Are non-stimulants underutilised because of fear of misuse or stigma? 

There’s growing discussion around whether non-stimulant ADHD treatment stigma contributes to these medications being overlooked. While stimulant medications are often the first line of treatment, non-stimulants like atomoxetine and guanfacine offer important alternatives, especially for those who don’t respond well to stimulants or have concerns about misuse. 

One reason prescribing patterns favour stimulants is that they tend to act more quickly and are more familiar to clinicians. However, stimulants come with a higher risk of misuse, which makes the underuse of safer non-stimulants a missed opportunity. The fear of being seen as a “weaker” option or the assumption they are less effective can both reinforce this trend. 

Why non-stimulants matter 

Non-stimulants are often the better choice in specific situations. Here’s how they help: 

Lower misuse potential  

Medications like atomoxetine are not controlled substances and carry less risk of addiction or diversion. Treatment implication: Useful for people with substance use history or where misuse is a concern. 

Better for comorbid conditions 

 People with anxiety, tics or seizures often tolerate non-stimulants better than stimulants. Treatment implication: Safer and more effective in complex cases. 

Gradual but stable effects 

 Non-stimulants may take longer to work but offer steady symptom control without the ups and downs. Treatment implication: They’re a good option when slow, consistent improvement is the goal. 

Visit providers like ADHD Certify for personal consultations and medication planning that considers your unique needs. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Medication misuse and stigma.