Dexmethylphenidate (commercially known as Focalin) is a pharmaceutical drug used to treat Attention Deficit Hyperactivity Disorder. It is very similar to Ritalin, but it only contains the d-isomer of methylphenidate. It is a stimulant that affects the central nervous system. Dexmethylphenidate has approximately a 6-hour duration of effect.^[1]

Dexmethylphenidate has a similar side-effect profile to Methylphenidate^[2] and can be administered without regard to food intake.^[3] Recently, it has become available in extended-release form, and has been shown to be as effective as d,l-methylphenidate, with flexible dosing and good tolerability.^[4][5]

FocalinXR capsules can be opened and the contents mixed with applesauce, pudding or similar foods. This enables administration to children who are unable to swallow pills, a unique advantage among ADHD medications. These capsules are an improvement to the regular Focalin tablets, because of their use as time-release distribution into the body. These FocalinXR capsules regularly begin their effects one hour after ingestion. Because of the time-release capability of these capsules, their effectiveness will last around six to eight hours.^[6]

A single isomer

The theory about the superiority of Focalin is that it is made of just one part of Ritalin, and leaves another part, which is inactive and may contribute to side effects, out. This improves upon the more common ADHD and ADD medications, such as Concerta or Adderall XR. These medicines are made of two isomers, one which contains the actual drug, and one which contains a placebo, of sorts. In reality, you only need one of those isomers for the medicine to work. The second isomer lingers in the body, because it is semi-difficult for the body to get rid of this "mirror isotope", and often can cause unwanted side effects. Xopenex, one isomer of racemic albuterol, which is used to treat asthma, is made the same way. Because there is only one isomer actively releasing medicine to the body in Focalin XR, the same effect is reached with a smaller dose, and less side effects.

The CAS number of enantiomerically pure dextro-methylphenidate is 19262-68-1.

Usage

The Focalin XR capsules are also a great choice for children because of their flexibility in usage and ingestion. As mentioned before, the capsules can be opened and their contents mixed with applesauce or pudding to help children who cannot swallow large capsules to acquire an alternate form of ingestion. This is due to the SODAS (Spheroidal Oral Drug Absorption System) delivery system, also used in Ritalin LA. These capsules also have a very convenient dosage plan. Doses come in five, ten, fifteen, and twenty milligram capsules. To determine the dosage that will be administered, one to four five milligram capsules are taken, and a treatment plan can be formulated based upon results and behavior. This is a good alternative for children, because there is a large variability of doses, and a plan can be chosen to make children more comfortable while taking medication.^[7]

Reception

Many physicians and patients are offput by the capsules, because of high prices, variability of side effects between patients, and the controversy about its reliability and functionality. The main source of controversy in taking Focalin XR is the use of ingredients, natural and synthetic. Because it is mainly comprised of synthetic ingredients, there is a high level of uneasiness towards Focalin and Focalin XR. The mixture of chemicals in Focalin XR are said to have a strong effect on appetite suppression and insomnia, which is why this drug is also used as a treatment for Narcolepsy. While the manufacturer maintains that Focalin is “smoother” then Ritalin since it’s less then half the dose, it is still viewed as the lesser of two evils, which may not be good enough for some parents. As with many prescription drugs, Focalin has the potential to cause harmful side effects for some users that include the following: increased heart rate, vertigo, headaches, diarrhea, irritably and sweating. Less common yet still possible side effects include: Dehydration, Nervousness, urinary retention, high blood pressure, hallucinations and even hair loss for some. The large problem with Focalin and side effects is that many of these effects are highly variable among users. In rare cases, some effects may even appear and disappear, which leaves a large amount of controversy about the safety of Focalin-induced side effects.^[8]

Another noted fact about Focalin XR is that not only does it treat ADHD patients, it is also very effective in treating ADD. Although Focalin XR may not be right for all persons with ADD, it has shown high success rates in treating ADD as well as ADHD. Although some medications are not as effective in treating ADD as well as ADHD, such as Straterra, Focalin's effects can also have a lasting effect on ADD patients. Its use as a stimulant can increase energy in ADD patients, while still allowing them to maintain focus on events. This has caused parents to become more lenient towards its use in children with ADD.^[9]

See also

• Methylphenidate
• Dexedrine
• Amphetamine
• Methamphetamine

References

1. ^ Arnold, L.E., et al. (2004). "A double-blind, placebo-controlled withdrawal trial of dexmethylphenidate hydrochloride in children with attention deficit hyperactivity disorder". J Child Adolesc Psychopharmacol. 2004 Winter;14(4):542-54.
2. ^ Keating, G.M. & Figgitt, D.P. (2002). "Dexmethylphenidate". Drugs. 2002;62(13):1899-904; discussion 1905-8.
3. ^ Teo, S.K., et al. (2004). "A Single-Dose, Two-Way Crossover, Bioequivalence Study of Dexmethylphenidate HCl with and without Food in Healthy Subjects". J Clin Pharmacol. 2004 Feb;44(2):173-8.
4. ^ McGough J.J., Pataki C.S., Suddath R. (2005). "Dexmethylphenidate extended-release capsules for attention deficit hyperactivity disorder". Expert Rev Neurother. 2005 Jul;5(4):437-41.
5. ^ Silva, R., et al. (2004). "Open-Label Study of Dexmethylphenidate Hydrochloride in Children and Adolescents with Attention Deficit Hyperactivity Disorder". J Child Adolesc Psychopharmacol. 2004 Winter;14(4):555-63.
6. ^ "FocalinXR official web site".
7. ^ "Focalin XR for ADHD ".
8. ^ "The MindReference Review of Focalin XR".
9. ^ "Health and ADD".

External links

• Information from the U.S. National Institute of Health