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           Pharmacological Treatment

Medication has been prescribed for the condition we now call ADHD since 1937 when dexamphetamine (Dexedrine) was given to institutionalised children by their physician Dr. Charles Bradley who found it beneficial in improving both behaviour and academic performance. It remained the main drug treatment until Methylphenidate Hydrochloride (brand name Ritalin) was developed and licensed 20 years later in 1958. These drugs, known as psychostimulants, continued to be prescribed for several years to treat the symptoms of ADHD during which time other pharmaceutical companies started producing their own Methylphenidate Hydrochloride each one giving the drug their own brand names. Equasym, Medikinet, and Tranquilyn, like Dexedrine and Ritalin are available in what is known as immediate release or short-acting formulations. This means that their beneficial effect lasts for around 3-4 hours requiring more than one dose each day. Slow-release (or extended release) formulations EquasymXL, ConcertaXL MedikinetXL, and MatorideXL were subsequently introduced. EquasymXL, MedikinetXL, and MatorideXL are designed to be effective for 8 hours and ConcertaXL for 12 hours. Another extended release drug called lisdexamfetamine dimesylate (brand name Elvanse) became available in 2013.This drug is designed to provide beneficial effects for 12 hours.

The psychostimulant drugs used to treat ADHD increase the availability of two neurotransmitters (chemicals) in the brain, dopamine and noradrenaline (also called norepinephrine) which are believed to be deficient in people with ADHD. Both neurotransmitters contribute to maintaining alertness, increasing focus, sustaining thought, effort, and motivation.

A non-stimulant drug, atomoxetine (brand name Strattera) that specifically targets only noradrenaline has been used to treat ADHD either on its own or in conjunction with one of the psychostimulants. Strattera takes approximately 3-4 weeks to become fully effective and is then in the system 24/7.

Download Janssen’s informative booklet here.

Dr. Russell Barkley is a Clinical Professor of Psychiatry and Paediatrics at the Medical University of South Carolina in Charleston –

Thomas E. Brown, PhD, is assistant clinical professor of psychiatry at the Yale University School of Medicine and associate director of the Yale Clinic for Attention and Related Disorders

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