with your psychiatrist and discuss other stimulant-free options.