Methylphenidate long-acting

D-amphetamine and methylphenidate available in long-acting preparations effect are less reliable... 

Pelham, W., Greenslade, K., Vodde-Hamilton, M., Murphy, D., Greenstein, J., Gnagy, E., Guthrie, K., Hoover, M., and Dahl, R. (1990) Relative efficacy of long-acting stimulants on children with attention deficit-hyperactivity disorder a comparison of standard methylphenidate, sustained-release methylphenidate, sustained-release dextroamphetamine, and pemoline. Pediatrics 86 226-237. 

Concerta, Metadate Continuous Dosage (CD), Metadate Extended Release (ER), Methylin, Methylin Sustained Release (SR), Ritalin, Ritalin Long-Acting (LA), Ritalin-SR PMS-Methylphenidate... 

A critical part of the assessment must be to determine the patient s impairment at various times throughout the day to ensure that medication coverage overlaps with the time when the patient is most likely to benefit. As with all medication trials, it is important to start with a low dose of medication and keep increasing it slowly until the optimal risk-to-benefit ratio has been determined. Stimulant medication (methylphenidate, mixed amphetamine salts, and pemoline) and atomoxetine (a non-stimulant selective norepinephrine reuptake inhibitor, approved by the FDA for adult ADHD) are the first-line treatments of adult ADHD. Pemoline is not recommended as first-line treatment due to the risk of hepatoxicity. Stimulant drugs used to treat adults with ADHD are considered safe and effective, and have been well studied. There are several new long-acting formulations of... 

Ozdemir E, Karaman MG, Yurteri N, Erdogan A. A case of suicide attempt with long-acting methylphenidate (Concerta). Atten Deflc Hyperact Disord 2010 2 103-5. 

A 25-year-old man experienced spontaneous ejaculation without sexual arousal following testicular pain after micturition with the use of methylphenidate. His drug history included atomoxetine, which also gave spontaneous ejaculations following micturition. After 2 years, the patient mainly used the long-acting variant of methylphenidate (Concerta ) and sometimes the shorter-acting variant of methylphenidate (Ritalin ) [26 ]. 

Despite the documented efficacy and safety of the psychostimulants, their mechanism of action is not fully understood. Stimulants affect central nervous system (CNS) dopamine (DA) and norepinephrine (NE) pathways crucial in frontal lobe function. The stimulants act by causing release of catecholamines from the DA axons and blocking their reuptake. Methylphenidate releases catecholamines from long-term stores, so its effects can be blocked by pretreatment with reserpine. Amphetamines, on the other hand, release catecholamines from recently formed storage granules near the surface of the presynaptic neuron, so their action is not blocked by reserpine. In addition, the stimulants bind to the DA transporter in striatum (see Figures 2.6 and 2.7) and block the reuptake of both DA and NE. This action reduces the rate that catecholamines are removed from the synapse back into the axon and leads... 

MPH is most often taken in pill form. It is available in prescribed quantities of 5-, 10-, and 20-mg tablets. A sustained or delayed release 20-mg tablet is also available. In 2001, the FDA approved Concerta, a longer acting MPH tablet that is taken once a day. Besides its long lasting action, Concerta has another benefit Abusers sometimes grind MPH tablets into a powder and snort it up their noses, but Concerta is formulated so that it cannot be ground into a powder. According to the DEA, methylphenidate abusers also dissolve the immediate-release MPH tablets in water and then inject the mixture. 

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