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Cogmed Working Memory Training Outline: Everything You Want To Know About ADHD
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Return to ADDvisor Volume 2 2000 Index Number 20 October 18, 2000 In this issue: 1. Concerta - A New Medication for ADHD 2. Resources - Straight Talk about Psychiatric Medications for Kids
CONCERTA - A New Medication for ADHD
I attended a meeting during the first week of October, presented by Alza to promote the recently released ADHD medication, Concerta. Concerta is Methylphenidate (MPH) in a new delivery system. It is produced by Alza, a company that has created alternate delivery systems for other medications as well. The name of the delivery system is OROS. By delivering the medication using the OROS method, medication is released into the patient gradually in such a way as to last up to 12 hours with out the ups and downs experienced when taking other long acting medications such as Ritalin SR. While the medication looks like a capsule, it is more like a long tablet. The tablet has an overcoat of MPH that provides an immediate release of 22% of the entire dose within 1 hour. Once the MPH overcoat dissolves, water permeates the exposed semi_permeable tablet shell, expanding a push compartment and releasing the MPH through a laser_drilled hole at a controlled rate. There are two compartments within the tablet. The second compartment has a slightly larger amount of MPH in it as the Alza research showed that larger amounts are needed later in the day. As the push layer expands, MPH continues to be released for up to 12 hours after dosing, leaving minimal residual MPH with tablet shell that is eliminated through the stool. The MPH in the tablet is in a gel form which prevents it from being broken open and snorted. This can help to reduce abuse. Side effects are the same as those for MPH. The recommended dosing is 18mg, 36mg and 54mg. The following chart suggests the way Concerta compares to regular Ritalin dosing. Concerta ___ Ritalin 18mg _______ 5mg twice a day 36mg _______ 5-10mg twice to three times a day 54mg _______ 10-20mg twice to three times a day. One of the physicians that I work with in Illinois was in the beta test group for Concerta. He told me that only one of 40 patients with whom he has prescribed Concerta has had to be changed back to Ritalin. Some physicians find that they need to add an additional 5mg. Ritalin dose in the afternoon for some patients. Over 50% of ADHD patients are prescribed MPH. The other medications include Adderall, Dexedrine and Cylert. The initial preliminary data suggests that Concerta can eliminate multiple dosing, particularly during school, and reduce the "sawtooth" effect that comes from the sustained release MPH or the multiple dosing.
RESOURCES
An excellent book for parents who want to know about medications is Straight Talk about Psychiatric Medications for Kids by Timothy E. Wilens. Click on the banner for ADD Warehouse on this page to purchase this book.
CONTACT INFORMATION _______________________ Alan R. Graham, Ph.D. Bill Benninger, Ph.D. ADDvisor.com Voice: 1-866-ADDvisor Fax: 847-824-2386 Email: Alan@ADDvisor.com Bill@ADDvisor.com Web: www.ADDvisor.com
c) Copyright 2000 Alan R. Graham and Bill Benninger. All rights reserved The above material may be retransmitted or distributed to whomever you wish as long as not a single word is changed, added or deleted, including the contact information. However, you may not copy it to a web site. Republication of "The ADDvisor" in paper media is encouraged and permitted by organizations and associations which serve parents of ADHD children at the national, state and/or local level as long as the issue is reprinted in its entirety without charge and includes the contact information. With advance permission, we are happy to edit an issue to fit your space requirements. Republication is also encouraged under other circumstances, however, the advance permission of Alan R. Graham and/or Bill Benninger must be obtained in the event that changes in the text are desired or republication is to be made by individuals or by organizations other than those mentioned above.
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