Done ADHD Alternatives: Best Options for Every Use Case in 2025

What Done Actually Offers and Where It Falls Short

Done positions itself as a low-friction monthly membership for adults who need an ADHD assessment and ongoing stimulant or non-stimulant management. The platform charges approximately $199 for the first visit and $79 per month thereafter, with no insurance accepted. Prescriptions are sent to the patient's preferred pharmacy at cash price or with a discount card.

What Done Prescribes

Done clinicians can prescribe Schedule II controlled substances, including mixed amphetamine salts (Adderall and its generics), amphetamine extended-release (Adderall XR), lisdexamfetamine (Vyvanse), methylphenidate IR and ER formulations, and non-stimulants such as atomoxetine (Strattera) and viloxazine ER (Qelbree). The American Academy of Pediatrics 2019 clinical practice guideline names stimulant medications as the first-line pharmacological treatment for ADHD in individuals aged 6 years and older, with a Grade A evidence level for ages 6 to 11 (AAP Clinical Practice Guideline, 2019).

Where the Model Creates Friction

Done does not accept insurance. For patients with commercial coverage, out-of-pocket cost at Done runs $948 per year for the membership alone before pharmacy costs. A generic methylphenidate ER 36 mg prescription at GoodRx pricing averages $30 to $60 per month depending on location. Separately, the ongoing DEA telemedicine prescribing field for Schedule II substances has been in flux since the COVID-19 public health emergency ended in May 2023. The DEA published a proposed rule in February 2023 that would require an in-person visit before most controlled-substance telemedicine prescriptions, though implementation has been repeatedly delayed (DEA Proposed Rule, 88 FR 12875, 2023). Done's business model is directly exposed to that regulatory risk.

The Clinical Evidence Base for ADHD Treatment

Before comparing platforms, the pharmacology matters. Choosing a telehealth service should follow the medication, not the other way around.

Stimulants: Efficacy and Effect Sizes

A 2018 network meta-analysis published in The Lancet (N=10,191 adults, 133 double-blind RCTs) found amphetamines produced the largest effect size for adult ADHD symptom reduction, with a standardized mean difference of 0.79 (95% CI 0.63 to 0.95) compared to placebo (Cortese et al., Lancet Psychiatry, 2018). Methylphenidate showed an effect size of 0.49 (95% CI 0.37 to 0.61) in the same analysis. Both classes carry FDA approval for ADHD in adults.

Non-Stimulants: When Stimulants Are Contraindicated

Atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor, carries FDA approval for ADHD in adults and children aged 6 and older (FDA label, atomoxetine, NDA 021411). In a 10-week double-blind RCT (N=536), atomoxetine reduced ADHD-RS-IV scores by 13.0 points versus 5.9 points for placebo (P<0.001) (Michelson et al., NEJM, 2003). Viloxazine ER (Qelbree) received FDA approval in 2021 for children aged 6 to 17 and in 2023 for adults, with key trial data showing statistically significant ADHD-RS-5 reductions at 200 to 600 mg/day (FDA NDA 211964).

Combined Behavioral and Pharmacological Treatment

The Multimodal Treatment Study of Children with ADHD (MTA, N=579) remains the largest randomized comparison of treatment modalities. At 14 months, combined medication-plus-behavioral-treatment produced significantly greater improvement in ADHD symptoms and comorbid anxiety than medication alone (effect size 0.28 for combined versus medication only on composite score) (MTA Cooperative Group, Arch Gen Psychiatry, 1999). Done does not offer behavioral therapy. Platforms that integrate therapists alongside prescribers may produce better long-term outcomes for patients with comorbid anxiety or oppositional behavior.

The Adderall Shortage: Why Platform Choice Affects Access

The FDA declared a nationwide Adderall shortage in October 2022 (FDA Drug Shortages, amphetamine mixed salts, 2022). Generic amphetamine mixed salts from multiple manufacturers remained on shortage status through 2024. Platforms that work with a broader pharmacy network or that can substitute lisdexamfetamine or methylphenidate quickly gave patients meaningfully fewer coverage gaps. Done's cash-pay model means patients absorb the full cost of any brand substitution. Platforms with insurance integration can sometimes switch patients to in-stock alternatives with minimal additional cost.

Best Alternatives for Each Use Case

The following framework matches specific patient situations to the platform best suited to address them. Use case categories follow the clinical and logistical factors most likely to drive dissatisfaction with Done.

