Stimulant Medications- naming names Part II of III
Some of the more well known name medications used to treat ADHD:
Amphetamine Category Methylphenidate Category
Adderall XR Ritalin SR, LA
Dexedrine Methylin, Methylin SR
Vyvanse Focalin, Focalin XR
Amphetamine based stimulant
Amphetamine - discovered in 1887
Used to treat ADHD and Narcolepsy
Can be used to treat depression and also to treat obesity
25% levoamphetamine salts, 75% dextroamphetamine salts
Therapeutic effect is generally 4 to 4.5 hours
Same as Adderall above except for hours of action
The capsule contains 2 types of medication beads. This leads to 2 pulses of delivery. Length of action generally reported as about 6 hours.
Dexedrine (Brand name)
Dextroamphetamine (Generic name)
Indicated to treat ADHD and Narcolepsy
Can also be useful to treat depression and also to treat obesity
Does not have levoamphetamine
Therapeutic effect lasts about 4 to 4.5 hours.
Lisdexamfetamine (contracted from L-lysine- dextroamphetamine)
Does not have levoamphetamine
Used to treat ADHD and binge eating disorder. Can also be used to treat other issues as shown above.
Is a pro-drug to dextroamphetamine (shown above).
“Pro drug” means that it is an inactive version of dexedrine. It is only activated upon absorption when the L-lysine is cleaved from dextroamphetamine by an enzyme.
Lasts 8 to 10 hours generally, according to patient reports.
Racemic form- Both Levo and Dextro isomers in a 50-50 ratio. The L-isomer is more potent than the D- isomer in cardiovascular activity but much less potent in causing CNS effects.
Less effective in appetite suppression compared to dextroamphetamine
Duration of action- up to 10 hours
Besides treatment for ADHD, Evekeo has an indication to treat Narcolespy
Dextroamphetamine sulfate, Brand name (as opposed to the generic, Dexedrine aka dextroamphetamine)
Duration= 4 to 6 hours
Brand name for methylphenidate
Duration - generally about 4 hours
Differs from Ritalin in that its duration is up to 6-8 hours.
Slower to reach peak effect- happens around 2 to 3 hours after administration
Similar to Ritalin in that it is one peak
Differs from Ritalin in that its duration is longer, i.e. 6 to 8 hours
Capsule is made up of 2 different beads and therefore 2 different peaks of action.
Therefore, not slower to start acting (like Ritalin SR)
Methylin, Methylin ER
These are both brand names for methylphenidate (Ritalin)
Focalin, Focalin XR
Focalin is dexmethylphenidate
Each methylphenidate molecule has a mirror image, i.e. right sided and left sided or dextro and levo. Focalin only has the dextro side. The Levo is isolated out and removed.
It has the same impact as Ritalin but at half the dose. For example, 5mg Focalin is equivalent to 10mg Ritalin.
The difference between Focalin and Focalin XR is the duration. Duration times vary depending on the individual. That said, on average Focalin may last for about 6 hours and Focalin XR can last for 8 to 10 hours.
Methylphenidate that lasts for 12 hours.
Capsule constructed with a thin layer of ritalin on the outside for immediate action (about 30 to 40 min after ingestion).
Then it has tiny holes that allow for “pump action” where water pushes in and medication comes out, slowly, over about 12 hours.
Can be useful in older children who don’t go to bed as early as younger children.
It is good to cover the entire school day and homework time, if planned properly.
Methylphenidate in the form of a patch
For children who cannot swallow pills
Dosing- can cut the patch to the exact dose that is right for the child.
Duration- can stop by removing patch
Reports that it can irritate the skin. Therefore, may have to put in different places and rotate so as to avoid irritation in one spot.
A liquid form of methylphenidate
Good for children who cannot swallow pills
Good for exact dosing- to the drop. Cannot dose so precisely with pills
Duration- about 10 hours.