ADD/ADHD Articles
Often Overlooked, Focalin Offers Benefits
By Jay Tarnow, M.D.
There are a variety of drugs appropriatefor treating ADHD. Those that get themost attention are often those that havethe strongest marketing program behindthem. Because it lacks a strong marketingpush, Focalin is often overlooked, but itoffers unique benefits and deserves considerationwhen treating ADHD.
Focalin Dextro Methylphenidatewas developed three years ago. It isbased on a very old product, methylphenidate.Dextro Methylphenidate isthe dextro stereo isomer, in other wordsthe right side, only of methylphenidate.It was approved by the FDA in 2001.
In testing, it is shown that the right"dextro" form of methylphenidate ismore pharmacologically active than theleft "levo" and seems to be mostly depositedin the brain, and has less peripheraleffect.
Focalin comes in two forms. FocalinRegular (which reaches it's maximumblood level in 1.5 hours) has dosesof 2.5 mg., 5 mg., and 10 mg. It lastsapproximately four to six hours. FocalinXR (extended release) which comes in5, 10, and 20 mg capsules and lasts 10to 12 hours. Thus, it can be taken oncea day. Since XR comes in capsules it isparticularly easy to use for children whohave difficulty swallowing pills since thecapsules can be opened and the medicationsprinkled on applesauce, ice cream,etc. The dosing of Focalin (dextro methylphenidate)is approximately one-halfthat of methylphenidate.
| FocalinTM: Dosing Flexibility | |
| Methylphenidate | Focalin Dose |
| 5 mg | 2.5 mg |
| 10 mg | 5 mg |
| 20 mg | 10 mg |
| Focalin XRTM: Dosing Flexibility | |
| Methylphenidate | Focalin XRDose |
| 5 mg BID | 5 mg |
| 10 mg BID | 10 mg |
| 20 mg BID | 20 mg |
Research shows that Focalin is as effectiveas methylphenidate and has a similarpotential for side effects. The mosttypical side effects for the methylphenidatecompounds are loss of appetite, interferencewith sleep, and headaches.
Focalin, however, seems to offer benefitswhen compared to methylphenidate.My experience with Focalin is thatit seems to have fewer body-stimulatingeffects and, therefore, I have been able touse it in children, adolescents, and adultswho are anxious or who get jittery on thetypical forms of methylphenidate andmixed amphetamine salts.
I have found that Focalin causes lesseating disturbance and insomnia. It hasbeen my experience that many childrenwho have Attention Deficit Disorderand learning differences, also have agreat deal of academic anxiety. Therefore,Focalin has a unique place in treatingADHD/ADD.
In an effort document the clinicalbenefits we have found, The TarnowCenter is presently doing research intoFocalin XR in children six to twelveyears old.