What are the recommended first-line pharmacological treatments for adults diagnosed with ADHD?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Offer lisdexamfetamine or methylphenidate as first-line pharmacological treatment for adults with ADHD .

Consider switching to lisdexamfetamine for adults who have had a 6-week trial of methylphenidate at an adequate dose but have not derived enough benefit in terms of reduced ADHD symptoms and associated impairment .

Consider switching to methylphenidate for adults who have had a 6-week trial of lisdexamfetamine at an adequate dose but have not derived enough benefit .

Consider dexamfetamine for adults whose ADHD symptoms are responding to lisdexamfetamine but who cannot tolerate the longer effect profile .

Offer atomoxetine to adults if they cannot tolerate lisdexamfetamine or methylphenidate, or if their symptoms have not responded to separate 6-week trials of these medications .

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