Stimulant medications are the first-line treatment for ADHD, with non-stimulants often used if stimulants are ineffective. Here, by reinterpreting randomized controlled trials, addressing heterogeneity of treatment effects, and considering societal impact, we argue for equal consideration of stimulant and non-stimulants as first-line treatment options.
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Acknowledgements
S.V.F.’s research is supported by the Upstate Foundation, the EU’s Horizon 2020 research and innovation program under grant agreement 965381; NIH/NIMH grants U01AR076092, R01MH116037, 1R01NS128535, R01MH131685, 1R01MH130899 and U01MH135970; Massachusetts General, Otsuka Pharmaceuticals OAK-ISS-2023-001796, Oregon Health & Science University and Supernus Pharmaceuticals. His continuing medical education programs are supported by Collegium Pharmaceuticals, Corium Pharmaceuticals, Tris Pharmaceuticals and The Upstate Foundation.
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In the past year, S.V.F. received income, potential income, travel expenses continuing education support and/or research support from Aardvark, Aardwolf, Mentavi/ADHD Online, Ironshore/Collegium, Corium, Johnson & Johnson/Kenvue, Medice, Otsuka, Supernus and Alkermes. With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. He also receives royalties from books published by Guilford Press, Oxford University Press and Elsevier. He is program director of the ADHD Evidence Project and ADHD in Adults. J.H.N. is a consultant or on the advisory board for AGB Pharma, Cingulate Therapeutics, Hippo T&C, Lumos, Medice, Mentavi Health, MindTension, Otsuka, Signant Health, Supernus and the US National Football League; has received research support from Cingulate, MindTension and Supernus; and has received honoraria for disease state lectures from Apsen.
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Nature Mental Health thanks Steven R. Pliszka and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.
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Faraone, S.V., Newcorn, J.H. Rethinking the role of non-stimulants in ADHD treatment. Nat. Mental Health 4, 9–12 (2026). https://doi.org/10.1038/s44220-025-00564-7
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DOI: https://doi.org/10.1038/s44220-025-00564-7
