MEDIACTION

CHART
DRUG

FORM

DOSING

Short
ActingTablet

Starting dose for

children is 5 mg
twice daily, 3-4
hours apart. Add
third dose about
4 hours after
second. Adjust
timing based on
duration of
action. Increase
by 5-10 mg
increments. Daily
dosage above 60
mg not
recommended.Es
timated dose
range .3-.6
mg/kg/dose

COMMON SIDE DURATION OF

EFFECTS
EFFECTS

PROS

PRECAUTIONS

METHYLPHENIDATE
RITALIN

METHYLIN

5 mg

METADATE

10 mg

Generic MPH

20 mg

FOCALIN

Short
ActingTablet

(with isolated dextroisomer)

2.5 mg

Start with half

the dose
recommended
for normal short
acting
mehtylphenidate
above. Dose may
be adjusted in
2.5 to 5 mg
increments to a
maximum of 20
mg per day (10
mg twice daily).

Insomnia,
About 3-4
Works quickly
decreased
hours. Most
(within 30-60
appetite, weight helpful when minutes). Effective
loss, headache,
need rapid
in over 70% of
irritability,
onset and short
patients.
stomachache,
duration.
and rebound
agitation or
exaggeration of
pre-medication
symptoms as it is
wearing off.

As above.

About 3-4
hours. Most
helpful when
need rapid
There is
onset and short
suggestion that
Focalin (dextro- duration.Only
formulation
isomer) may be
with isolated
less prone to
dextro-isomer.
causing sleep or
appetite
disturbance.

Use cautiously in
patients with
marked anxiety,
motor tics or with
family history of
Tourette
syndrome, or
history of
substance
abuse. Don"t use if
glaucoma or on
MAOI.

Works
As above.
quickly(within 3060
minutes). Possibly
Expensive
better for use for
compared to other
evening needs
short acting
when day"s long
preparations.
acting dose is
wearing off.

5 mg
10 mg
RITALIN SR

MidActingTable Start with 20 mg

Insomnia,
t
daily. May
decreased
combine with appetite, weight
20mg
short acting for loss, headache,
quicker onset
irritability,
and/or coverage stomachache.
after this wears
off.

_____

________________

MidActingTable
t
10 mg

METHYLIN ER

20mg

Onset delayed Wears off more

for 60-90
gradually than
minutes.
short acting so less
Duration
risk of
supposed to be rebound.Lower
6-8 hours, but
abuse risk.
can be quite
individual and
unreliable.

As above.
Note: If crushed or
cut, full dose may
be released at
once, giving twice
the intended dose
in first 4 hours,
none in the
second 4 hours.

________________

METADATE ER
RITALIN LA

50% immediate release beads

and 50% delayed release beads

_____________

MidActingCaps
ule

Starting dose is
Insomnia,
Onset in 30-60
May swallow
Same cautions as
10-20 mg once
decreased
minutes.
whole or sprinkle
for immediate
daily. May be appetite, weight Duration about ALL contents on a
release.
adjusted weekly loss, headache,
8 hours.
spoonful of
in 10 mg
irritability,
applesauce. Starts
20 mg
increments to
stomachache,
quickly, avoids
30 mg
maximum of 60
and rebound
mid-day gap
40 mg
mg taken once
potential.
unless student
daily. May add
metabolizes
_____
_______________
short acting dose
medicine very
_
rapidly.
MidActingCaps in AM or 8 hours
If beads are
later in PM if
ule
chewed, may
needed.
release full dose at
once, giving entire
contents in first 4
hours.
10 mg

METADATE CD

20 mg

30% immediate release and 70% delayed release

beads
CONCERTA

30 mg
Long
ActingTablet

18 mg
22% immediate release

27 mg

and 78% gradual release

36 mg
54 mg

DEXTROAMPHETAMINE

FORM

DEXTROSTAT

Short
ActingTablet

Starting dose is
Insomnia,
Onset in 30-60
Works quickly
Same cautions as
18 mg or 36 mg
decreased
minutes.
(within 30-60
for immediate
once daily.
appetite, weight Duration about minutes). Given
release.
Option to
loss, headache, 10-14 hours.
only once a day.
increase to 72
irritability,
Longest duration
mg daily.
stomachache.
of MPH forms.
Doesn"t risk midday gap or
rebound since
medication is
released gradually
throughout the
day. Wears off
more gradually
Do not cut or
than short acting,
crush.
so less
rebound.Lower
abuse risk.
DOSING

COMMON SIDE DURATION OF

EFFECTS
EFFECTS

PROS

PRECAUTIONS

For ages 3 -5
Insomnia,
Onset in 30-60
Approved for
Use cautiously in
years: starting
decreased
minutes.
children under 6.
patients with
dose is 2.5 mg of appetite, weight Duration about
marked anxiety,
tablet. Increase loss, headache,
4-5 hours.
motor tics or with
by 2.5 mg at
irritability,
family history of
weekly intervals, stomachache.
Tourette
increasing first
syndrome, or
dose or
history of
adding/increasin
substance abuse.
g a noon dose,
Don"t use if
until effective.
glaucoma or on
MAOI.

