Stimulants, Wakefulness-promoting Agents, and Nonstimulant Attention Deficit Hyperactivity Disorder Medications

The treatments for attention deficit hyperactivity disorder (ADHD) as well as for excessive daytime sleepiness of narcolepsy, obstructive sleep apnea/hyponea syndrome, and shift work sleep disorder have been advanced and expanded rapidly in the past 15 years. The pharmacotherapeutic armamentaria for those disorders include stimulants (amphetamine, methamphetamine, methylphenidate, and lisdexamfetamine), wakefulness-promoting agents (modafinil and armodafinil for narcolepsy), as well as nonstimulant ADHD medications (atomoxetin, a norepinephrine reuptake inhibitor; guanfacine and clonidine α2A agonists). In this review, a brief history, chemical classifications, and pivotal clinical data of those therapeutic drugs which were approved as indications by the US Food and Drug Administration are discussed. Common off-label applications of those drugs in psychiatric practice are also mentioned.