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Ritalin, Metadate, Methylin, Concerta



mixed amphetamine salts








Immediate release products

Ritalin, Adderall, Dexosyn

IR products DOA

3-4 hours, maybe up to 12 hours for Adderall, dosed BID-TID

Focalin info

R-isomer of methylphenidate, smoother effect (less ups and downs, rebounds and insomnia), allows for higher dose, start at half the methylphenidate dose

as a group, ER products have what characteristics?

once daily dosing, increased compliance, decreased appetite

Ritalin SR info

delayed release, no effect seen for 1st 2 hours, DOA is 4 hours

Dexedrine Spansule info

no evidence of extended action

Metadate ER info

linear release, DOA is 6 hours

Concerta info

OROS delievery system (shell is impregnated with drug to get quick release (22%), then GI fluid enters capsule and makes it swell, small amounts of drug are pushed out the hole in the cap for timed release beginning 4 hours after ingestion (78%))

Metadate CD info

30%/70% beaded system, mimics two doses of immediate release product

Ritalin LA and Adderall XR infor

50/50 beaded formulation, mimics two doses of immediate release products

Vyvanse info

D-amphetamine prodrug, lysine moiety is cleaved in GI tract, less abuse potential

Daytrana info

transdermal methylphenidate, worn on hip for 9 hours

adverse effects of stimulants

decreased appetite, decreased growth, insomnia, rebound, SUDDEN CARDIAC DEATH



Straterra info

selective NE reuptake inhibitor, not a stimulant, once daily dosing, effects may not be seen for 2-4 weeks, liver toxicity and suicide



Intuniv info

alpha-2 agonist, once daily dosing, not controlled, Tenex is not the same on a mg-mg basis



Provigil info

CNS arousal agent, indicated for narcolepsy, euphoric effect but low abuse potential

second line agents

bupropion, venlafaxine, clonidine

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