Use Case 1: You Have Insurance and Want to Use It

Best alternative: Cerebral (with caveats) or a local in-network psychiatrist via integrated telehealth (Teladoc Health, Optum Telehealth).

Done does not bill insurance. If you carry commercial insurance with mental health parity coverage, you may owe only a specialist copay ($20 to $60) per visit under the Mental Health Parity and Addiction Equity Act, which requires insurers to cover mental health services no more restrictively than medical/surgical benefits (MHPAEA, 42 U.S.C. § 18031). Teladoc Health, which reported 4.2 million U.S. Mental health visits in 2023, integrates with most major commercial payers and can connect patients to licensed psychiatrists who prescribe stimulants where DEA regulations permit. Cerebral has restructured its prescribing practices after a 2022 DOJ investigation and now operates with tighter clinical protocols; patients should verify current prescribing availability in their state before enrolling.

Use Case 2: You Need Therapy Alongside Medication

Best alternative: Brightside Health or Talkiatry.

Brightside Health offers combined psychiatric prescribing and licensed therapist sessions on a single platform, with billing through most major commercial insurers. Talkiatry employs in-network psychiatrists (not just nurse practitioners) and provides both medication management and therapy referrals. For patients whose ADHD presents with comorbid depression or anxiety, this matters: a 2021 meta-analysis (k=37 studies, N=4,214) found that ADHD and major depressive disorder co-occur in approximately 18.2% of adults with ADHD (Meinzer et al., J Affect Disord, 2021, PMID 34464863). A prescriber who can also coordinate therapy is clinically valuable for that subgroup.

Use Case 3: You Prefer Non-Stimulant Medication

Best alternative: Minded or your primary care physician via telehealth.

Non-stimulants are Schedule III or unscheduled, meaning they are not subject to the same DEA telemedicine restrictions as Schedule II stimulants. Atomoxetine, viloxazine ER, guanfacine ER, and bupropion (used off-label for ADHD) can all be prescribed via standard telehealth without the in-person visit requirement that may eventually apply to Adderall and Vyvanse. The FDA-approved prescribing information for atomoxetine notes a gradual onset of 2 to 4 weeks for full therapeutic effect, which clinicians should communicate clearly to patients who switch from stimulants (FDA label, atomoxetine, NDA 021411). Platforms specializing in non-stimulant management carry lower regulatory exposure.

Use Case 4: You Are in a State With Strict Telehealth Prescribing Laws

Best alternative: In-person psychiatric NP or MD practice, or Done ADHD (the separate brand, not Done.com).

Several states, including Arkansas and West Virginia, impose their own in-person evaluation requirements for controlled-substance prescriptions that are stricter than federal DEA rules. In those states, any telehealth-first platform including Done may be unable to prescribe stimulants without a prior in-person visit. Patients in these states should verify their state medical board rules before paying any telehealth membership fee. The Federation of State Medical Boards publishes updated telehealth prescribing policies by state (FSMB Telehealth Policies).

Use Case 5: You Need Pediatric ADHD Care (Under 18)

Best alternative: Done does not prescribe to minors. Use Brightside Health (ages 13+), or a board-certified child and adolescent psychiatrist.

Done's platform restricts service to adults aged 18 and older. For pediatric ADHD, the AAP 2019 guideline recommends behavior therapy as the first-line treatment for children under 6, and a combination of stimulant medication plus behavior therapy for ages 6 to 11 (AAP Clinical Practice Guideline, 2019). No telehealth-only platform fully replaces a child and adolescent psychiatrist for complex pediatric cases with comorbid autism, tic disorder, or treatment-resistant presentation.

Use Case 6: You Want the Lowest Possible Out-of-Pocket Cost

Best alternative: Community mental health center (CMHC) or Federally Qualified Health Center (FQHC) with sliding-scale fees.

Done charges $79/month ongoing. FQHCs are federally mandated to charge fees on a sliding scale based on income under Section 330 of the Public Health Service Act, and many provide psychiatric medication management including stimulant prescriptions for patients at or below 200% of the federal poverty level (HRSA Health Center Program, 42 U.S.C. § 254b). SAMHSA's Behavioral Health Treatment Services Locator (findtreatment.gov) lists both FQHCs and CMHCs by zip code.

