Top 8 Methylphenidate-Based Medications for ADHD: What You Should Know

ADHD affects 15.5 million adults and 7 million children in the US. Dealing with it can also be tough, especially when searching for the right treatment. Methylphenidate is a common medication prescribed for ADHD. It helps control symptoms in children, teenagers, and adults.

How does it work? The drug boosts certain brain chemicals to enhance focus and control impulses. However, you might worry about side effects, long-term safety, and its effectiveness over time. This medication works well, but it's important to weigh the risks and benefits.

In this article, you'll discover how methylphenidate functions, its possible side effects, and the top 8 methylphenidate ADHD medications to manage it successfully.

Understanding Methylphenidate

Methylphenidate is a medicine that stimulates the central nervous system. It helps increase certain chemicals in the brain linked to motivation and reward. You can get it in quick-release forms or longer-lasting versions, giving doctors flexibility in treatment.

This medication is the most commonly prescribed treatment for ADHD in children and teenagers worldwide. The FDA approves it for people aged six and older as a main treatment for ADHD. For adults, it is usually used as a second option to treat narcolepsy.

Sometimes, doctors prescribe it for other reasons, like reducing fatigue in cancer patients, treating depression in older adults, managing apathy in Alzheimer’s disease, and enhancing cognitive functions. However, its effectiveness for these uses is only moderate.

Mechanism of Action

Methylphenidate works by stopping the reabsorption of norepinephrine and dopamine, which increases their levels in the brain. This boosts activity in the central nervous system. It also slightly affects serotonin receptors and helps regulate dopamine transporters, which might protect the brain.

These actions suggest it could help with conditions like Parkinson’s disease and addiction to methamphetamine.

Long-Term Safety

The long-term safety of methylphenidate was studied in the ADDUCE study. This two-year research project was conducted in 27 mental health centers across Europe. It included 1,410 children and teenagers aged 6 to 17. They were split into three groups: those starting methylphenidate for the first time, those not taking any ADHD medication, and a control group without ADHD.

It found no increased risk of mental or nerve-related side effects. However, those taking methylphenidate had a slight increase in heart rate and blood pressure. This means regular heart health checks are important. No serious side effects were reported, showing that long-term use is safe for children and teenagers with ADHD.

Effectiveness for ADHD

Research shows that methylphenidate reduces key ADHD symptoms in about 70% of cases compared to a placebo. This effectiveness lasts for at least two years. However, we don’t know if it works well beyond that because treatment guidelines only confirm its benefits for up to two years.

However, one study looked at its effects after two years. The ADHD Rating Scale (ADHD-RS) measures were used to show how severe ADHD symptoms are. A higher total score means more severe symptoms.

At the start, the ADHD Rating Scale scores were 21.4 for those continuing treatment and 19.6 for those who stopped. After seven weeks, the scores changed to 21.9 for the continuation group and 24.7 for the discontinuation group.

The group that kept taking methylphenidate showed significant improvement, with a mean difference of -4.6. Additionally, 40.4% of those who stopped treatment saw their symptoms get worse, compared to only 15.9% in the continuation group.

Benefits

Studies on the broader effects of ADHD medications, including methylphenidate, have found that they reduce by 9–58% the risks of:

• Injuries
• Car accidents
• Educational challenges
• Substance use disorders

Importantly, there’s no increased risk of suicidal thoughts or seizures.

Side Effects

Methylphenidate is commonly prescribed for ADHD and narcolepsy, but it can cause side effects. Some are mild, while others can be more serious.

Knowing what to expect helps you manage them and seek help when needed. Below are some of the side effects associated with methylphenidate.

Common Side Effects

When you first take methylphenidate, you might notice some side effects. These often go away over time. However, if they persist or get worse, it’s important to talk to your doctor.

Here are some common side effects:

• Nervousness
• Irritability
• Trouble sleeping
• Dizziness
• Nausea
• Vomiting
• Loss of appetite
• Weight loss
• Stomach pain
• Diarrhea
• Heartburn
• Dry mouth
• Headaches
• Muscle tightness
• Drowsiness
• Restlessness
• Involuntary movements
• Decreased sexual desire
• Heavy sweating
• Back pain

Serious Side Effects

Some side effects from methylphenidate need immediate medical attention. They could signal serious health issues. Keep an eye out for:

• Fast, pounding, or irregular heartbeat
• Chest pain and shortness of breath
• Feeling extremely tired or weak
• Trouble speaking clearly
• Fainting or numbness in arms or legs
• Seizures and vision changes
• Unusual thoughts, delusions, or paranoia
• Seeing or hearing things that aren’t there
• Mood swings or extreme excitement
• Frequent, painful, or long-lasting erections
• Numbness or color changes in fingers or toes
• Unexplained wounds on fingers or toes
• Fever, hives, or rashes
• Blistering or peeling skin
• Swelling in the face, lips, or throat
• Hoarseness
• Trouble breathing

