Managing Stimulant Medication for Attention-Deficit/Hyperactivity Disorder: An Update

Esther H. Wender

doi:10.1542/pir.23-7-234

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Esther H. Wender, MD*

^*Clinical Professor of Pediatrics, Albert Einstein College of Medicine, Bronx, NY

Introduction

Since publication in this journal of the review article Managing Stimulant Medication for Attention-deficit/Hyperactivity Disorder (1), new forms of methylphenidate and mixed amphetamine salts have been approved for use in the treatment of attention-deficit/hyperactivity disorder (ADHD). In this update, all of the currently approved forms of methylphenidate and amphetamine are reviewed. These are the only stimulants that are considered first-line treatment for ADHD, according to the recently published American Academy of Pediatrics (AAP) clinical practice guideline. (2) In the current article, the newer forms of the stimulant medications are compared with the older versions, and guidelines for switching from one form to another are provided. The reader is encouraged to study the original article for recommendations regarding initial titration, maintenance, and termination of stimulant medication.

Available Stimulant Medications

The available methylphenidate and amphetamine medications are listed in Table 1⇓, including recently modified formulations. As stated in the original review article and the AAP guidelines, titration should begin with one of these two families of medication. …