Background

The drugs usually prescribed to treat attention deficit hyperactivity disorder (ADHD) are generally effective and safe. Most children and teenagers—60 percent to 80 percent—who take them become less hyperactive and impulsive, are better able to focus, and are less disruptive at home and school. However, there is no good evidence showing those benefits last for longer than two years.

Adults with ADHD appear to benefit from taking medication. But far fewer studies have examined the effectiveness of the medicines in adult men and women.

Our analysis found that stimulant medications, such as methylphenidate (Ritalin), might be slightly more effective than non-stimulant medications also used to treat ADHD, which include Intuniv, Kapvay, and Strattera. Our findings indicate that none of the stimulants are clearly more effective than any other. Each raises different safety issues, however, and you should discuss them with your doctor. Dosing convenience (such as taking one pill a day instead of two or more; oral solutions for those who have difficulty swallowing tablets; or the use of a skin patch) and the period of time that a medicine is active in your body are critical elements of ADHD treatment.

This report on prescription drugs to treat ADHD is part of a Consumer Reports project to help you find safe, effective medicines that give you the most value for your healthcare dollar. To learn more about the project and other drugs we’ve evaluated, go to CRBestBuyDrugs.org.

This information is produced by Consumer Reports and Consumer Reports Best Buy Drugs, a public information project supported by grants from the States Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.

Do You Need an ADHD Drug?

Because diagnosis of the condition can be difficult, and a variety of medical and psychiatric disorders can cause symptoms that mimic ADHD, many children and teenagers taking these medicines might either not have ADHD or have only mild symptoms that do not require medication. Be sure to get a careful diagnosis from a physician or mental-health professional with expertise in ADHD and a second opinion if you have doubts.

The symptoms in the section below can help you figure out if you or your child should be assessed for ADHD by a doctor or mental health expert.

Symptoms

If you or your child has six or more of the following symptoms and behavioral patterns—from either list—persistently for six months, ADHD may be the cause.

Inattention

■ Difficulty paying attention to details

■ Frequent hasty mistakes in schoolwork, work, or other activities

■ Difficulty sustaining attention in performing tasks or play activities

■ Difficulty listening when spoken to directly

■ Unable or slow to complete assignments and tasks

■ Difficulty organizing tasks and activities

■ Difficulty with tasks that require sustained mental effort

■ Loses things necessary for tasks or activities

■ Easily distracted by extraneous stimuli or sights or sounds

■ Easily bored

■ Forgetful in daily activities

■ Tendency to daydream

Hyperactivity and Impulsivity

■ Fidgets with hands or feet or squirms in chair

■ Leaves seat in classroom or in situations in which remaining seated is expected

■ Runs around excessively in situations in which it is inappropriate

■ Difficulty engaging in leisure activities in a quiet manner

■ “On the go” or acting as if “driven by a motor” much of the time

■ Excessive or impulsive talking

■ Blurts out answers before questions have been completed

■ Difficulty in waiting for his or her turn to speak

■ Interrupts or intrudes on others

■ Hot-tempered; easily agitated or angered

■ Low tolerance of stress

Our Recommendations

Taking into account the evidence for effectiveness, safety, dosing convenience, duration of action, and cost, we have chosen the following as Consumer Reports Best Buy Drugs to treat ADHD:

Methylphenidate has a long track record that shows it is generally safe and effective. The monthly cost ranges from $15 to $197, depending on strength. As this report is being finalized, there’s an ongoing shortage of generic methylphenidate due to manufacturing problems. If you’re unable to get a prescription filled, ask your doctor or pharmacist about obtaining the drug from a different part of the country. That might be easier at large chain pharmacies, such as at Target or Walgreens.

