ADHD Medications
Stimulants
Medication | Forms | Dose (Start, Initial Target, Max) | ||
Long-acting | ||||
Methylphenidate OROS (Concerta) | Extended release tab 18,27,36,54 mg | Child: Start 18 mg q AM, increase by 9-18 mg weekly, max 72 mg daily (or 1 mg/kg/day) Adolescent/ Adult: Start 36 mg q AM, increase by 9-18 mg weekly, max 90 mg qAM | ||
Adderall XR (amphetamine mixed salt) | Caps 5,10,15,20,25,30 mg | Child: Start 5-10 mg q AM, increase by 5 mg weekly, max 30 mg qAM Adolescents/Adult: Start 5-10 mg q AM, increase by 5 mg weekly, max 50 mg qAM | ||
Dexedrine spansule | Cap 10,15 mg | Child: Start 10 mg q AM, increase by 2.5-5 mg weekly, max 20-30 mg qAM Adult: Max 50 mg daily | ||
Vyvanse® (lisdexamfetamine dimesylate) | Cap 10,20,30,40, 50,60,70 mg | Child: Start 20 mg qAM, titrate up 10 mg weekly, max 60 mg qAM Adolescent: Start 30 mg qAM, titrate 10 mg weekly, max 70 mg qAM Adult: Start 30 mg daily, increase by 10 mg weekly, max 70 mg q AM | ||
Methylphenidate (Biphentin) | Cap 10,15,20,30,40,50,60,80 mg | Child: Start 10 mg qAM, titrate up by 5-10 mg weekly, max 60 mg qAM Adolescent: Start 20 mg qAM, titrate up by 5-10 mg weekly, max 80 mg qAM | ||
Short-acting | ||||
Dexedrine® (dextro-amphetamine sulphate) | 5mg tab | Child/youth: Start 2.5 - 5mg bid, increase 2.5-5 mg weekly, max 20-30 mg qAM Adult: Max 50 mg daily | ||
Methylphenidate (Ritalin) | Tab 5,10,20 mg | Child: Start 2.5 mg bid-tid, increase 5 mg weekly, max 60 mg qAM Adult: Start 2.5 mg bid-qid; increase by 5 mg weekly; max 100 mg daily |
Stopping Stimulant Medications
Stimulant medications can usually be stopped suddenly without needing to taper down.
Non-Stimulants
Medication | Forms | Dose (Start, Initial Target, Max) | ||
Alpha adrenergic | ||||
Clonidine (Catapres) | Child: Start 0.05mg nightly, max 0.35 mg daily in divided doses. | |||
Guanfacine XR (Intuniv) | Tab XR: 1, 2, 3, 4 mg | As monotherapy Child: Initially 0.5-1 mg at bedtime titrated to maximum dosage of 3 mg qhs or divided doses Adolescent: Up to 7 mg qhs or divided doses As adjunctive therapy Child/Adolescent: 4 mg max | ||
Others | ||||
Atomoxetine (Strattera) | Cap 10, 18, 25, 40, 60, 80,100 mg | Child: Start 0.5 mg/kg/day, titrate up to 0.8 mg/kg/day initial therapeutic target; max 1.2 mg/kg/day Adolescent: Start 0.5 mg/kg/day; titrate up to 60 mg/day then 80 mg/day Max dose lesser of 1.4 mg/kg/day or 100 mg daily Adult: Start 40 mg daily x 1-2 weeks; then titrate up to 60-80 mg q AM Max lesser of 1.4 mg/kg/day or 100 mg | ||
Bupropion SR (Wellbutrin SR) | Tab: 100, 150 mg ; Do not crush/ cut/ chew | Child: Unknown Adol/adult: Start 100 mg, initial target 150 mg daily; max 400 mg daily | ||
Bupropion XL (Wellbutrin XL) | Tab: 150, 300 mg ; do not crush/cut/chew | Child: Unknown Adol/adult: Start 150 mg, initial target 300 mg; max 450 mg |
* Disclaimer: This medication table is a rough summary only and is not a replacement for clinical judgment and consulting a drug reference such as PDR or Lexi-Comp.
Stopping Non-Stimulants
Alpha adrenergics such as clonidine or guanfacine should be stopped gradually over 2-4 weeks, in order to avoid any rebound hypertension.
Atomoxetine, bupropion are long acting and have antidepressant effects, and should also be tapered gradually and then stopped over 4-weeks.