Medication
ADHD medication comparison
Compare the main medication families first. Brand-level detail makes much more sense once the underlying medicine and formulation are clear.
Short answer
There is no universally “best” ADHD medicine. NICE sequencing, individual response, side effects, formulation and personal circumstances all matter.
Comparison
At a glance
| Medicine family | Type | Typical place in NICE pathway | Formulation notes |
|---|---|---|---|
| Methylphenidate | Stimulant | First-line in children and young people; first-line option in adults | Immediate and multiple modified-release products; release profiles differ |
| Lisdexamfetamine | Stimulant | First-line option in adults; used after methylphenidate in children/young people when indicated | Longer-acting prodrug of dexamfetamine |
| Dexamfetamine | Stimulant | Considered in defined situations where lisdexamfetamine helps but its longer effect is not tolerated | Shorter-acting amphetamine |
| Atomoxetine | Non-stimulant | Used when stimulant options are not tolerated or have not provided adequate benefit | Different onset and response timescale from stimulants |
| Guanfacine | Non-stimulant | Mainly used in children/young people; adult use requires specialist/tertiary advice under NICE | Different mechanism and monitoring considerations |
NICE NG87 – ADHD: diagnosis and management ↗ · NHS SPS – modified-release methylphenidate ↗
A better framework
Do not compare brands as if they are separate drugs
For methylphenidate especially, many brand names contain the same active drug but release it differently. The useful comparison is therefore usually:
- Which medicine family?
- Immediate or modified release?
- Which release profile or brand?
- How does the individual respond?