5 mg

10 mg

For 6 years and

over, start with 5
mg once or twice
daily. May
increase total
daily dose by 5
mg per week
until reach
optimal level.
Tablet is given on
awakening. Over
6 years, one or
two additional
doses may be
given at 4-6 hour
intervals. Usually
not need more
than 40 mg/day.

Good safety
record.

High abuse
potential
particularly in
tablet form.

Rebound
agitation or
exaggeration of
pre-medication
symptoms as it is
wearing off.

Somewhat longer
action than short
acting
methylphenidate.

_____

________________

May also elicit

psychotic
symptoms.

Short
ActingTablet
5 mg

DEXEDRINE
*2004 PDR does not list short acting Dexedrine
tablets
DEXEDRINE SPANSULE

Long Acting

Spansule
5 mg
________________

10 mg
15 mg

dextroamphetamine sulfate ER

_____

5mg
10 mg
15 mg
MIXED AMPHETAMINE

FORM

ADDERALL

Short
ActingTablet

In chldren 6 and Same as above. Onset in 30-60 May avoid need

As above. Less
older who can
minutes.
for noon dose. likely to be abused
swallow whole
Duration about rapid onset. Good intranasal or IV
capsule, morning
5-10 hours.
safety record.
than short
dose of capsule
acting. Must use
equal to sum of
whole capsule.
morning and
noon short
acting. Increase
total daily dose
by 5 mg per
week until reach
optimal dose to
maximum of 40
mg/day.
COMMON SIDE DURATION OF
DOSING
EFFECTS
EFFECTS
PROS
PRECAUTIONS
Starting dose is 5 Same as above. Onset in 30-60 Wears off more
Same as for
or 10 mg each
minutes.
gradually than Dexedrine tablets.
morning (age 6
Duration about dextroamphetami
and older). May
4-5 hours.
ne alone, so
be adjusted in 5rebound is less
10 mg
likely and more
increments up to
mild.
30 mg per day.

ADDERALL
5 mg
7.5 mg
10 mg
12.5 mg
15 mg

Starting dose is 5 Same as above. Onset in 30-60 Wears off more

Same as for
or 10 mg each
minutes.
gradually than Dexedrine tablets.
morning (age 6
Duration about dextroamphetami
and older). May
4-5 hours.
ne alone, so
be adjusted in 5rebound is less
10 mg
likely and more
increments up to
mild.
30 mg per day.

20 mg
30 mg
ADDERALL XR

50% immediate release beads

and 50% delayed releasebeads

ATOMOXETINE
STRATTERA

Long
Starting dose is 5 Same as above. Onset in 60-90
May swallow
Same as for
ActingCapsule
or 10 mg each
minutes
whole or sprinkle
Dexedrine
morning (age 6
(possibly
ALL contents on a Spansules except
and older). May
sooner).Duratio
spoonful of
that it has
be adjusted in 5n 10-12 hours. applesauce. May
documented
5 mg
10 mg
last longer than
efficacy when
increments up to
most other
sprinkled on
10 mg
30 mg per day.
sustained release
applesauce.
15 mg
stimulants. Less
20 mg
likely rebound
than with long
25 mg
acting
30 mg
dextroamphetami
COMMON SIDE DURATION OF
FORM
DOSING
EFFECTS
EFFECTS
PROS
PRECAUTIONS
Long
ActingCapsule

10 mg
18 mg

Starting dose is
0.5 mg/kg. The
targeted clinical
dose is
approximately
1.2 mg/kg.
Increase at
weekly intervals.
Medication
must be used
each day. Usually
started in the
morning, but
may be changed
to evening. It
may be divided
into a morning
and an evening
dose, particularly
if need higher
doses.

In children:
decreased
appetite, GI
upset (can be
reduced if
medication
taken with food),
sedation (can be
reduced by
dosing in
evening),
lightheadedness.

Starts working Avoids problems Use cautiously in

within a few
of rebound and
patients with
days to one
gaps in coverage.
hypertension,
week, but full
tachycardia, or
effect may not
cardiovascular or
be evident for a
cerebrovascular
month or more.
disease because it
Duration all day
can increase blood
(24/7) so long
pressure and heart
as taken daily
rate. Has some
as directed.
drug interactions.
While extensively
tested, short
duration of
population use.

In adults:
insomnia, sexual
side effects,
increased blood
pressure.

