Manage early morning ADHD symptoms and functional impairment with treatments that are effective from awakening

The early morning routine before school can be a particularly challenging time for children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Morning-dosed stimulants often fail to adequately address early morning ADHD symptoms and impaired functioning, due to the delay in their onset of effect, which has a significant impact on the entire family. Clinicians should consider treatments that are effective from awakening, such as methylphenidate delayed release/extended release administered in the evening, methylphenidate transdermal system applied to the skin before awakening, or long-acting non-stimulants such as atomoxetine and guanfacine extended release, to improve ADHD symptoms and functioning during the early morning.