Using Focalin XR for ADHD Treatment

Focalin XR (dexmethylphenidate hydrochloride) is an oral, extended-release stimulant approved for treatment of attention deficit hyperactivity disorder (ADHD) for children ages 6 to 12, teenagers, and adults. It is the same medication as Focalin but has therapeutic effects that typically last for 12 hours (as opposed to four). Focalin XR begins to work an average of 45 minutes after it is taken.

How It Works

ADHD is a disorder of the brain that can cause inattention, hyperactivity, and impulsivity. The most common treatment has been prescription-strength stimulant medications, which are believed to maintain alertness and help people with ADHD concentrate and focus.

It is believed that there may be a combination of genetic and environmental factors that lead to ADHD, and that stimulant drugs may reduce some of the symptoms by increasing neurotransmitter activity in certain regions in the brain.

Focalin and Focalin XR are composed of dexmethylphenidate HCL, an isomer of the active ingredient in Ritalin (methylphenidate)—one of the first drugs used to treat ADHD. Isomers are nearly identical forms of a molecule that differ in the arrangement of their atoms, which can make them act differently in the body. The idea behind Focalin is that the dexmethylphenidate HCl isomer may have a more potent therapeutic effect than the methylphenidate in Ritalin and may produce fewer side effects.

Because of this difference, Focalin is often prescribed at half the dose of Ritalin with equivalent therapeutic effects.

Focalin XR vs. Other ADHD Stimulants

Long-acting or extended-release stimulants have been considered advantageous because they can be taken fewer times per day, reducing the risk of missed doses or symptom fluctuations throughout the day. Besides Focalin XR, Adderall XR, Vyvanse, Ritalin LA, Concerta, and Daytrana (Ritalin patch) are all examples of long-acting stimulants commonly used for the treatment of ADHD.

However, when you consider that Daytrana, Ritalin LA, and Concerta are all long-acting forms of Ritalin (methylphenidate), the number of choices is not quite as extensive as it appears in terms of the pharmacological action of these medications.

Like other once-daily or other extended-release ADHD medications, Focalin XR lasts throughout the entire day.

At this time, there have not been convincing studies proving that Focalin is better or safer than Ritalin, Adderall, or other stimulants. Generally, Focalin is most often compared to Ritalin in clinical studies, and the long-acting forms of each medication are compared with each other. So far, it appears that Focalin XR is as efficacious and safe as Ritalin LA.

How It's Used

Focalin XR is available in 5, 10, 15, 20, 25, 30, 35, and 40-mg capsules. The recommended dose of Focalin XR is the same as the total dose of Focalin. For example, if you or your child has taken Focalin 10 mg twice per day, then the Focalin XR dose would be 20 mg once per day.

Focalin XR, as well as Ritalin LA, are capsules composed of 50 percent immediate-release beads and 50 percent delayed-release beads, trying to mimic twice-daily dosing. 

If you or your child is given a prescription for Focalin XR, it should be taken in the morning. It can be taken with or without food. You should not cut or chew the capsule because this will impact its ability to be properly absorbed by your body.

Instead, if you have a hard time swallowing it, the capsule can be opened and the contents sprinkled on to food, which should be small enough to be swallowed without chewing. Focalin XR uses a mechanism called SODAS (Spheroidal Oral Drug Absorption System), which is what makes this possible.

Side Effects, Interactions, and Contraindications

Focalin XR might not be safe for you if you have a heart condition, glaucoma, psychiatric illness, thoughts of suicide, tics, high blood pressure, vascular disease, or seizures.

It can potentially interact with a variety of medications, such as antidepressants, blood thinners, anticonvulsants, and blood pressure medications, so be sure that your prescribing doctor is aware of anything you are taking.

When you are taking Focalin XR, your doctor will periodically assess its impact on your symptoms of ADHD and whether you are experiencing any of the drug's potential side effects, of which there are several. The decision as to whether you should continue to take the medication or not depends on your personal experience with it—both pros and cons.

Side effects of Focalin XR include:

• Insomnia
• Restlessness
• Stomach aches, nausea, loss of appetite
• Dizziness
• Headaches
• Dry mouth

Serious, but less common side effects include:

• Seizures
• Hallucinations and/or paranoia
• Heart rhythm problems
• Aggression or other behavior changes
• Depression, suicidal ideation (thinking about suicide)
• Vision changes
• Priapism (prolonged erection without arousal, which is often painful)

Addiction, Abuse, Misuse

Focalin XR is a stimulant and this category of medication does have the potential for abuse. It can be used to feel "high" or to stay awake for a prolonged period of time. The drug can be diverted and has been known to be misused by people who do not have ADHD for these same reasons, and also for weight loss.

It is not clear whether Focalin XR leads to tolerance, which is a decreased response to your dose, or a need for an increased dose to achieve the same response. Most people do not need to increase the dose of Focalin XR in order to achieve therapeutic control of ADHD symptoms.

A Word From Verywell

There are a number of medications approved for the treatment of ADHD, and choosing the right one can be confusing. Your doctor will determine which medication is most likely to be the right fit for you. However, if your symptoms do not improve or you experience side effects, your medication can be changed to another one that may have a better effect.

Often, behavioral therapy is another option that can be used for the treatment of ADHD, either instead of or in addition to, prescription medications.

If you're worried about the cost of medication, your doctor may have a voucher for a free trial of Focalin XR. Focalin XR Savings Cards are also available online.