Dexmethylphenidate vs Methylphenidate for ADHD: Comparison of Differences & Uses

Dexmethylphenidate

It is the generic name of a brand-name medication called Focalin. It is part of a class of medications known as central nervous system stimulants.

This medication works by increasing the levels of norepinephrine, neurotransmitters, and dopamine in the brain.

It is produced by Novartis, a Swiss multinational pharmaceutical company based in Basel, and it was originally approved by the US Food and Drug Administration in 2005.

Uses

It treats symptoms of attention deficit hyperactivity disorder, a group of behavioral symptoms which include hyperactivity, inattentiveness, and impulsiveness. An estimated 5 percent of American children have attention deficit hyperactivity disorder, according to the American Psychiatric Association (APA).

Common symptoms of ADHD in children may include:

  • the child finds it hard to wait for his/her turn in conversations, play, or standing in line;
  • the child is inattentive;
  • the child cannot concentrate for long on specific tasks;
  • the child is continuously interrupting people;
  • the child is constantly chattering;
  • the child is overactive, restless, fidgety.

Dosage

The usual initial recommended dose is 5 mg per day taken in two doses. For people currently using methylphenidate, the usual recommended dose is 10 mg per day. The maximum recommended dose is 20 mg per day.

Important note – this medication can be habit-forming. Therefore, do not take a larger dose than your doctor prescribes. Long-term abuse can cause psychological dependence, tolerance, psychosis (a condition characterized by an impaired relationship with reality), and abnormal behavior. The medication should be used cautiously in people with a history of alcohol or drug abuse.

Side Effects and Precautions

Common side effects may include:

  • upset stomach;
  • headaches;
  • dry mouth;
  • trouble sleeping;
  • nervousness;
  • dizziness;
  • decreased appetite;
  • anxiety.

Rare side effects may include:

  • blurred vision;
  • seizures, especially in people with a history of seizures;
  • slowing of growth in children;
  • serious allergic reactions.

To make sure this central nervous system stimulant is safe for you, tell your healthcare provider if you or anyone in your family has ever had:

  • blood circulation problems in the feet or hands;
  • suicidal actions or thoughts;
  • seizures or epilepsy;
  • bipolar disorder;
  • a history of drug or alcohol addiction;
  • psychosis;
  • motor tics or Tourette’s syndrome;
  • an abnormal brain wave test;
  • depression.

Methylphenidate

It is a drug that belongs to the family of medications known as stimulants. Its brand name is Ritalin. It works by stimulating the central nervous system in a manner that is similar to amphetamines, but its actions are milder than those of amphetamines. Another important difference is that this drug is not focused on motor activities but on mental activities which contribute to hyperactivity and impulse control.

Uses

It is typically prescribed to treat ADHD and ADD. It has been approved by the FDA for use in patients age 6 years and older.

Dosage

It comes in these forms: extended-release oral tablet, oral tablet, chewable oral tablet, extended-release orally disintegrating tablet, and extended-release chewable oral tablet.

The usual recommended initial dose is 5 mg to 10 mg, taken 2 or 3 times per day. The maximum dose is 60 mg per day. If symptoms worsen, contact your healthcare specialist for further instructions.

Notes – do not stop taking the medication without talking to your healthcare professional, particularly if you have used the medication for a long period of time. More importantly, it can be habit-forming and should be used cautiously by patients who have a history of alcohol/drug abuse or a mental/mood disorder.

Side Effects and Precautions

Common side effects may include:

  • increased blood pressure;
  • sleep problems (insomnia);
  • unexplained weight loss;
  • feeling nervous or irritable;
  • loss of appetite;
  • stomach pain;
  • mood changes;
  • headaches;
  • fast heart rate;
  • nausea.

Rare side effects may include:

  • a seizure (convulsions);
  • trouble breathing;
  • skin color changes (red, pale, or blue appearance) in the toes or fingers;
  • a feeling like you might pass out;
  • muscle twitches (tics);
  • chest pain;
  • changes in your vision;
  • hallucinations (hearing or seeing things which are not real);
  • unexplained wounds;
  • penis erection which is painful or lasts 4 hours or longer;
  • paranoia;
  • a cold feeling;
  • hostility;
  • aggression;
  • new behavior problems.

To make sure this central nervous system stimulant is safe for you, tell your healthcare provider if you or anyone in your family has ever had:

  • blood circulation problems in the feet or hands;
  • psychosis;
  • Tourette’s syndrome;
  • seizures or epilepsy;
  • motor tics (muscle twitches);
  • an abnormal brain wave test (EEG);
  • stomach, esophagus, or intestines problems;
  • bipolar disorder;
  • a history of drug or alcohol addiction;
  • suicidal thoughts or actions;
  • depression.

Bottom Line – Dexmethylphenidate vs Methylphenidate

Dexmethylphenidate (brand name – Focalin) is a mild stimulant to the central nervous system that affects chemicals in the brain which contribute to impulse control and hyperactivity. It is chemically similar to methylphenidate.

Methylphenidate (brand name – Ritalin) is a central nervous system stimulant of the piperidine and phenethylamine classes which is used in the treatment of ADHD.

According to a 2010 study done at the Department of Pharmacy and Health Outcomes, New York, USA, both these medicines are safe and effective drugs to treat the symptoms of attention deficit hyperactivity disorder. However, both stimulate the central nervous system in a manner that is similar to amphetamines (a stimulant substance of the phenethylamine class that produces effects like wakefulness, stimulation, and euphoria), however, their actions are milder than amphetamines.

Image credit – Shutterstock

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References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671958/
https://academic.oup.com/ijnp/article/17/6/961/692761
https://www.ncbi.nlm.nih.gov/pubmed/15662147

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