In this case, we may need to treat both conditions. In some cases, we will stop the stimulant and substitute another medication. In other cases, we add a second agent to the stimulant regimen. They can provide 24-hour coverage, and may not create the sleep difficulties sometimes associated with the stimulants. However, they have a number of potential drawbacks.
Tricyclics can cause dry mouth, blurred vision, constipation, dizziness and sedation.
The tricyclics, especially desipramine, can cause changes in cardiac conduction. Children are more sensitive to this effect than are adults. Like the tricyclics, it can provide 24-hour coverage. The chemical structure of bupropion resembles that of amphetamine. It does not have a potential for addiction.