Overdose Symptoms

Taking too much methylphenidate can be dangerous. If you or someone you know shows any of these signs, seek emergency medical help right away:

• Nausea, vomiting, and diarrhea
• Fainting, dizziness, or blurred vision
• Restlessness or rapid breathing
• Anxiety
• Agitation
• Shaking or muscle twitching
• Seizures or loss of consciousness
• Extreme happiness or confusion
• Hallucinations and sweating
• Flushing and fever
• Fast heartbeat and widened pupils
• Dry mouth or nose
• Muscle weakness, fatigue, or dark urine

In severe cases, an overdose of methylphenidate can lead to serious complications like excessive thirst and dangerously low sodium levels, especially in children.

For example, a case report described an 8-year-old boy who accidentally took his sibling's extended-release methylphenidate. Within hours, he felt extremely thirsty and became aggressive. He later developed life-threatening low sodium levels and had to be intubated because of seizures. Drinking too much water made his condition worse.

Top 8 Methylphenidate-Based Medications for ADHD

Let’s explore the top 8 methylphenidate-based medications you can use to manage ADHD. Each option has unique features to help control your symptoms effectively.

Source: Mediglow

Concerta is a prescription medicine designed to manage ADHD in children aged 6 and older, teenagers, and adults up to 65 years old. It belongs to the central nervous system stimulant class of drugs.

This medication works by affecting chemicals in your brain that control hyperactivity and impulsive behaviors. Concerta is an extended-release tablet, which means it releases its effects gradually throughout the day. You usually take it once daily, providing steady symptom relief.

Pros

• Concerta is effective for treating ADHD in different age groups.
• It provides extended-release, offering all-day symptom management.
• You can take Concerta with or without food.
• Taking it once a day causes minimal disruption to your daily routine.
• Concerta has FDA-approved doses for children as young as 6 years old.

Cons

• Concerta has a high potential for abuse and dependency.
• It can cause serious side effects like heart problems or psychosis.
• Concerta is not suitable for people with conditions like glaucoma, Tourette’s syndrome, or severe anxiety.
• There is a risk of dangerous interactions with MAO inhibitors and other medications.
• Children taking Concerta need frequent monitoring for growth.

Source: Mediglow

Concerta is a prescription medicine designed to manage ADHD in children aged 6 and older, teenagers, and adults up to 65 years old. It belongs to the central nervous system stimulant class of drugs.

This medication works by affecting chemicals in your brain that control hyperactivity and impulsive behaviors. Concerta is an extended-release tablet, which means it releases its effects gradually throughout the day. You usually take it once daily, providing steady symptom relief.

Pros

• Concerta is effective for treating ADHD in different age groups.
• It provides extended-release, offering all-day symptom management.
• You can take Concerta with or without food.
• Taking it once a day causes minimal disruption to your daily routine.
• Concerta has FDA-approved doses for children as young as 6 years old.

Cons

• Concerta has a high potential for abuse and dependency.
• It can cause serious side effects like heart problems or psychosis.
• Concerta is not suitable for people with conditions like glaucoma, Tourette’s syndrome, or severe anxiety.
• There is a risk of dangerous interactions with MAO inhibitors and other medications.
• Children taking Concerta need frequent monitoring for growth.

Source: GoodRx

Daytrana is a prescription patch that contains methylphenidate, a central nervous system stimulant. You apply the patch to your hip, and it slowly releases the medicine throughout the day. This patch is made to treat ADHD in children and teenagers aged 6 to 17.

The patch helps you focus better, reduces hyperactivity, and manages impulsive behaviors. It is part of a complete treatment plan that might include counseling or other therapies. Daytrana offers an alternative to pills, making it easier for those who prefer not to take medicine by mouth.

Pros

• Daytrana comes in a convenient patch form that controls the daily release of medication.
• The patch helps improve focus and reduce hyperactivity.
• You can easily adjust the dosage by changing how long you wear the patch.
• Daytrana is suitable for children aged 6 and older.
• It is part of a comprehensive ADHD treatment plan, which can include counseling.

Cons

• Daytrana may cause skin irritation or permanent discoloration where the patch is applied.
• It can lead to dependence or addiction if it is misused.
• Daytrana is not safe for people with severe anxiety, glaucoma, or tics.
• You need to handle the patch carefully to prevent accidental exposure.
• There is a potential for serious side effects like heart issues or psychosis.