Cost Comparison

Generic Name and Strength1

Brand Name

Drug Is a
Generic?2

Frequency of
Use Per Day3

Average
Monthly Cost4

Amphetamine mixture 5 mg tablet

Adderall

No

Two

$303

Amphetamine mixture 10 mg tablet

Adderall

No

Two

$294

Amphetamine mixture 5 mg tablet

Generic

Yes

Two

$96

Amphetamine mixture 10 mg tablet

Generic

Yes

Two

$84

Amphetamine mixture 5 mg continuous-delivery capsule

Adderall XR

No

One

$291

Amphetamine mixture 10 mg continuous-delivery capsule

Adderall XR

No

One

$284

Amphetamine mixture 5 mg continuous-delivery capsule

Generic

Yes

One

$181

Amphetamine mixture 10 mg continuous-delivery capsule

Generic

Yes

One

$184

Atomoxetine 10 mg capsule

Strattera

No

One

$218

Clonidine 0.1 mg sustained-release tablet

Kapvay

No

Two

$167

Dextroamphetamine 5 mg tablet

Generic

Yes

Two

$24

Dextroamphetamine 10 mg tablet

Generic

Yes

Two

$37

Dextroamphetamine 5 mg sustained-release capsule

Generic

Yes

One

$86

Dextroamphetamine 10 mg sustained-release tablet

Dexedrine

No

One

$229

Dextroamphetamine 10 mg sustained-release capsule

Generic

Yes

One

$100

Dextroamphetamine 15 mg sustained-release tablet

Dexedrine

No

One

$272

Dextroamphetamine 15 mg sustained-release tablet

Generic

Yes

One

$115

Dexmethylphenidate 10 mg sustained-release capsule

Focalin XR

No

One

$226

Guanfacine 1 mg sustained-release tablet

Intuniv

No

One

$220

Lisdexamfetamine 20 mg capsule

Vyvanse

No

One

$201

Methylphenidate 5 mg tablet

Methylin

BG

Two

$23

Methylphenidate 5 mg tablet

Ritalin

No

Two

$66

Methylphenidate 5 mg tablet

Generic

Yes

Two

$18

Methylphenidate 10 mg tablet

Methylin

BG

Two

$29

Methylphenidate 10 mg tablet

Ritalin

No

Two

$86

Methylphenidate 10 mg tablet

Generic

Yes

Two

$15

Methylphenidate 20 mg tablet

Methylin

BG

Two

$43

Methylphenidate 20 mg tablet

Ritalin

No

Two

$115

Methylphenidate 20 mg tablet

Generic

Yes

Two

$38

Methylphenidate 10 mg sustained-release tablet

Generic

Yes

One

$32

Methylphenidate 10 mg sustained-release tablet

Ritalin LA

No

One

$179

Methylphenidate 10 mg sustained-release tablet

Metadate CD

No

One

$187

Methylphenidate 10 mg sustained-release tablet

Methylin ER

BG

One

$34

Methylphenidate 18 mg sustained-release tablet

Generic

Yes

One

$172

Methylphenidate 18 mg sustained-release tablet

Concerta

No

One

$207

Methylphenidate 20 mg extended-release tablet

Methylphenidate ER

Yes

One

$33

Methylphenidate 20 mg sustained-release tablet

Methylphenidate SR

Yes

One

$34

Methylphenidate 20 mg sustained-release tablet

Metadate ER

BG

One

$57

Methylphenidate 20 mg sustained-release tablet

Methylin ER

BG

One

$38

Methylphenidate 20 mg sustained-release tablet

Ritalin SR

No

One

$99

Methylphenidate 20 mg sustained-release capsule

Metadate CD

No

One

$186

Methylphenidate 20 mg sustained-release capsule

Ritalin LA

No

One

$187

Methylphenidate 27 mg sustained-release tablet

Concerta

Yes

One

$215

Methylphenidate 27 mg sustained-release tablet

Generic

No

One

$176

Methylphenidate 30 mg sustained-release tablet

Metadate CD

No

One

$188

Methylphenidate 30 mg sustained-release tablet

Generic

Yes

One

$144

Methylphenidate 30 mg sustained-release tablet

Ritalin LA

No

One

$183

Methylphenidate 40 mg sustained-release tablet

Metadate CD

No

One

$259

Methylphenidate 40 mg sustained-release tablet

Generic

Yes

One

$145

Methylphenidate 40 mg sustained-release tablet

Ritalin LA

No

One

$194

Methylphenidate 54 mg sustained-release tablet

Concerta

No

One

$252

Methylphenidate 54 mg sustained-release tablet

Generic

Yes

One

$197

Methylphenidate 5 mg chewable tablet

Methylin

No

Two

$335

Methylphenidate 5 mg/5 ml solution

Methylin

No

Two

$317

Methylphenidate 10 mg/5 ml solution

Methylin

No

Two

$549

Methylphenidate 5 mg/5 ml solution

Generic

Yes

Two

$240

Methylphenidate 10 mg/5 ml solution

Generic

Yes

Two

$351

Methylphenidate 10 mg/9 hr disc

Daytrana

No

One

$242

Selected drugs and dosages only. For a complete price list, go to CRBestBuyDrugs.org to download the free report.

1. Not all dose forms are listed. Higher doses, not generally or widely used in children, are not represented.
2. BG indicates that the drug is a "branded generic," a medicine that is generic but given a special name by its maker for marketing purposes.
3. As typically prescribed, but dosing varies with these drugs.
4. Monthly costs reflect national average retail prices for January 2012, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Symphony Health Solutions, which is not involved in our analysis or recommendations.

NOTE: The information contained in the Consumer Reports Best Buy Drugs™ reports is for general informational purposes and is not intended to replace consultation with a physician or other health care professional. Consumer Reports is not liable for any loss or injury related to your use of the reports. The reports are intended solely for individual, non-commercial use and may not be used in advertising, promotion, or for any other commercial purpose.


Copyright 2010, Consumers Union of United States, Inc

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