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
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
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
D-amphetamine prodrug, lysine moiety is cleaved in GI tract, less abuse potential
transdermal methylphenidate, worn on hip for 9 hours
adverse effects of stimulants
decreased appetite, decreased growth, insomnia, rebound, SUDDEN CARDIAC DEATH
selective NE reuptake inhibitor, not a stimulant, once daily dosing, effects may not be seen for 2-4 weeks, liver toxicity and suicide
alpha-2 agonist, once daily dosing, not controlled, Tenex is not the same on a mg-mg basis
CNS arousal agent, indicated for narcolepsy, euphoric effect but low abuse potential
second line agents
bupropion, venlafaxine, clonidine
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