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Stimulant Medications for ADHD The following medications appear to be the best to treat ADHD. Methylphenidate is the generic form of Ritalin. It is a Schedule II drug, meaning that it is highly regulated stimulant medication. It is in available in the following forms: Metadate CD: This comes in a 10, 20, and 30 mg capsule with special time released beads. It typically lasts for about the whole school day (8 hours), but does not seem to last into the late afternoon or evening. It is the only medication that is FDA approved to be sprinkled in applesauce or pudding, if you have problems swallowing. This may be the best for the morning and for the school day. Very few side effects compared to other stimulants. Ritalin LA: This is a new version of Ritalin, that may be fairly good. It appears to have an even 8 hour delivery, perhaps longer. Concerta: This uses a special osmotic pump that provides a sort of IV drip for about 12 hours. It is great technology and truly gives about 11.5 to 12 hours of coverage. It comes in 18, 27, 36, and 54 mg sizes. This lasts longer than Metadate, and provides good afternoon coverage as well. Cannot be divided. Drink with at least 8 oz of water. Concerta is not as strong in the first half of the day as the second half. Some people supplement Concerta with a short acting dosage of methylphenidate in the morning to help it "get going." Also many people take either another full dosage in the afternoon or supplement with a short acting dosage of methylphenidate for the evening time. Focalin: This is the newest version of methylphenidate. The molecule for Ritalin has been divided to keep the active half of the Ritalin. Thus one needs to take only half as much for the same effect. It may have fewer side effects. And you can feel better giving your child only half as much! Focalin is also available in a long acting form as well. Ritalin: Lasts 3.5 to 4 hours. Typically three dosages needed per day. Uneven effect during the day, and also rebound effect (behavior may worsen) when it wears off. Generic methylphenidate: It lasts 3.5 to 4.5 hours. Its optimal peak value is somewhere between 30 minutes after it has been taken up to about 2.5 hours after it is taken. Generic is usually not much different than name brand Ritalin. The FDA requires that a generic be equivalent to the original. However, this can be anywhere from 80% to 120% of the strength. If your pharmacy changes suppliers, (the pill doesn't look the same) and your child responds differently, this may be a tip off to a different strength generic. One authority stated that in order to get good results one needs to give a dose every two hours. That is probably not possible to manage well with children, and most adults have trouble with that frequent of a dosing schedule. And most physicians would not prescribe enough to take it that often. Best to Avoid: Ritalin SR or Methylphenidate SR that comes in
20 mg form. Most authorities report that it does not work reliably
from day to day or person to person. If it works, fine, but it often doesn't.
Some report that it really doesn't last longer than regular methylphenidate. The main reason to use it is cost, not effectiveness. This drug was very popular
in the past because it was supposed to last longer. But it was often a
poor functioning drug, and with the much better choices now, it would be a
definite "last
choice." It can not be divided. Another type of stimulant drug used for ADHD is dextroamphetamine and dextroamphetamine compounds. These are also a Schedule II drug. Adderall: The original formula of a special version of dextroamphetamine compounds, and lasts from 4 to 8 hours, depending on the strength of the dosage. The higher the dosage, the longer it lasts. The advantage of Adderall is that it comes in many size pills and each can be divided in quarters, making the medication very easy to fine tune. Adderall sometimes increases tearfulness and moodiness. Adderall was originally marketed as a diet pill under a different name. Thus it suppresses appetite considerably. The appetite suppression is often quite severe at first, and often stabilizes after a week or two. Adderall should not be chewed or made into a powder and sprinkled in applesauce or pudding. Adderall XR: It is the same as taking two doses of Adderall 4 hours apart. Thus 10 mg of Adderall XR is the same as taking 2 doses of 5 mg. Adderall 4 hours apart. Adderall XR comes in 5, 10, 15, 20, 25 and 30 mg dosages. Adderall XR cannot be divided. While not recommended, it seems to work to break open the capsules and sprinkle on food for those who have trouble swallowing. Adderall appears to have some delayed absorption if taken with food high in fat. Vyvanse is a pro-drug version similar to Adderall. It seems to have fewer side effects. Dexedrine and Dexedrine Spanules: Hints for taking Stimulant Medications Stimulants (all of the above) should not be taken within one hour of citric acid products. Orange Juice is the obvious thing to avoid. But anything wrapped in foil (pop tarts) may have citric acid as a preservative. So check labels, and you help your medication be more effective. Make sure you take plenty of liquid with Concerta...It won't work well if you don't. Problems Swallowing: Here is a great trick for kids. Use a carbonated beverage (without citric acid if a stimulant). Using a straw, have the child suck in soda after placing the pill in their mouth. The bubbling action will make it hard to tell where the pill is in the mouth, and the sucking action will help pull the medication down. Adderall can be affected by a meal high in fat contact. It will likely slow the delivery of Adderall into your system.
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© 2012 John E. Swank, MS, LPCC Swank Counseling , 21 Robinhood Lane, Troy, OH 45373 Number of visits to pages on our website since December 26,2011 The content of this website is for public use and for information only. It is not intended to be used in any other manner. The authors disclaim any liability, loss, injury, or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this website. The information on this site is not intended to replace examination or treatment by a qualified healthcare professional and should not be used for diagnostic or treatment purposes. Correspondence from this website is not necessarily secure, and confidential information should not be shared. Disclosure and Privacy Information
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