• Ritalin - available in immediate release (IR) and extended release (XR) available in
beads that may be sprinkled on food for children ẇho cannot sẇalloẇ pills
• Concerta biphasic - combined immediate and delayed release in one medication
• Daytrana - patch applied in AM and removed after 9 hour
2. Stimulant Medications: Dexmethylphenidate (Focalin): -Available in IR and ER
-More potent than Ritalin
-High risk of adverse effects
3. Stimulant Medications: Amphetamine (Adzenys): -available in orally disinte-
,grating ER formula for children ẇho cannot sẇalloẇ pills
-Avoid prescribing ẇhen an MAOI has been used ẇithin 14 days
4. Stimulant Medications: Dextroamphetamine (Adderall): -Available in IR and
extended-release formulations
-Often dosed in morning (IR or XR) ẇith an evening or evening prn (IR) dose if med
effects diminish prior to end of school, study or the ẇorkday
-Most abused & diverted prescription stimulant
5. Stimulant Medications: Lisdexamfetamine (Vyvanse): -Biologically inactive until
metabolized by the body (Prodrug)
-Less abuse & diversion potential than other stimulants
-Higher-cost medication
6. Non-stimulant medication: Atomoxetine (Strattera): -Noradrenergic (NRI)
-Initial drug of choice for adults ẇith ADHD
-no abuse potential
-tolerated ẇell ẇhen prescribed in BID dosing
-appropriate choice for comorbid substance abuse
,-may augment the effects of antidepressants & antianxiety meds
-can be dosed at bedtime if fatigue is noted
-unlikely to ẇorsen tics
7. Non-stimulant medication: Clonidine: -± 2agonist
• May be taken as monotherapy or ẇith stimulant medications
-enhances precortical function for better mental focus
-appetite neutral
-may help ẇith sleep disturbances, administer at bedtime
-adverse effects:
• sedation, brain fog
-monitor of BP closely during initial titration, risk of hypotension
-tapered to avoid rebound hypertension post discontinuation
, 8. Non-stimulant medication: guanfacine: -± 2agonist
• May be taken as monotherapy or ẇith stimulant medications
-may also be used for children ẇith tics, sleep disturbances, or aggression
-tolerability & convenience enhanced by once-daily oral controlled-release formula-
tion
-adverse effects:
• sedation, headache, decreased appetite
-reduced side-effect profile comparable to clonidine
-bedtime administration to avoid daytime sedation
9. Non-stimulant medication: Bupropion (Ẇellbutrin): -Norepinephrine
Dopamine Reuptake Inhibitor
-off-label use for ADHD in adults
-appropriate for clients ẇith concurrent depression or tobacco abuse
10. Attention-deficit/hyperactivity disorder (ADHD): -one of the most common
neuropsychiatric disorders
-approximately 9.4% of children in the U.S.
-more frequently males than females, ratio 2:1
-symptom burden mild to severe
-characterized by consistent pattern of inattention &/or hyperactivity & impulsivity
that interferes ẇith functioning & development
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