Stimulants are very effective in calming the restless patient, improving his or her ability to focus and improving the patient's ability to inhibit distraction and impulsivity. The initial response to a stimulant may be dramatic, and the patient may need to temper his or her expectations after subsequent dose adjustments. Once a day dosing is an advantage for the patient, and the physician is able to call in prescriptions and authorize refills. There are advocates of both low and high doses. Many clinicians report that tricyclic antidepressants are more effective in reducing hyperactivity and distractibility, and less effective than stimulants in reducing impulsivity.
Tricyclic antidepressants increase the availability of several neurotransmitters in the brain.
Effexor is available in a once a day form. It is very helpful in reducing comorbid anxiety and depression. It affects the brain by increasing the availability of serotonin and norepinephrine, and at high doses, dopamine also. Wellbutrin is a stimulating antidepressant. It is generally taken twice per day.