Dexedrine, Cylert, and Adderall in the Treatment of ADHD
Dexedrine is not prescribed very often for the treatment of ADHD out here in California, but those patients that we've seen on it have done well. Typically it is prescribed to patients who have not responded to Ritalin very well. It has the advantage of having a very nice long-lasting product (one dose per day). Usually it will not be prescribed to teenagers, or to individuals with a history of substance abuse. It can have retail value in the high school parking lot, and can be misused and abused.
Cylert (Sodium Pemoline)
Cylert seems to be prescribed most by neurologists and by the few pediatricians who are afraid to prescribe Ritalin.
We don't recommend Cylert at all, and wonder why anyone actually prescribes it at all any more. It only works about half the time with patients, and can have very serious side-effects. We have been told that it causes hepatitis in 1/1000 of patients. We cannot verify this, but it's good enough for us to not recommend it to patients anyway. Even the manufacturer recommends against it as the first medication tried in treating Attention Deficit Disorder.
Besides Attend works as well or better and is much healthier and safer, so why mess with a medication that can cause such serious problems?
Adderall is no longer a "new" drug in the treatment of Attention Deficit Disorder. The patients that we know who have tried it really have come to like it.
It is a "cocktail" drug, or a mixture of four drugs, all from the amphetamine family. As a result it has a broad spectrum of symptom coverage. It also tends to last for about six hours per dose, so it can cover the entire school day. It can be less "harsh" than Ritalin. ADDerall might be worth talking to your doctor about as either the first or second medication to try.
ADDerall tablets come in 5, 10, 20, and 30 mg doses offering great flexibility to a physician in targeting the optimum dose for any patient. Even greater flexibility is offered because the tablets are double-scored so they can be accurately split into halves or quarters. This means that ADDerall can be administered in increments as low as 1.25 mg, or adjusted in 1.25 mg increments.
ADDerall begins to work more gradually than Ritalin, or Dexedrine, and the "drop-off" slope is also much more gradual, meaning that there is less of a "trough" time at the end of the dose.
You can learn more about ADHD and the various treatment options for it at the ADHD Information Library.
Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.
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