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Attention Deficit Hyperactivity Disorder

Ritalin vs Dexidrine

03/27/2000

Question:

As a follow-up to my previous question on Ritalin, can you tell me what the difference is between Ritalin and Dexidrine and the pros and cons regarding the use of each for a recently diagnosed adult ADD patient? Particularly one with a history of prescription drug abuse? Thanks.

Answer:

Ritalin (a brand of methylphenidate); Dexedrine, Dexedrine Spansules and Dextrostat (all brands of dextroamphetamine); and Adderall (a combination of four dexedrine salts) are all "stimulants". The term "stimulant" is used because they stimulate a part of the brain that is underactive. All have similar possible negative side effects and similar possible positive effects. However, in one person, dexedrine might cause terrible sleep problems while Ritalin did not, and in another person the opposite responses may be seen. Since ADD is a large catagory of many ADD-subtypes, there may be certain subtypes that are more likely to respond positively to one than to another, but that has never been well compared in studies. The differences are subtle enough that it is rare for even ADD specialists to make absolute choices on which to start for a given patient, other than regarding length of dose. Although there is much variability, on average, regular Ritalin and dexedrine last about 4 hours, Dexedrine spansules last about 8 hours and Adderall lasts about 6 hours. in those instances that I know enough about a patient to medicate them with a stimulant even with a history of drug abuse, I have not found any good reasons to choose one over the other.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati