Next i’ll be focusing on the medication choices for adhd i’ll spend almost all of my time talking about the stimulants but we’ll mention which non stimulants are used the medications we use most commonly for the stimulants which have consistently shown the most benefit for adhd there are three major groups of stimulants the ritalin group whose chemical name is
Methylphenidate the adderall group a medicine which is a mixture of four amphetamine salts and the dexedrine group whose chemical name is dextroamphetamine these medicines all appear to help by increasing those brain chemicals which are low in adhd dopamine and norepinephrine there are non stimulant medications which may be used in some children with adhd they’re
Not generally as effective as stimulants but in situations in which the stimulants aren’t working they may be appropriate strattera whose chemical name is adam oxy teen is a medication which increases levels of norepinephrine and this is how it seems to work to other medications intuniv or guanfacine and cafe or clonidine have more recently been approved for adhd
They helped by decreasing overactive portions of the brain they are also less effective than stimulants they may be useful alone but sometimes they can be helpful when added to a stimulant i won’t be discussing these in much more detail as the stimulants are still the first choice medications but if your child has problems with stimulants you may want to discuss
These other medications with the doctor each of the three stimulant groups of medications have preparations that last differing periods of time depending on when your child needs help with the adhd most children though benefit best from medications that last 12 hours as their adhd causes problems both in and out of school there are two 12-hour medications in the
Ritalin group concerta and focal and xr and for most children these are going to be the best preparations they’ll last through the school day and then usually into the afternoon so that they can help with after-school activities homework and time with family for children who can’t swallow pills focalin xr is a good medication because you can open up the capsule
And sprinkle the beads on foods such as pudding or applesauce and then simply eat the food with the beads mixed in you can’t do this with concerta there are times though when shorter acting medications may be useful the 4-hour medications methylphenidate focalin and ritalin are probably best used in the afternoon if the long-acting medication has worn off or it
Can help for homework or other activities on the weekend if your child isn’t taking a long-acting medication on those days there’s an intermediate group of medications that lasts about 6 hours these include metadata er and methylphenidate er generally we don’t find that they’re very helpful as they may start working slowly and don’t usually last long enough to
Help through the school day for some children an eight hour preparation may be useful ritalin la and meta dates cd work for approximately eight hours these are best for children who just need help in school but don’t seem to have problems when outside the school setting lastly there’s de tirana this ritalin preparation comes in a patch which is placed on the skin
The length of benefit from date rana varies depending on how long you keep it on it can be a little more difficult to use because the patch can irritate the skin also it may take one to two hours to start working after you put it on in the adderall group there are two preparations first there’s adderall tablets which last four to six hours these are similar to
The short acting ritalin and best use late in the day or on weekends adderall xr is similar to concerta and lasts about 12 hours and is the best choice for most children taking an adderall preparation like focalin xr you can open up the adderall xr capsule and sprinkle it on food in the dexedrine group there are three preparations dexedrine tablets which last
Four hours dexedrine capsules which last eight hours and vyvanse which lasts 12 hours they would be used in similar situations to the ritalin preparations that lasts for that period of time the dexedrine capsule can be opened up and sprinkled on food of note dexedrine medications may cause more side effects than either the ritalin or adderall group and may not be
As good a choice of medication how quickly do medications start working and how long do they last the stimulant medicines generally start working within 30 to 60 minutes so if your child is on the right medication and dose you’ll see improvement within an hour of taking it of note the patch date rana may take two hours to start working as i mentioned earlier the
Medicines last variable periods of time some as little as four hours and some up to 12 hours and those 12 hour preparations are the ones we recommend most commonly the non stimulant medications strattera intuniv and cap they don’t work as quickly as the stimulants and may take several days to several weeks before you see maximal benefit these medicines generally
Are taken once or twice a day and lasts most of the day one important note medications sometimes changes over time your child’s doctor will discuss the right medication for your child
Transcribed from video
ADHD Medication Choices By My Doctor – Kaiser Permanente
