1. Why are stimulants usually prescribed before nonstimulants?
3. Some of the nonstimulants are still fairly new. Are they safe in terms of addiction risk or side effects?
4. Why do nonstimulants take longer to start working than stimulants?
5. Will the nonstimulant medications eventually stop working?
6. Is there a major cost difference among nonstimulants?
2. How can I figure out if a nonstimulant will be right for my child?
9. Will I have to take these medications forever?
8. Will I be able to afford this medication?
7. JAK inhibitors are still pretty new – are you sure they’re safe?
6. I read that JAK inhibitors increase the risk of blood clots. Should I be worried?
5. Can taking a JAK inhibitor cause cancer?
4. Why do I need to get certain vaccinations first?
3. Will taking a JAK inhibitor shut down my immune system?
2. If one JAK inhibitor doesn’t help me, does that mean none of them will?
1. Which JAK inhibitor is most likely to help me?
FAQs About Nonstimulants, Answered
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Stimulants are often very effective, which is why healthcare providers typically begin with them. But they just don’t work for some children, and nonstimulants are a good alternative. “Right now, on average, stimulants have a higher effect on ADHD symptoms than nonstimulants do,” Newcorn says. “But that doesn’t mean that a nonstimulant couldn’t be really, really good for one person.” He adds, “When [healthcare professionals] talk about an effect of a drug, we’re talking about an average effect … so that includes the people who do really well and the people who don’t do really well. But when you’re the parent, you’re only interested in how your kid is going to do.”
“There isn’t any one thing that you can tell someone to look for, or ask for, or ask about that will tell them whether they should use a nonstimulant or not,” explains Newcorn. In the end, no medication can cure ADHD. But the right medication at the right dosage might make a big difference in your child’s life. Fine-tuning is important: It is not a one-size-fits all scenario. “If you have an interest in using a nonstimulant and seeing whether it works, and [then] it doesn’t work, you move on,” says Newcorn. There’s no way to know which is the right choice until your child tries various options.
“The nonstimulants have no addiction potential,” Newcorn says. “They’re safe. They’re approved. They’re effective.” That said, all medications pose a risk of side effects, and nonstimulants are no different. Always talk to your doctor about these before starting a new medication.
Stimulant medications enter and exit the bloodstream — and therefore exert their effect on ADHD symptoms — relatively quickly, whereas the concentration of nonstimulants needs to build up in the body over days and weeks to start working. Keep in mind that other factors, such as your child’s age, genetics, and metabolism, influence how quickly or slowly stimulant and nonstimulant medications affect them — and for how long.
4. Why do nonstimulants take longer than stimulants to start working?
“There’s no real evidence of that,” says Newcorn. If your child’s medication appears to no longer have the same effect that it once did, bring it up with your doctor. There “may be a more nuanced explanation for what’s going on,” explains Newcorn. For example, if your child’s symptoms change over time, the treatment may no longer be as effective for them.
The cost varies, depending on which medication was prescribed as well as your insurance coverage. Atomoxetine (Strattera) retails for around $400 for a one-month supply, though most people pay much less: With coupons it drops to around $33 per month, which still can be more expensive than clonidine ER (Kapvay) and guanfacine ER (Intuniv), which typically cost just several dollars. Atomoxetine is also available as a generic, which is covered by most insurance and Medicare plans. The newest nonstimulant, Qelbree, is likely more expensive, but actual pricing levels are still unclear. Talk to your doctor about getting free samples to try the medication as well as available options to help you cover the cost, such as saving cards from the pharmaceutical company.