Doesn"t cause a
"high," thus it
does not lead to
abuse, and so a) it
is not a controlled
drug and b) may
use with history of
substance abuse.

25 mg
40 mg
60 mg
BUPROPRION

FORM

DOSING

WELLBUTRIN IR

Short
ActingTablet

Starting dose is
37.5 mg
increasing
gradually (wait at
least 3 days) to
maximum of 2-3
doses, no more
than 150
mg/dose.

COMMON SIDE DURATION OF

EFFECTS
EFFECTS
Irritability,
decreased
appetite, and
insomnia.

About 4-6
hours.

PROS

PRECAUTIONS

Helpful for ADHD Not indicated in

patients with
patients with a
comorbid
seizure disorder or
depression or
with a current or
anxiety. May help previous diagnosis
after school until
of bulimia or
home.
anorexia. May
worsen tics. May
cause mood
deterioration at
the time it wears
off.

doses, no more
than 150
mg/dose.

home.

anorexia. May
worsen tics. May
cause mood
deterioration at
the time it wears
off.

IR-75 mg
100 mg
WELLBUTRIN SR

Long
ActingTablet
SR-100 mg

Starting dose is
100 mg/day
increasing
gradually to a
maximum of 2
doses, no more
than 200
mg/dose.

Same as
Wellbutrin IR

About 10-14
hours.

Long
Starting dose is
ActingTablet15
150 mg /day
0mg
increasing
gradually to a
300mg
maximum of 2
doses, no moe
than 300
mg/day.

Same as
Wellbutrin IR

About 24 +
hours.

Same for
Same as
Wellbutrin IR.
Wellbutrin IR. If a
Lower seizure risk second dose is not
given, may get
than immediate
mood
release
form.Avoids noon deterioration at
around 10-14
dose.
hours.

150mg
200 mg
WELLBUTRIN XL

ALPHA-2 AGONISTS

FORM

DOSING

CATAPRES

Tablet

(clonidine)

0.1 mg

Starting dose is
.025 -.05 mg/day
in evening.
Increase by
similar dose
every 7 days,
adding to
morning, midday, possibly
afternoon, and
again evening
doses in
sequence. Total
dose of 0.1 .3mg/day divided
into 3-4 doses.
Do not skip days

0.2 mg
0.3 mg
------------------------------

--------

CLONIDINE

Tablet
0.1 mg

Same for
Wellbutrin IR.

Same as
Wellbutrin IR.

Single daily dose.

Smooth 24 hour
coverage. Lower
seizure risk than
immediate release
form.

COMMON SIDE DURATION OF

EFFECTS
EFFECTS
Sleepiness,
hypotension,
headache,
dizziness,
stomachache,
nausea, dry
mouth,
depression,
nightmares.

PROS

Onset in 30-60 Helpful for ADHD

minutes.
patients with
Duration about
comorbid tic
3 - 6 hours.
disorder or
insomnia. Good
for severe
impulsivity,
hyperactivity
and/or aggression.
Stimulates
appetite.
Especially helpful
in younger
children (under 6)
with ADHD
symptoms
asociated with
prenatal insult or
syndrome such as
Fragile X.

PRECAUTIONS
Sudden
discontinuation
could result in
rebound
hypertension.
Minimize daytime
tiredness by
starting with
evening dose and
increasing slowly.
Avoid brand and
generic
formulations with
red dye, which
may cause
hyperarousal in
sensitive children.

0.2 mg
0.3 mg
CATAPRES Patch

TTS-1

Corresponds to
Same as
Duration 4-5
doses of 0.1 mg, Catapres tablet days, so avoids
0.2 mg and 0.3
but with skin the vacillations
mg per patch. patch there may in drug effect
be localized skin seen in tablets.
reactions.

TTS-2

(If using .1 mg tid

tablets, try TTS 2
but likely need
TTS 3).

TTS-3

Same as above.

Same as above.
May get rebound
hypertension and
return of
symptoms if it
isn"t recognized
that a patch has
come off or
becomes loose. An
immature student
may get excessive
dose from
chewing on the
patch.

TENEX

1 mg

(guanfacine)

2 mg
3 mg
--------

-----------------------

1 mg

guanfacine tablets

2 mg
3 mg

Starting dose is
0.5 mg/day in
evening and
increase by
similar dose
every 7 days as
indicated. Given
in divided doses
2-4 times per
day. Daily dose
range 0.5 4mg/day. DO
NOTskip days

Compared to Duration about

clonidine, lower 6 - 12 hours
chances/severity
of side effects,
especially
fatigue and
depression. Also
less headache,
stomache,
nausea, dry
mouth. Unlike
clonidine,
minimal problem
of rebound
hypertension if
doses are
missed.