ADHD
Neurodevelopmental condition with inattention, hyperactivity, and impulsivity onset in childhood. AAP 2019 and NICE NG87 recommend psychostimulants (methylphenidate, lisdexamfetamine), atomoxetine, and behavioural therapy. Nootropics and herbal preparations (piracetam, ginkgo, omega-3 monotherapy) are not included.
ICD-10 F90.09 drugs
Also known as: Attention deficit hyperactivity disorder
Drugs used for this condition
- AAtomoxetineSecond line · Centrally acting sympathomimeticsSecond-line ADHD therapy in children over 6, adolescents, and adults after stimulant failure or intolerance (methylphenidate, lisdexamfetamine) per NICE 2018, AAP 2019, and Spanish SEPP 2022. Starting dose 0.5 mg/kg once daily, increased to 1.2 mg/kg (max 100 mg/day) after 7–14 days. Full effect at 4–6 weeks. Particularly effective in patients with comorbid anxiety or tics (stimulants exacerbate them).
- AMethylphenidateFirst line · Centrally acting psychostimulantFirst-line for attention-deficit hyperactivity disorder in children over 6 and adults per AAP 2019, NICE NG87 (2018), and the Spanish SEPyP 2024 consensus. Children start at 5 mg 1–2 times daily; adults at 18 mg (Concerta) once daily in the morning. Cortese 2018 meta-analysis showed efficacy 0.78 SMD on ADHD symptoms in children. Mandatory pre-treatment psychiatric assessment, cardiovascular risk evaluation (ECG, BP, arrhythmia family history), and baseline growth and weight. Reassessment every 3–6 months.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DAntibodies to S-100 brain-specific protein (homeopathic)Not recommended · Homeopathic products (local classification)Antibodies to brain-specific protein S-100, in homeopathic dilution, are marketed as a remedy for attention deficit hyperactivity disorder (ADHD) in children and adults. This product has not shown meaningful benefit in ADHD, and there is no reliable evidence for this use. ADHD responds to approaches with proven effect: behavioral therapy, support from teachers and psychologists, and, when needed, medication selected by a physician. Do not use this product in place of treatment with proven benefit, since that can cost time and access to real help.
- DBacopa monnieri (brahmi)Not recommended · Plant nootropic adaptogen from Ayurvedic medicine, supplement. Not registered as medicine in EU or AEMPSBacopa monnieri (brahmi) is an Ayurvedic herb sold as a supplement for memory and focus, including for children and adults with ADHD. Its benefit specifically for ADHD has not been shown: there is no solid evidence base for this use, and the few small studies do not confirm an effect. ADHD responds to other approaches, namely behavioral therapy and medicines with proven efficacy (stimulants, atomoxetine) chosen by a doctor. The herb itself is well tolerated in this role, but there is no basis for relying on it to treat ADHD.
- DCholine bitartrateNot recommended · Essential nutrient, dietary supplement. The basic choline form used in supplements. Not registered as a medicine in the EU or USA; sold as a supplement in RussiaCholine bitartrate is a dietary form of choline, marketed as a supplement for attention and focus, including in ADHD. No convincing benefit for ADHD has been shown, and there is no solid evidence base for this use. ADHD responds to approaches with proven effect – behavioral therapy and medication (stimulants, atomoxetine) chosen by a clinician.
- FGinkgo biloba extractNot recommended · Herbal agents for cognitive disordersOnline, ginkgo is promoted as a 'natural remedy for concentration and ADHD'. AAP 2019 and NICE NG87 do not include herbal preparations in ADHD treatment. First-line is psychostimulants (methylphenidate, lisdexamfetamine), atomoxetine, and behavioural therapy. Ginkgo in children increases bleeding risk and can interact with other drugs.
- FHopantenic acid (calcium hopantenate)Not recommended · Nootropics (local classification). Russian and Japanese development.Pantogam is frequently prescribed in Russian paediatric neurology for ADHD as a «mild and safe nootropic». AAP, NICE, and CADDRA ADHD guidelines do not list the drug. First-line ADHD treatment in international guidelines is psychostimulants (methylphenidate, lisdexamfetamine) and behavioural therapy; no GABA-derivative nootropics are included.
- FPiracetamNot recommended · Old «nootropics» (local classification)International ADHD guidelines (AAP 2019, NICE NG87) list psychostimulants (methylphenidate, lisdexamfetamine), atomoxetine, and behavioural therapy as first-line. Piracetam is not in these documents. Russian paediatric practice sometimes prescribes it 'to improve concentration' – this contradicts the guidelines.
- FSemax (Met-Glu-His-Phe-Pro-Gly-Pro)Not recommended · Neuropeptides and nootropics (local classification). Russian development.Semax in Russia is indicated for cognitive disorders in children, including ADHD. AAP, NICE, and CADDRA ADHD guidelines do not list the drug. First-line ADHD treatment in international guidelines is psychostimulants (methylphenidate, lisdexamfetamine) and behavioural therapy; no peptide drugs based on ACTH fragments are included.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit