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20-September-2008 09:55:55 - Dexmethylphenidate Dexmethylphenidate Systematic IUPAC name R,R-+-Methyl 2-phenyl-2-2-piperidylacetate Identifiers CAS number 113-45-1 ATC code N06BA04 PubChem 4158 DrugBank APRD00657 Chemical data Formula C14H19NO2 Mol. mass 233.31 g/mol Pharmacokinetic data Bioavailability 11 - 52% Protein binding 30% Metabolism Liver Half life 2 - 4 hours Excretion Urine Therapeutic considerations Pregnancy cat. C Legal status Controlled S8AU Schedule IIICA Class BUK Schedule IIUS Routes Oral Dexmethylphenidate sold commercially by Novartis as Focalin, also available generically in the US exclusively from Teva is a pharmaceutical drug used to treat Attention Deficit Hyperactivity Disorder. It is a stimulant that affects the central nervous system. Dexmethylphenidate has approximately a 6-hour duration of effect the XR version spans 12 hours covering a full day, and has been demonstrated to be more effective than methylphenidate at reducing the symptoms of childhood ADHD.1 Dexmethylphenidate has a similar side-effect profile to Methylphenidate Ritalin2 and can be administered without regard to food intake.3 Recently, it has become available in extended-release form, and has been shown to be as effective as d, l-methylphenidate, with flexible dosing and good tolerability.45 Contents 1 Mode of action 2 Therapeutic use 3 Negative effects 3.1 Focalin 3.2 FocalinXR 4 Usage 5 See also 6 References 7 External links Mode of action Methylphenidate, as usually synthesized, is a racemate, consisting of two molecules with identical chemical structures but different chirality. Dexmethylphenidate consists of the isomer that is more effective, with the other levomethylphenidate removed. Because of this, an individual's therapeutic dose of dexmethylphenidate will generally be half their therapeutic dose of methylphenidate.citation needed The same concerns that apply to other stimulant drugs should be considered: Reports of sudden cardiac death in children caused Canada to stop marketing Adderall XR another stimulant used to treat ADHD for a period in 2005. Heart problems have been reported, predominantly in young people taking ADHD stimulants, though the FDA has not concluded that the category of stimulants increase risk of cardiac problems for a person without a heart condition. Suicidal thinking has been reported in young people who are taking antidepressants at the same time they are taking an ADHD stimulant. Therapeutic use Dexmethylphenidate is used as a treatment for ADHD, ideally in conjunction 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. Also, listening skills may improve, there is a possibility it will help stop fidgeting, and maybe help to organize tasks better. Because it is a stimulant, it may also help with narcolepsy. An average daily dose is around 20mg. Typically an individual's active dose of dexmethylphenidate will be half the dose of methylphenidate.citation needed There is a possibility of withdrawal symptoms if dexmethylphenidate use is discontinued suddenly. As with other stimulants, withdrawal symptoms may include emotional or behavioral depression. Tapering off is recommended, under the supervision of a doctor. Addiction, which involves compulsive or harmful drug-seeking behavior, is rare but not impossible.6 Negative effects Focalin Trouble sleeping, nausea, stomach pain, headache, nervousness, loss of appetite, or weight loss are common side effects. Rare but much more serious side effects: Uncontrolled muscle movements e.g., stiffness, twitching, shaking, high fever, outbursts of words/sounds, swelling of the ankles/feet, blurred vision, mental/mood/behavior changes e.g., agitation, aggression, mood swings, depression, hallucinations, abnormal thoughts/behavior, extreme tiredness, and severe sweating, easy bleeding/bruising, shortness of breath, fainting, chest/jaw/left arm pain, sudden vision changes, signs of infection fever, persistent sore throat, fast/irregular/pounding heartbeat, weakness, seizures, confusion, slurred speech, and severe headaches. Focalin can show up as THC on drug test. Also, there is a potential for a severe allergic reaction, but it is extremely rare. Trouble breathing, itching, a rash, swelling, or severe dizziness are all signs/symptoms of this allergic reaction. FocalinXR FocalinXR has all the same negative effects that Focalin has; the XR also includes heartburn, dizziness, dry mouth as a more common negative effect. 7 Usage The FocalinXR capsules are sometimes prescribed over other extended release stimulants because the capsules can be opened and their contents mixed with applesauce or pudding to help children who cannot, or will not, swallow large capsules. This is possible due to the SODAS Spheroidal Oral Drug Absorption System delivery system, also used in Ritalin LA. Focalin XR come in five, ten, fifteen, and twenty milligram capsules. To determine appropriate dosage doctors first prescribe one to four 5mg capsules. An appropriate treatment plan is then based on the patient's reaction to the initial dose. 8 See also Amphetamine-- Adderall Atomoxetine-- Strattera Dextroamphetamine-- Dexedrine Methylphenidate-- Concerta, Ritalin Lisdexamfetamine-- Vyvanse Methamphetamine-- Desoxyn References ^ Arnold, L.E., et al. 2004. A double-blind, placebo-controlled withdrawal trial of dexmethylphenidate hydrochloride in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 2004 Winter;144:542-54. ^ Keating, G.M. Figgitt, D.P. 2002. Dexmethylphenidate. Drugs. 2002;6213:1899-904; discussion 1905-8. ^ Teo, S.K., et al. 2004. A Single-Dose, Two-Way Crossover, Bioequivalence Study of Dexmethylphenidate HCl with and without Food in Healthy Subjects. J Clin Pharmacol. 2004 Feb;442:173-8. ^ McGough J.J., Pataki C.S., Suddath R. 2005. Dexmethylphenidate extended-release capsules for attention deficit hyperactivity disorder. Expert Rev Neurother. 2005 Jul;54:437-41. ^ Silva, R., et al. 2004. Open-Label Study of Dexmethylphenidate Hydrochloride in Children and Adolescents with Attention Deficit Hyperactivity Disorder. J Child Adolesc Psychopharmacol. 2004 Winter;144:555-63. ^ Oral Uses. ^ Drug Treatments-Focalin. ^ Focalin XR for ADHD. External links Information from the U.S. National Institute of Health Retrieved from http://en..org/wiki/Dexmethylphenidate Categories: Stimulants | Dopamine reuptake inhibitorsHidden categories: All articles with statements | Articles with statements since May 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Hrvatski РуÑ?Ñ?кий Tiếng Việt ä¸æ–‡ This page was last modified on 14 August 2008, at 05:2
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