CNS stimulants and drugs used for attention deficit hyperactivity disorder

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CNS stimulant medication (methylphenidate, lisdexamfetamine) is only indicated for the treatment of attention deficit hyperactivity disorder (ADHD) under specialist supervision. Initiation, stabilisation and ongoing supervision are provided by the relevant specialist. Unacceptable side-effects or a poor response to first-line treatment can be discussed with the specialist. When response to stimulants is inadequate or when stimulants are unsuitable or not tolerated, use of the non-stimulant atomoxetine or guanfacine may be considered.

For information on prescribing in ADHD and the characteristics and release profiles of immediate and modified-release formulations of methylphenidate, refer to SIGN guidance (www.sign.ac.uk) and to the shared-care protocol. In a small minority of patients response to methylphenidate therapy may differ if the formulation changes; brand name prescribing may be required as per BNF advice.

ATOMOXETINE

Important: Therapy notes

MHRA advice: Atomoxetine (Strattera▼): increases in blood pressure and heart rate (December 2014) (www.gov.uk).

Important: Formulation

Capsules 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg (s)

Important: Formulation

Oral solution 4mg/mL (s)

GUANFACINE

Important: Therapy notes


Risk minimisation materials

Important: Formulation

Modified release tablets 1mg, 2mg, 3mg, 4mg (S)

LISDEXAMFETAMINE

Important: Therapy notes


Risk minimisation materials

Important: Formulation

Capsules (CD schedule 2) 20mg, 30mg, 40mg, 50mg, 60mg, 70mg (s)

METHYLPHENIDATE

Important: Therapy notes


Risk minimisation materials

Important: Formulation

Tablets (CD schedule 2) 5mg, 10mg, 20mg (s)

Important: Formulation

Modified release tablets (Xenidate XL®) (CD schedule 2) 18mg, 27mg, 36mg, 54mg (s)

Important: Formulation

Modified release capsules (Equasym XL®) (CD schedule 2) 10mg, 20mg, 30mg (s)

Important: Formulation

Modified release capsules (MedikinetXL®) (CD schedule 2) 5mg, 10mg, 20mg, 30mg, 40mg (s)