CNS stimulants and drugs used for attention deficit hyperactivity disorder (Formulary)

CNS stimulant medication (methylphenidate, lisdexamfetamine) is only indicated for the treatment of attention deficit hyperactivity disorder (ADHD) under specialist supervision. Initiation, stabilisation and ongoing supervision are provided by the relevant specialist. Unacceptable side-effects or a poor response to first-line treatment can be discussed with the specialist. When response to stimulants is inadequate or when stimulants are unsuitable or not tolerated, use of the non-stimulant atomoxetine or guanfacine may be considered.

For information on prescribing in ADHD and the characteristics and release profiles of immediate and modified-release formulations of methylphenidate, refer to SIGN guidance (www.sign.ac.uk) and to the shared-care protocol. In a small minority of patients response to methylphenidate therapy may differ if the formulation changes; brand name prescribing may be required as per BNF advice.

ATOMOXETINE

Important: Therapy notes

MHRA advice: Atomoxetine (Strattera▼): increases in blood pressure and heart rate (December 2014) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg (s)

Important: Formulation and dosage details

Formulation:

Oral solution 4mg/mL (s)

GUANFACINE

Important: Therapy notes


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Modified release tablets 1mg, 2mg, 3mg, 4mg (s)

LISDEXAMFETAMINE

Important: Therapy notes


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Capsules (CD schedule 2) 20mg, 30mg, 40mg, 50mg, 60mg, 70mg (s)

METHYLPHENIDATE

Important: Therapy notes

MHRA advice: Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations (September 2022) (www.gov.uk).


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Tablets (CD schedule 2) 5mg, 10mg, 20mg (s)

Important: Formulation and dosage details

Formulation:

Modified release tablets (Xenidate XL®) (CD schedule 2) 18mg, 27mg, 36mg, 54mg (s)

Important: Formulation and dosage details

Formulation:

Modified release capsules (Equasym XL®) (CD schedule 2) 10mg, 20mg, 30mg (s)

Important: Formulation and dosage details

Formulation:

Modified release capsules (MedikinetXL®) (CD schedule 2) 5mg, 10mg, 20mg, 30mg, 40mg (s)

SOLRIAMFETOL

Important: Therapy notes

  • To be used second line after the use of modafinil with the goal of improving wakefulness in patients with narcolepsy who did not respond to or did not tolerate modafinil.

Important: Formulation and dosage details

Formulation:

Film-coated tablets 75mg, 150mg (specialist recommendation only)

Dosage:

See SMC advice 2439.

Document Id: F080