Examples: methylphenidate (IR<SR<ER<CR), dextroamphetamine (IR<SR), lisdexamfetamine, amphetamine
(immediate release - IR, sustained release - SR, extended release - ER, controlled release - CR)
Indication: attention deficit hyperactivity disorder
Dosing:
-long acting formulations are dosed once daily in the morning
-shorter acting formulations may be dosed up to twice daily
-dose may be started at a low dose for children and titrated up
-certain capsule formulations may be opened and given with food/water
Adverse Effects:
-Cardiovascular: increased heart rate and blood pressure
-Insomnia (hence dosed earlier in the day, preferably morning)
-Nausea, reduced appetite, anorexia (hence to give with a larger meal at breakfast)
-Growth restriction in children
-Headache, dry mouth
-Rare: sexual dysfunction, tics, psychosis, hyperthyroidism, seizures
Drug Interactions:
-MAOI inhibitors: hypertensive crisis; wait 14 days before starting stimulants
-Sympathomimetics: theophylline and ephedrine - increased cardiovascular stimulation