Dexedrine treatment of ADHD
The use of Dexedrine to control hyperactive children with behavior problems has been known since the 1920's, but drug trials were not conducted until the early 1930's. Dextroamphetamine was approved by the FDA in 1958.
In the 1950's the semi-synthetic derivative, methylphenidate, was developed and marketed as ritalin. It was supposed to minimize the side effects of appetite suppression and insomnia. Since the targeted patients were always children, ritalin became the medication of choice for treating ADHD. Though a new compound of Dexedrine, Addderall, is coming back into favor because of its longer action.
It has stronger side effects on appetite suppression and insomnia, but often it is "smoother" than Ritalin and patients are more comfortable with it. Ritalin tends to cause more nausea or stomach discomfort, and may produce more moodiness. Both Ritalin and Dexedrine have short acting forms that last about 4 hours.
It comes in both long and short acting forms. The short acting tablet comes in 5 mg dosages, and reaches a peak level two hours after administration. The longer acting spansule is available in 5 mg, 10 mg, and 15 mg sizes and reaches a peak blood level eight to 10 hours after administration. This permits once daily dosing with the spansule.
Side effects are: agitation/irritability, insomnia, dry mouth, headache, nausea, weight loss. Other side effects are reduced stature, ticks, "zombie" demeanor, stomach aches, moodiness and if its similarities to Ritalin hold,
5 mg For ages 3 -5 years:
starting dose is 2.5 mg of tablet. Increase by 2.5 mg at weekly intervals, increasing first dose or adding / increasing a noon dose, until effective.
For 6 years and over, start with 5 mg once or twice daily. May increase total daily dose by 5 mg per week until reach optimal level. Tablet is given on awakening. Over 6 years, one or two additional doses may be given at 4-6 hour intervals. Usually not need more than 40 mg/day.
Side effects: Insomnia, decreased appetite, weight loss, headache, irritability, stomachache.
Rebound agitation or exaggeration of pre-medication symptoms as it is wearing off.
May also elicit psychotic symptoms.
Onset in 30-60 minutes. Duration about 4-5 hours. Approved for children under 6. Good safety record.
Somewhat longer action than short acting methylphenidate. Use cautiously in patients with marked anxiety, motor tics or with family history of Tourette syndrome, or history of substance abuse. Don't use if glaucoma or on MAOI. Dexedrine has high abuse potential particularly in tablet form.