Table 3. Medications FDA-approved for ADHD (alphabetical by class)
Generic
(Brand) Dosage Form Typical Starting Dose
FDA
Maximum/Day Comments
Amphetamine Preparations
Short-acting > Short-acting stimulants often used as initial treatment in small children (< 16 kg ),
but have disadvantage of bid-tid dosing to control symptoms throughout day.
> Longer-acting stimulants offer greater convenience, confidentiality, and compliance
with single daily dosing, but may have greater problematic effects on evening
appetite and sleep.
> Adderall XR
®
cap may be opened and sprinkled on soft food.
Amphetamine,
Dextroamphetamine
Adderall
®
a
5, 7.5, 10, 12.5, 15, 20, 30 mg tabs 3-5 yr: 2.5 mg daily
≥ 6 yr: 5 mg daily-bid
40 mg
Dextroamphetamine
Dexedrine
®
a
5 mg tab 3-5 yr: 2.5 mg daily
≥ 6 yr: 5-10 mg daily
Long-acting
Amphetamine,
Dextroamphetamine
Adderall XR
®
5, 10, 15, 20, 25, 30 mg caps ≥ 6 yr: 10 mg daily 30 mg
Dextroamphetamine
Dexedrine Spansule
®
5, 10, 15 mg caps ≥ 6 yr: 5 mg daily-bid 40 mg
Lisdexamfetamine
Vyvanse
®
20, 30, 40, 50, 60, 70 mg caps ≥ 6 yr: 30 mg daily 70 mg
Dexmethylphenidate Preparations
Short-acting
Focalin
®
2.5, 5, 10 mg tabs 2.5 mg bid 20 mg
Long-acting
Focalin XR
®
5, 10, 15, 20, 30 mg tabs 5 mg q am 30 mg
Methylphenidate Preparations
Short-acting > Short-acting stimulants often used as initial treatment in small children (< 16 kg ),
but have disadvantage of bid-tid dosing to control symptoms throughout day.
> Longer-acting stimulants offer greater convenience, confidentiality, and compliance
with single daily dosing, but may have greater problematic effects on evening
appetite and sleep.
> Metadate CD
®
, Ritalin LA
®
, and Focalin XR
®
may be opened and sprinkled on
soft food.
> Concerta
®
tab should be swallowed whole with liquids.
> Concerta
®
nonabsorbable tab shell may be seen in stool.
Methylin
®
a
2.5, 5, 10 mg chewable tabs 5 mg/mL, 10 mg/mL oral sol'n
Ritalin
®
a
5, 10, 20 mg tabs 5 mg bid 60 mg
Intermediate-acting
Metadate ER
®
10, 20 mg tabs 10 mg q am 60 mg
Ritalin SR
®
a
20 mg tabs
Metadate CD
®
10, 20, 30, 40, 50, 60 mg caps 20 mg q am
Ritalin LA
®
10, 20, 30, 40 mg caps
Long-acting
Concerta
®
18, 27, 36, 54 mg tabs ≥ 6 yr: 18 mg q am 72 mg
Daytrana
®
(transdermal system)
10, 15, 20, 30 mg patches ≥ 6 yr: Begin with 10 mg patch
daily, then titrate up weekly by
patch strength
30 mg
Selective Norepinephrine Reuptake Inhibitors (SNRI)
Atomoxetine
Strattera
®
10, 18, 25, 40, 60, 80, 100 mg
caps
Children and adolescents
< 70 kg : 0.5 mg/kg/d for 4 d;
then 1 mg/kg/d for 4 d;
then 1.2 mg/kg/d
> 70 kg : 40 mg for ≥ 3 d,
then 80 mg daily
Lesser of
1.4 mg/kg or
100 mg
> Consider if active substance abuse or
severe side effects of stimulants (mood
lability, tics).
> Give q am or divided doses bid (effects on
late evening behavior).
> Do not open cap.
> Monitor closely for suicidal thinking
and behavior, clinical worsening, or
unusual changes in behavior.
> Not a Schedule II medication.
Alpha
2
-adrenergic Agonists
Clonidine
Kapvay
®
0.1, 0.2 mg 0.1 mg 0.4 mg > Taper when discontinuing — 0.1 mg q3-7d
Guanfacine
Intuniv
™
1, 2, 3, 4 mg tablets 6-17 yr: 1 mg q am 4 mg
