1. ADHD MEDICATIONS Myths and Facts ADHD Awareness Day, Oct by Theresa Cerulli, M.D. Neuropsychiatrist

2. ADHD Medication Categories 1. Stimulants
a. Methylphenidates
b. Amphetamines
2. Non-Stimulants

3. ADHD Medications Stimulants Non-Stimulants Off-Label meds Atomoxetine
Methylphenidates -
Ritalin, Ritalin LA, Daytrana, Metadate ER, Metadate CD Concerta, Focalin IR, Focalin XR
Amphetamines-
Adderall IR, Adderall XR, Dexedrine
Vyvanse (prodrug)
Non-Stimulants
Atomoxetine
Intuniv, Kapvay
Off-Label meds
Wellbutrin SR, XL
Provigil
Tenex, Clonidine
TCA’s

4. Stimulants Methylphenidate Products Ritalin, Methylin Ritalin SR
Concerta
Metadate ER and CD
Methylin ER
Ritalin LA
Focalin
Focalin XR
Daytrana (patch)
Amphetamines
Dexedrine
Dexedrine Spansules
Adderall
Adderall XR
Vyvanse (Prodrug)

5. Stimulant Medication Side Effects
Short Term Stimulant Side Effects:
Loss of appetite
Weight loss
Insomnia
Headache
Irritability
Feeling jittery
Dry mouth
Anxiety
Tachycardia
Nausea/GI side effects
Exacerbation of Tics
Long Term Stimulant Side Effects:
Possible Delayed Growth Spurt
Possible decrease in height
Possible Tic Disorders
Most recent studies show no evidence of growth problems or tic disorders compared with ADHD patients who never took stimulant medications

6. Stimulants: FDA Warning Label

7. Non-Stimulants
FDA approved for treating ADHD -
Strattera (atomoxetine)
Intuniv (long-acting guanfacine),
Kapvay (long-acting clonidine)
Off Label meds, not FDA approved for ADHD -
Provigil, Wellbutrin XL, tenex, clonidine, Tricyclic antidepressants (TCA’s)

8. Non-Stimulant Side Effects
Strattera- Sedation, GI side effects, dizziness, liver, SI
Intuniv, Kapvay - Sedation, lightheadedness/dizziness
Wellbutrin- HA, dry mouth, sweating, nausea, decreases seizure threshold
TCA’s- Sedation, wt gain, dry mouth, postural hypotension, sexual dysfunction, cardiac (Check EKG)
Provigil- Insomnia, HA

9. Brain Neurotransmitters
Medications
Brain Neurotransmitters
Dopamine
Norepinephrine
Serotonin
Diet and Nutrition

10. Neurotransmitters

11. Degree of Action on Neurotransmitter
Proposed mechanism of action based on animal studies

12. Delivery Systems How is your medication released?
How does your medication get to where its going?

13. OROS Delivery System (Concerta)

14. SODAS Delivery Adderall XR, Ritalin LA, Focalin XR

15. Adderall Intuniv Focalin Strattera
ADHD Medications
Adderall Intuniv Focalin Strattera
How Do You Choose?

16. Medication Considerations
Family history
Genetic subtype of ADD
Mechanism of Action of medication
Length of Action of medication
Patient’s daily schedule
FDA approval vs. off label use of medication

17. The Upside ADHD Medications Can - Improve Focus and Concentration
Increase productivity
Calm Hyperactivity
Increase attention to details
Improve communication/listening skills
Enhance executive functioning (organization, time management, problem solving)