NR546 Week 7 Assignment ADHD Medications Table

Drug Name

(include if IR, XR, ODT, LA) 

Indication (include approved ages) 

Neurotransmitter(s) Affected 

Target Symptoms

Short-acting, intermediate-acting or long-acting.

Duration of action, peak (if noted)

Notable side effects /Patient education instructions 

Methylphenidate (D/L)

(Concerta, Ritalin)

ADHD
• Concerta: ≥6 years
• Ritalin IR/LA: ≥6 years
Blocks reuptake of dopamine (DA) and norepinephrine (NE).
Inattention, hyperactivity, impulsivity; improves executive function/working memory.

IR: Short-acting (~3–4 h).
LA (Ritalin LA): Intermediate (~6–8 h).
Concerta (OROS): Long-acting (~10–12 h); ascending release over first 6–7 h; T_max ~6–10 h.

↓ appetite/weight, insomnia, abdominal pain, headache; ↑ BP/HR; irritability; tics (rare). Education: Morning; do not take in the late day; do not crush/chew ER/OROS; observe growth/appetite/BP/HR; C-II abuse/diversion.

Dexmethylphenidate (Focalin) (D)

ADHD ≥6 years

Selective DA/NE reuptake inhibition (D-threo enantiomer).
Inattention, hyperactivity, impulsivity.

IR: Short-acting (~4–6 h).
XR: Long-acting (~8–12 h).

Similar to methylphenidate: ↓ appetite, insomnia, GI upset, headache; ↑ BP/HR. Education: Typically use ~½ the racemic methylphenidate dose; morning dosing; swallow XR whole.

Jornay PM

ADHD ≥6 years
DA/NE reuptake inhibition.
Early-morning & daytime inattention/hyperactivity/impulsivity.

Long-acting. Designed for evening dosing; delayed absorption overnight with a rise in early morning; effect persists throughout the day (once daily).

Take in evening (generally 6:30–9:30 pm); do not take in morning; swallow capsules whole or sprinkle on applesauce (do not chew). Typical stimulant AEs: ↓ appetite, insomnia, ↑ BP/HR. C-II: monitor growth and vitals.

Amphetamine 

(Adzenzys)

ADHD
• XR-ODT: children 6–12 y, adolescents 13–17 y, adults (specific max doses vary)
• ER suspension: similar

Increases synaptic DA/NE (release and reuptake inhibition).
Inattention, hyperactivity, impulsivity.

XR-ODT/ER: Long-acting (once daily; all-day coverage).

AEs: ↓ appetite/weight, insomnia, dry mouth, anxiety/irritability; ↑ BP/HR; rare priapism. Education: Place XR-ODT on tongue to dissolve; once daily morning; avoid acidic foods around dose; C‑II; monitor BP/HR and growth.

Dextroamphetamine/amphetamine salts (Adderall, Mydayis )

ADHD
• Adderall IR/XR: generally ≥6 years (IR historically used ≥3 y; follow local labeling)
• Mydayis: ≥13 years to adults (not for ≤12 y)
Promotes DA/NE release; inhibits reuptake; mild MAO effects.

Inattention, hyperactivity, impulsivity; morning-to-evening symptom control (XR/Mydayis).

Adderall IR: Short-acting (~4–6 h).
Adderall XR: Long-acting (~10–12 h).
Mydayis: Ultra–long-acting (~16 h).

AEs: ↓ appetite/weight loss, insomnia, headache, dry mouth, ↑ BP/HR; potential growth suppression; misuse/diversion risk. Education: Morning dosing; XR/Mydayis swallow whole (sprinkle applesauce ok for some caps—eat immediately); avoid late doses; monitor vitals/growth.

Lisdexamfetamine

(Vyvanse)

Prodrug converted to dextroamphetamine → ↑ DA/NE.

Inattention, hyperactivity, impulsivity; smoother effect with lower abuse tampering potential.

Long-acting (~10–14 h adults, ~10–12 h children); once daily AM.

AEs: ↓ appetite/weight, insomnia, dry mouth, irritability; ↑ BP/HR. Education: Take once each morning; do not divide a single dose; capsules may be opened and mixed with water/yoghurt OJ (consume immediately); C‑II; monitor vitals/growth.

Atomoxetine

ADHD ≥6 years and adults

Selective norepinephrine reuptake inhibitor (NRI).
Inattention, hyperactivity/impulsivity; useful with tics/anxiety or stimulant intolerance; all‑day coverage including evenings.

Long-acting; once or twice daily; onset over 1–4 weeks (full effect up to 6–8 weeks).

AEs: GI upset, decreased appetite, fatigue/somnolence, dry mouth, sexual dysfunction; ↑ BP/HR; rare severe liver injury. **Boxed warning:** ↑ suicidal ideation in children/adolescents. Education: Not a controlled substance; take consistently; do not use with MAOIs; monitor mood, vitals, and LFTs if symptoms.

Clonidine 

ADHD 6–17 years (ER); adjunct to stimulants or monotherapy

Central α2‑adrenergic agonist (↓ sympathetic outflow).

Hyperactivity/impulsivity, irritability, aggression; tics; sleep initiation (IR at bedtime).

ER: Long-acting (twice daily dosing; effect ~24 h coverage).

AEs: Sedation/somnolence, dizziness, hypotension, bradycardia, dry mouth, constipation. Education: Do not stop abruptly, taper to avoid rebound hypertension; dose ER BID with larger dose HS; caution with other sedatives; monitor BP/HR.

Guanfacine

ADHD 6–17 years (ER); adjunct or monotherapy

Selective α2A‑adrenergic agonist (prefrontal cortex).

Hyperactivity/impulsivity, emotional dysregulation; tics; helps sleep (less sedating than clonidine).

ER: Long-acting (once daily; T_max ~5 h).

AEs: Somnolence, hypotension, bradycardia, dizziness, dry mouth. Education: Take once daily, same time; avoid high‑fat meals (↑ exposure); do not stop abruptly; monitor BP/HR.

Bupropion 

(Wellbutrin)

Major depressive disorder & seasonal affective disorder (XL) in adults; **Off‑label ADHD** (adolescents/adults when stimulants not tolerated)

Norepinephrine–dopamine reuptake inhibitor (NDRI).

Inattention, low motivation, fatigue (off‑label in ADHD); depression; smoking cessation (Zyban®).

IR: Short/intermediate; SR: ~12 h; XL: ~24 h.

AEs: Insomnia, anxiety, dry mouth, headache, nausea. **Seizure risk** (dose‑related). **Contraindicated** in seizure disorders and eating disorders (bulimia/anorexia). Education: Morning dosing for XL; avoid bedtime doses; do not crush/chew SR/XL; watch for mood changes; many CYP2B6/CYP2D6 interactions