Other Medications to Treat Attention-Deficit Hyperactivity Disorder
The Food and Drug Administration (FDA) has not approved the use of antihypertensives for ADHD. Four children have died while taking a combination of the stimulant methylphenidate (Ritalin®) and the antihypertensive clonidine (Catapres), but the cause of these deaths is unclear.
Some evidence suggests that the sedation induced by antihypertensives like clonidine (Catapres) and guanfacine (Tenex) helps reduce symptoms of ADHD when combined with stimulants. Antihypertensives also may be helpful in patients with ADHD and tics.
Antihypertensives may be used as an alternative to stimulant medications, especially in the 30 percent of children who cannot tolerate stimulants, and in children with conduct problems. However, antihypertensives may not improve attention deficit or distractibility.
The physician should perform a thorough cardiovascular history and examination before prescribing an antihypertensive. These drugs should be used carefully and monitored with blood pressure checks and heart rate analyses in all patients.
The most common side effects of antihypertensives include the following:
- Dry mouth
- Mildly low blood pressure
When discontinuing these drugs, the dosage is tapered slowly. Abrupt discontinuation can lead to headache, agitation, and elevated pulse rate and blood pressure.
Antiepileptic drugs such as carbamazepine (Tegretol, Epital) and gabapentin (Neurontin) are not FDA-approved to treat ADHD. These drugs can effectively treat symptoms of bipolar disorder and may be used in people with ADHD who experience mood swings. However, gabapentin may actually worsen oppositional behavior in some ADHD cases.
Neuroleptics (also called conventional antipsychotics) such as halperidol (Haldol) may be used to treat tic disorders, schizophrenia, and rarely, ADHD with tic disorder. These drugs are associated with significant adverse side effects, including tardive dyskinesia, a serious neurological disease that causes disturbing, involuntary muscle movement. Use of neuroleptic drugs for ADHD is unsupported, has not been studied formally, and is potentially harmful.