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Is Methylin ER effective in treatment of severe ADHD?

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Psychiatrist
Practicing since : 2005
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My granddaughter has been diagnosed with severe ADHD. What do you know about the drug Methylin ER? I hear from some parents that with stimulant drugs that the time of efficacy is important. Most parents are recommending Vyvanse since it has a long time being effectivd ( 12 hours or 13) compared to Attenrol which is 8 hours. Doctor wants to start on that and if she has mania type systems they can discontinue right away and the would go to Strattera which takes longer to be noticed in system. What is your opinion? She is 16 and very bright ( all ap classes) but unable to do class work in her Sophmore year despite being third in state competition in debate. Lots of sommatic issues and not going to school, anxiety, withdrawn. Has a small circle of friends.
Posted Fri, 29 Aug 2014 in Child Health
 
 
Answered by Dr. Sunil Gupta 4 hours later
Brief Answer:
Please see details below

Detailed Answer:
Hi,

I went through your query in detail and can understand your concern regarding your granddaughter's condition and her medications.

Methylin ER is extended release formulation of meythlphenydate and Vyvanse is lisdexamfetamine dimesylate. Both are stimulants which are effective mediations for ADHD. Strattera and Attentrol are both the same drug containing Atomoxetine which is also one of the treatment option of ADHD.

In general, methylphenydate and amphetamines are the first line treatment options of ADHD. Both are effective drugs. In general, the extended release version of methylphenydate as well as Vyvanse are both long acting and used as once daily dose. Both are equally effective as well. However, it has been seen that the effects of Vyvanse lasts slightly longer and the patients don't experience much ups and downs in the symptoms. However, mostly the effects differ from patient to patient.

In general, we start with any one of the stimulants and if the patient is fine with it and responds well, continue with the same. In case of any problems or side effects, we can shift to some other stimulant.

In comparison, Atomoxetine is found to slightly less effective than methylphenydate and amphetamine salts and considered if the stimulants are not tolerated well. It is usually the second line drug fro ADHD.

Your psychiatrist is just being careful about using the stimulants because of family history of bipolar disorder. Stimulants just might increase the chance of inducing mania and it is good that your psychiatrist is careful and observant about any such possibility.

Regarding time taken for reply, usually it varies and can be few minutes to few hours depending on when your question is picked up the the specialist that you have chosen.

I do hope that I was able to answer your query. Please let me know if you have any further queries.

I wish a speedy recovery for your granddaughter.

Best wishes.

Dr. Sunil Gupta


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