Drug		Brand names	Initial dosage	Usual dosage	Maximal dosage (per day)	Adverse effects
First-line agents (stimulants)
Methylphenidate
	Immediate release	Ritalin, Methylin	5 mg twice per day	10 to 20 mg two to three times per day	60 mg	Appetite suppression and weight loss, abdominal pain, headache, irritability, growth effects, tics, cardiovascular effects, insomnia
	Extended release	Ritalin SR, Metadate ER, Methylin ER	10 mg twice per day, or 20 mg once per day	20 to 40 mg once per day, or 40 mg in the morning and 20 mg in the early afternoon	60 mg
	Long acting	Ritalin LA, Metadate CD	20 mg once per day	20 to 40 mg once per day	60 mg
		Concerta	18 mg every morning	18 to 54 mg every morning	72 mg
		Daytrana (patch worn nine hours per day)	10 mg	10 to 30 mg	30 mg	Same as other methylphenidate brands; skin irritation and rash
Dexmethylphenidate		Focalin	2.5 mg twice per day	5 to 10 mg twice per day	20 mg	Same as methylphenidate; causes fewer headaches, but more stomach pain than methylphenidate
Dextroamphetamine
	Short acting	(formerly Dextrostat)	2.5 mg twice per day	5 to 15 mg twice per day, or 5 to 10 mg three times per day		Same as methylphenidate
	Intermediate acting	Dexedrine Spansule, Adderall*	5 mg once or twice per day	5 to 30 mg once per day, or 5 to 15 mg twice per day	40 mg
	Long acting	Adderall XR*	10 mg once per day	10 to 30 mg once per day	30 mg
Second-line agents
Atomoxetine		Strattera	10 to 18 mg once per day	18 to 60 mg once per day	100 mg	Similar to methylphenidate; nausea, vomiting, fatigue, mild increase in blood pressure and pulse
Third-line agents
Bupropion (sustained and extended release)		Wellbutrin	100 to 150 mg twice per day (sustained release); 150 mg once per day (extended release)	150 mg twice per day (sustained release); 150 to 300 mg once per day (extended release)	300 mg	Weight loss, insomnia, agitation, anxiety, dry mouth, seizures
Imipramine		Tofranil	30 to 40 mg once per day	37.5 to 75 mg twice per day	150 mg	Anticholinergic effects, dry mouth, constipation, tachycardia, changes on electrocardiography, sudden death, arrhythmias
Desipramine		Norpramin	25 mg once or twice per day	50 mg twice per day, or 100 mg once per day	150 mg	Same as imipramine
Clonidine		Catapres	0.025 to 0.05 mg per day	0.1 to 0.3 mg per day, divided into three or four doses	0.4 mg	Drowsiness, dizziness, dry mouth, orthostatic hypotension
Guanfacine		Tenex	0.5 mg per day	0.5 to 4 mg per day, divided into two to four doses	4 mg	Same as clonidine, but lower incidence and severity