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Attention Deficit Hyperactivity Disorder

Methylphenidate Medications and Effects

01/12/2001

Question:

Our 13 yr. old son was taking Ritalin for 5 years, just for school. He was off Ritalin for 1 year and continued to do well in school. This year, his teacher asked if he had been on medication for concentration. Upon the suggestion, we consulted his doctor who started him taking 36 mg of Concerta, for the time release benefit and less peak & valley effects. Please give us any information on Concerta, and any long term concerns. Thanks

Answer:

Concerta®, Ritalin®, Methylin® and Metadate® are all methylphenidate (MTP). MTP also comes in a generic, referred to simply as "methylphenidate". Ritalin® was the first brand of MTP to go through the Food and Drug Administration (FDA) so it is used as the "standard" for FDA testing of MTP products. The basic difference between Concerta® and Ritalin® is the delivery system. Concerta® is oros®-MTP which means it is distributed slowly via three "timed" compartments (the outer coating plus two separated inner compartments). There are several other oros® delivered medications available including several heart medications, so the system is not a new one. Oros®-MTP has less peaks and valleys in studied serum levels. Of note, although, by-far, the great majority of patients I have on MTP prefer the oros-MTP, some do not and a few even complain that it "has too many peaks and valleys." This just speaks to the important addage "Every body is different and some do not respond to one, several, or any medications in the `average` way the drug literature says they will." Also, please browse the previous NetWellness ADD questions and see 12/15/2000.

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Response by:

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