Focalin XR for ADHD

ADHD (attention-deficit/hyperactivity disorder) is a disorder of the brain that can cause inattention, hyperactivity, and impulsivity. For instance, a person who has ADHD might have difficulty sustaining focus, staying organized, sitting still, and delaying gratification. The average age of diagnosis for ADHD is seven years old. 

Lately, parents and pediatricians have had a lot of options when choosing medications to treat children who have ADHD. In addition to short-acting stimulants, they could choose among long-acting stimulants, like Adderall XR, Vyvanse, Ritalin LA, Concerta, and Daytrana (the Ritalin patch). Or they could use Strattera, Intuniv, or Kapvay, which are all non-stimulants.

However, when you consider that Daytrana, Ritalin LA, and Concerta are all long-acting forms of methylphenidate or Ritalin, the number of choices seems much more limiting.

Fortunately, there is another stimulant that is related to Ritalin that can be used to treat ADHD. Focalin XR (dexmethylphenidate hydrochloride) is a long-acting form of Focalin and can be used to treat children, teens, and adults who have ADHD. Like other once-a-day or extended-release ADHD medications, Focalin XR is reported to last throughout the entire school day.

Since, like Ritalin LA, it uses SODAS (Spheroidal Oral Drug Absorption System), Focalin XR is an extended-release capsule that can be opened and sprinkled on food, which is helpful for kids who can't swallow pills.

The theory about why Focalin may be a superior treatment for ADHD is that it is made of just one part of Ritalin, and leaves another part, which is inactive and may contribute to side effects, out. Medications are made of two isomers or parts and you really need only one of those parts for the medicine to work. For example, Xopenex, one isomer of racemic (mixed) albuterol, which is used to treat asthma, is made the same way.

In addition to supposedly being more effective and having fewer side effects, making a medicine by taking away one isomer often allows you to use a lower dose of the medicine. And, in fact, Focalin is often prescribed at half the dose that someone on Ritalin might take.

Unfortunately, there have not been any convincing studies that show that Focalin is better or safer than Ritalin or Adderall. There has been a head-to-head study between Focalin and Ritalin, but it concluded that Focalin was 'as efficacious and safe' as Ritalin.  That study did show that Focalin could be used at half the dose of Ritalin and the scientists felt that there was 'some suggestion of a slightly longer duration,' so hopefully, Focalin XR will be shown to work a little longer than the current extended-release forms of Ritalin.

Focalin XR is now available in eight strengths, including 5-, 10-, 15-, 20-, 25-, 30-, 35-, and 40-mg (milligram) capsules. The variety of dosages makes fine-tuning a child's dose fairly easy.

If you're worried about the cost of the drug, your pediatrician may have a voucher for a free trial of Focalin XR if you would like to try it. Focalin XR Savings Cards are also available online.

And keep in mind: Psychotherapy is another option that can be used to treat ADHD either instead of or in addition to drug therapy. 

_Sources:

_{CDC. Attention-Deficit/Hyperactivity Disorder (ADHD).} http://www.cdc.gov/ncbddd/adhd/data.html.

_{Focalin XR Prescribing Information Sheet. June 2012.}

_{NIMH. Attention Deficit Hyperactivity Disorder.} http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml.

_{Wigal S - J Am Acad Child Adolesc Psychiatry - 01-NOV-2004; 43(11): 1406-14.}