In the UK, three different types of medication are available to treat ADHD symptoms.
Those containing the active ingredient methylphenidate – Concerta XL, Equasym XL, Medikinet, Medikinet XL, and Ritalin. It is also called Methylphenidate Without any brand name.
They contain dexamfetamine as the active ingredient. It is available in generic form or in the newly released Elvanse which contains lisdexamfetamine. This is a form of dexamfetamine that is inactive and is converted to dexamfetamine by the body.
They contain atomoxetine as the active ingredient. Strattera is the only available drug at this time.
Methylphenidate, dexamfetamine, and other stimulant medicines are commonly grouped under this name. For over 30 years, stimulant medicines are used to treat ADHD in children.
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What are they?
All of these medications work by affecting certain natural chemicals in the brain.
They act on chemicals such as noradrenaline, and dopamine that are found in brain areas that control attention and behavior. These areas appear to be underactive among people with ADHD.
These medicines don’t work on everyone, and we don’t know how they work. They can control the symptoms of ADHD in some people.
What are the uses of these devices?
A psychiatrist or pediatrician who specializes in ADHD will diagnose ADHD and then prescribe medication.
Doctors, parents, and children should all be involved in the decision to use a medicine. The initial prescription is usually done by child psychiatrists or specialists, but sometimes your GP can continue the prescribing.
The age of your child will determine when you use medicines.
What are they?
The symptoms of ADHD can be controlled by medications. They can help improve attention span and calmer, less hyperactive, or aggressive behavior.
This could mean that your child can:
Listen to others better
Focus and concentrate better
Think more clearly
Think before you act
Stay interested in a topic
Sit still and do not fidget.
Your child may be at risk of:
Understanding schoolwork is easier
You’re less likely to get bored, restless, or disruptive
No need to act impulsively to be stimulated or interested
Learn better to improve your school results
Find it easier to interact with others and make new friends.
This will help your child develop better self-esteem, and improve their behavior.
Medicines don’t cure ADHD. To get the most out of their medication, children with ADHD need encouragement and support.
How long do I need to take the medicine?
This is a situation that will differ depending on each individual.
Even after the doctor has increased their dose to an optimal level, some children still don’t improve. This will need to be discussed with your child’s physician.
If your child improves with medication, you should continue the treatment for a minimum of one year.
After a certain period (e.g. a year) of stabilization, it’s common for your doctor to suggest that your child take a break from his medication. It is done to observe how your child acts without the medication, as medicines are only used to control ADHD, and not to cure it.
You may want to do this every year to see if the treatment should continue. However, you must always consult your child’s physician.
Stop taking it if there is no difference in the effects of taking or not taking it.
Some children will need to continue taking their medicine for many, many years. Some children can stop taking the medicine once they hit puberty. Others need to take it all through adolescence.
What are the side effects?
Although all medicines can have side effects, not everyone experiences them. People respond to medications in different ways.
Reduce the dosage if side effects are an issue. Sometimes side effects improve after several weeks.
The most common side effects of stimulant medications are reduced appetite and difficulty falling asleep.
The most common side effects of atomoxetine include decreased appetite and stomach pain.
The doctor will regularly measure the weight and height of your child to ensure that growth is not affected due to the medication’s appetite-suppressing effect.
The doctor will monitor the child’s blood pressure and heart rate regularly to ensure that they don’t rise to unacceptable levels.
Methylphenidate
In the UK, there are five different brands of methylphenidate. Unbranded methylphenidate is also available.
Medkinet, Ritalin, and generic methylphenidate
All immediate-release methylphenidate tablets, including Medikinet and Ritalin (or generic methylphenidate), are available in the form of an instant-release tablet. The effects begin to wear off within 30-60 minutes after taking the dose.
It is recommended that children take the tablets two to three doses a day. Some may also require a dose early in the evening.
It is best to avoid giving your child the last dose within four hours before bedtime. This may make it difficult for them to fall asleep.
Your child’s doctor will adjust the dose according to their individual needs. To get the right dose, tablets may need to be quartered or halved.
The generic and Medikinet methylphenidate tablet strengths are 5mg (10mg) and 20mg (20mg).
Only 10mg of Ritalin is available in tablets.
