AGENT OR INTERVENTION | ONSET AND DURATION | DOSING IN PEDIATRICS AGE ( ≥ 6 Y; WEIGHT ≤ 40 KG) | PRICE, $* | COMMENTS |
---|---|---|---|---|
Short-acting psychostimulant | ||||
Methylphenidate IR | O: 30–60 min | Initial: 5 mg morning and noon | 15 |
|
Ritalin, generic | D: 3–5 h | Typical: 10 mg 3 times daily | 25 | |
| Maximum: 60 mg/d | |||
Dextroamphetamine IR | O: 30–60 min | Initial: 2.5 mg morning and noon | 26 | |
Dexedrine | D: 4–6 h | Typical: 10 mg 2 times daily | 82 | |
| Maximum: 30 mg/d | |||
Intermediate-acting psychostimulant | ||||
Methylphenidate SR | O: 60 min | Initial: 20 mg every morning | 22 |
|
Ritalin SR, generic | D: 4–8 h | Typical: 40 mg every morning | 35 | |
Maximum: 60 mg/d | ||||
Dextroamphetamine SR | O: 60 min | Initial: 10 mg every morning | 34 | |
Dexedrine Spansules | D: 6–8 h | Typical: 15 mg every morning | 40 | |
Maximum: 30 mg/d | ||||
Long-acting psychostimulant | ||||
Methylphenidate long-acting | O: 30–60 min | Initial: 18 mg every morning | 80 |
|
Concerta (tablet) | D: 8–12 h | Typical: 36 mg every morning | 103 | |
| Maximum: 54 mg/d | |||
Methylphenidate long-acting capsule | O: 30–60 min | Initial: 10 mg every morning | 31 | |
Biphentin (capsule) | D: 10–12 h | Typical: 30 mg every morning | 66 | |
| Maximum: 60 mg/d | |||
Amphetamine mixed salts | O: 30–60 min | Initial: 10 mg every morning | 86 | |
Adderall XR (capsule) | D: 8–12 h | Typical: 30 mg every morning | 123 | |
| Maximum: 30 mg/d | |||
Nonstimulant (selective norepinephrine reuptake inhibitor) | ||||
Atomoxetine | O: NA | Initial: 10 mg every morning or 0.5 mg/kg/d | 150 |
|
Strattera | D: 24 h | Typical: 25 mg every morning or 1.2 mg/kg/d | 150 | |
Maximum: 60 mg/d or 1.4 mg/kg/d | ||||
Other drug options (off label) | ||||
Bupropion, clonidine, TCAs (desipramine, imipramine, nortriptyline), risperidone, modafinil | NA | NA | NA | NA |
Nondrug intervention options | ||||
Behavioural therapy, environmental interventions (eg, more regular or structured schedule) | NA | NA | NA | NA |
D–duration, IR–immediate release, NA–not applicable, O–onset, SR–sustained release, TCA–tricyclic antidepressant, XR–extended release.
Data from Virani,3 McDonagh et al,9 Virani et al,17 and Lee et al.18
↵* Reflects initial and typical approximate cost per 30 days in Saskatchewan; includes markup and dispensing fee; price for generic product used where available. Provincial formulary coverage might vary.