What factors should be considered when converting from one medication to another in the treatment of attention deficit hyperactivity disorder (ADHD)?

Updated: Sep 09, 2021
  • Author: Maggie A Wilkes, MD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Conversions for psychostimulants are always approximations, especially when one is converting between stimulants, such as methylphenidate and dextroamphetamine. Different forms of the same drug have slightly different pharmacokinetics, and patients often have different responses to them. FDA-recommended conversions between short-acting and long-acting (LA) preparations of the same drug are based on attempts to match serum-concentration curves and not clinical-performance curves.

In clinical practice, ratios for converting among medications vary by ADHD (ADD) manifestations, adverse effects, comorbidities, and the patients' metabolism. Common approximations are described below. Individual patients vary; therefore, close follow-up, and possibly titration, is initially necessary.


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