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Dexmethylphenidate

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Dexmethylphenidate

Dexmethylphenidate, sold under the brand name Focalin among others, is a central nervous system (CNS) stimulant used in the treatment of attention deficit hyperactivity disorder (ADHD) in those over the age of five years. It is taken by mouth. The immediate-release formulation lasts up to five hours while the extended-release formulation lasts up to twelve hours. It is the more active enantiomer of methylphenidate. Methylphenidate has been shown to be more effective than atomoxetine and superior in treating ADHD symptoms when compared.

Common side effects include abdominal pain, loss of appetite, and fever. Serious side effects may include psychosis, sudden cardiac death, mania, anaphylaxis, seizures, and priapism. Safety during pregnancy and breastfeeding is unclear.

Dexmethylphenidate was approved for medical use in the United States in 2001. It is available as a generic medication. In 2023, it was the 127th most commonly prescribed medication in the United States, with more than 4 million prescriptions.

Dexmethylphenidate is used as a treatment for attention deficit hyperactivity disorder (ADHD), usually along with psychological, educational, behavioral or other forms of treatment. It is proposed that stimulants help ameliorate the symptoms of ADHD by making it easier for the user to concentrate, avoid distraction, and control behavior. Placebo-controlled trials have shown that once-daily dexmethylphenidate XR was effective and generally well tolerated.

Improvements in ADHD symptoms in children were significantly greater for dexmethylphenidate XR versus placebo. It also showed greater efficacy than osmotic controlled-release oral delivery system (OROS) methylphenidate over the first half of the laboratory classroom day but assessments late in the day favoured OROS methylphenidate.

Methylphenidate is contraindicated for individuals with agitation, tics, glaucoma, heart defects or a hypersensitivity to any ingredients contained in methylphenidate pharmaceuticals.

Pregnant women are advised to only use the medication if the benefits outweigh the potential risks. Not enough human studies have been conducted to conclusively demonstrate an effect of methylphenidate on fetal development. In 2018, a review concluded that it has not been teratogenic in rats and rabbits, and that it "is not a major human teratogen".

Products containing dexmethylphenidate have a side effect profile comparable to those containing methylphenidate.

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