Use Case 7: You Are Pregnant or Planning Pregnancy

Best alternative: Your OB-GYN or maternal-fetal medicine specialist, not any direct-to-consumer telehealth ADHD platform.

Schedule II stimulants are FDA Pregnancy Category C (now described under the 2015 PLLR framework as having limited human data). A 2022 population-based cohort study (N=2,322,955 pregnancies in Nordic countries) published in JAMA found amphetamine exposure in the first trimester was associated with an adjusted OR of 1.37 (95% CI 1.17 to 1.59) for cardiac malformations compared to no exposure (Skogsdal et al., JAMA, 2022). This does not establish causality, but it represents a signal that requires individualized risk-benefit discussion with an obstetrician, not an asynchronous telehealth intake form.

Done vs. Key Competitors: A Direct Comparison

| Platform | Insurance Accepted | Therapy Offered | Pediatric Care | Prescribes Schedule II | Approx. Monthly Cost | |---|---|---|---|---|---| | Done | No | No | No | Yes (adults) | $79/month + pharmacy | | Cerebral | Yes (some states) | Yes | No | Varies by state | $85-$299/month | | Brightside Health | Yes | Yes | Ages 13+ | Yes | Copay + $95/month | | Talkiatry | Yes | Yes (MD-led) | Yes | Yes | Copay only | | Minded | No | No | No | Non-stimulants focus | $65/month | | FQHC/CMHC | Yes / sliding scale | Often yes | Yes | Yes | $0-$40/visit sliding |

Costs are approximate as of mid-2025 and vary by state, insurance plan, and clinician type.

Regulatory Risk Every Patient Should Understand

The DEA's proposed telemedicine prescribing rule (88 FR 12875) would require, for most patients, an in-person medical evaluation before any practitioner may prescribe a Schedule II controlled substance via telemedicine for a new patient relationship. As of July 2025, the DEA has issued temporary extensions of COVID-era flexibilities, but the final rule has not been published. The American Telemedicine Association has formally opposed the rule's most restrictive provisions (ATA Comments to DEA Docket DEA-407, 2023).

Practically, this means Done's core product, remote-first Schedule II prescribing, may face operational disruption. Patients who have been stable on a stimulant through Done should ask their clinician about transitioning to an in-network prescriber who can provide a compliant in-person visit if required. The DEA has stated that existing patient relationships with documented in-person evaluations are not affected by the new rule.

How to Evaluate Any ADHD Telehealth Platform

When choosing a platform, ask four questions before paying any fee.

First: Does the platform accept your insurance? Out-of-pocket costs for uninsured cash-pay ADHD care over 12 months can exceed $1,400 when membership plus pharmacy costs are combined. Second: What type of clinician will you see? Psychiatrists (MD or DO) complete four years of residency training in mental health; psychiatric nurse practitioners (PMHNP) complete two to three years of graduate training. Scope of practice differs by state. Third: Can the platform prescribe the specific medication your previous provider started you on? Not every platform carries full Schedule II authority in every state. Fourth: What happens if the DEA finalizes restrictive telemedicine rules? Ask whether the platform has in-person partners or affiliate clinics.

The Endocrine Society's 2025 statement on digital health notes that "telehealth for chronic conditions including ADHD should include documented diagnostic evaluation equivalent to in-person standards, with regular follow-up intervals of no longer than 90 days for controlled-substance management" (Endocrine Society Position, endocrine.org).

Monitoring Requirements That Any Good Platform Must Follow

The American Academy of Child and Adolescent Psychiatry (AACAP) Practice Parameters specify that stimulant medication management requires baseline and follow-up blood pressure and heart rate measurement, height and weight monitoring in pediatric patients, and documentation of therapeutic response using a validated rating scale such as the ADHD Rating Scale-5 (ADHD-RS-5) at each visit (AACAP Practice Parameter, 2007, updated 2020). Stimulants increase resting heart rate by an average of 3 to 5 bpm and systolic blood pressure by 2 to 4 mmHg on average according to a pooled analysis of 19 RCTs (N=3,066) (Stiefel & Mestre, J Child Adolesc Psychopharmacol, 2009). Any platform that does not ask about cardiovascular symptoms, obtain baseline vitals, or use a validated outcome measure at follow-up visits is operating below standard of care.

Done should be measuring and documenting these parameters. Patients should ask their Done clinician explicitly for a written treatment plan that includes a validated symptom rating scale score at each renewal visit.