Concerta XL
Concerta XL, also known as methylphenidate extended-release, is a form of methylphenidate.
These tablets release 22 percent of the methylphenidate in their outer layer, which is enough to provide an initial dose.
The effects can last up to 12 hours. The effect is similar to taking three daily dosages of Ritalin or Medikinet.
Your child should only need to take one dose a day, which is the morning dose.
Concerta XL comes in three strengths: 18mg (27 mg), 36mg (36 mg), and 30mg (18mg).
If the tablets are chewed, they will stop working.
The capsule-shaped tablets make it easier to swallow them whole.
Concerta XL tablets pass through a child’s digestive system but do not fully dissolve. If you or your child see the shell of the tablet in their stools, this is perfectly normal and harmless.
Equasym XL
Equasym XL also comes in an extended-release methylphenidate form.
The capsules immediately release 30 percent of methylphenidate, providing a morning dose. The remaining 70% of the dose will be released throughout the afternoon.
The capsules are enough to last the entire school day without the need for your child to take another dose at lunch. This is similar to taking Ritalin or Equasym at lunch and in the morning.
These capsules are only effective for the day of school, not the entire day. For some children, their effects may fade too soon in the evening.
Your doctor may recommend that your child take a small amount of immediate-released methylphenidate to address this problem.
Equasym XL comes in strengths of 10mg (20mg) and 30mg (30mg).
The capsules can be swallowed with liquid. You can also open the capsule, and sprinkle the contents onto a spoonful of soft food you can easily swallow without chewing. The capsules or their contents mustn’t be chewed, as this can stop them from working.
Medikinet XL
These capsules contain methylphenidate in an extended-release form.
The capsules immediately release 50% of the methylphenidate, providing an initial dose for the morning. The remaining 50% of the dose will be released throughout the afternoon.
The capsules are enough to last the entire school day without the need for your child to take another dose at lunchtime. This is similar to taking Ritalin or Equiasym at lunch and in the morning.
These capsules are only effective for the day of school, not the entire day. For some children, their effects may fade too soon in the evening.
Your doctor may recommend that your child take a small amount of methylphenidate for immediate release to help with the problem.
The strengths of Medikinet XL are 5mg. 10mg. 20mg. 30mg. and 40mg.
The capsules can be swallowed with liquid. You can also open the capsule, and sprinkle the contents onto a spoonful of soft food you can easily swallow without chewing. The capsules or their contents mustn’t be chewed, as this can stop them from working.
Dexamfetamine
Only Dexamfetamine comes without a trademark. It used to be sold as Dexedrine, the brand name.
The effects last between three and four hours. It begins working 30-60 minutes after taking the dose. The usual dosage is two or three doses a day.
The dose may be adjusted by your doctor to suit the needs of your child. Tablets may also need to be cut to achieve the right dose.
Only 5mg of Dexamfetamine is available in tablets. The tablets are scored, and they can be cut in half.
Dexamfetamine can also be purchased as a liquid.
Lisdexamfetamine
Elvanse is the only brand available in the UK of lisdexamfetamine.
The lisdexamfetamine will gradually convert into dexamfetamine throughout the day. One morning dose has effects that last 13 hours. This is equivalent to taking three standard daily doses.
Elvanse capsules are available in strengths of 30mg (for the lowest strength), 50mg (for medium strength), and 70mg (for the highest).
The capsule can be opened and the contents mixed in a glass of water or orange juice, or soft food such as yogurt. The capsule can also be opened, and the contents added to a glass of orange juice or water. Or you can mix it with yogurt or a soft food like yogurt. Mix well with a spoon, breaking up any powder bits. The entire mixture should be consumed immediately.
Atomoxetine
In the UK, Strattera is only available as atomoxetine.
It may take up to four weeks before atomoxetine is fully effective.
For the first seven-day period, a low dose is prescribed. The doctor will then increase the dose as necessary.
Strattera should be taken in the morning. If side effects are an issue, you can split the dose with one taken in the morning followed by one late afternoon/early night.
The strengths of Strattera capsules are 10mg (or 18mg), 25mg (or 40mg), 60mg (or 80mg), and 100mg.
Because the powder in the capsules is irritating, it should not be split or crushed.
Strattera liquid is also available.