Source: DailyMed

Metadate CD is a prescription medicine used to treat ADHD, ADD, and narcolepsy. It is a central nervous system stimulant. This medication helps manage hyperactivity and control impulses by affecting certain chemicals in your brain.

Metadate CD comes in capsule form, giving you flexibility in how you take it. You can swallow the capsules whole or sprinkle them on soft foods, making it easier for some people to take. The medication is designed to be taken once a day, providing steady control of your symptoms throughout the day.

Pros

• Metadate CD helps you improve focus and reduce hyperactivity.
• It effectively manages ADHD, ADD, and narcolepsy symptoms.
• The once-daily dose keeps your symptoms under control all day.
• You can swallow the capsules whole or sprinkle them on food, making it convenient.
• Metadate CD also comes in chewable and liquid forms for easier use.

Cons

• Metadate CD can be habit-forming and may lead to misuse or addiction.
• It can cause serious side effects like heart problems or psychosis.
• The medication is not safe for people with glaucoma, severe anxiety, or Tourette’s syndrome.
• Metadate CD may cause circulation issues in your fingers or toes.
• It is dangerous to take Metadate CD with MAO inhibitors within 14 days.
• Children taking Metadate CD need close monitoring for growth effects.

Source: GoodRX

Quillivant XR is a liquid medicine used to treat ADHD. It is a central nervous system stimulant. This medication helps you focus better and reduces impulsive and hyperactive behavior. Quillivant XR releases its effects slowly throughout the day. Doctors usually prescribe it for children aged six and older. It is not approved for younger kids.

Pros

• Quillivant XR helps improve attention and reduces hyperactivity.
• It provides extended-release, offering all-day symptom control.
• The easy-to-use liquid form is ideal for those who can’t swallow pills.
• You can take Quillivant XR with or without food.
• The dosage can be easily adjusted based on your needs.

Cons

• Quillivant XR can cause serious side effects like heart problems or psychosis.
• It is not safe for people with glaucoma, severe anxiety, or Tourette’s syndrome.
• Quillivant XR may cause circulation issues in your fingers or toes.
• It can have dangerous interactions with MAO inhibitors if used within 14 days.

Source: Pharmaceutical

Aptensio XR is a liquid medicine used to treat ADHD in people aged six and older. It is a central nervous system stimulant. This medication helps you focus better, reduce impulsive actions, and manage hyperactivity by releasing its active ingredient slowly throughout the day. Doctors might also prescribe Aptensio XR for narcolepsy. It offers flexible dosing options to fit individual needs.

Pros

• Aptensio XR provides long-lasting symptom control with just one dose each day.
• It improves attention, reduces impulsivity, and helps manage hyperactivity.
• If you have trouble swallowing capsules, Aptensio XR can be mixed with soft foods.
• You can take Aptensio XR with or without food, making it convenient.
• This medication is suitable for children aged six and older.

Cons

• Aptensio XR can be habit-forming and has a risk of misuse or addiction.
• It may cause serious side effects, including heart problems and psychosis.
• The medication might lead to circulation issues in your fingers or toes.
• Aptensio XR is not recommended for people with glaucoma, severe anxiety, or Tourette’s syndrome.
• It is unsafe to use Aptensio XR with MAO inhibitors taken within the last 14 days.
• Children taking Aptensio XR need their growth monitored closely.

Source: Drugs.com

Jornay PM is a capsule used to treat ADHD in people aged six and older. It contains methylphenidate hydrochloride, a central nervous system stimulant. This medication helps you regulate attention, behavior, and impulsivity.

You take Jornay PM in the evening. It has a special two-layer release system that makes the medicine work when you wake up. This provides steady symptom control all day long.

Pros

• Jornay PM is designed for once-daily use in the evening to cover your entire day.
• It improves focus, reduces hyperactivity, and decreases impulsivity.
• The capsule is easy to take and can be sprinkled on applesauce.
• Jornay PM helps regulate dopamine and noradrenaline levels to manage ADHD symptoms.
• It is suitable for children aged six and older.

Cons

• Jornay PM can be habit-forming and may lead to misuse or addiction.
• It can cause serious side effects like heart problems or psychiatric symptoms.
• The medication may lead to circulation issues in your fingers or toes.
• Children taking Jornay PM need their growth closely monitored.
• It is unsafe to use Jornay PM with MAO inhibitors taken within the last 14 days.

Source: Cotempla

Cotempla XR-ODT is a tablet used to treat ADHD in children aged 6 to 17. This medicine helps increase attention and reduce hyperactivity and impulsiveness. The tablet dissolves in your mouth without needing water, making it easy to use when you’re on the go.

Pros

• Cotempla XR-ODT helps improve focus, reduce impulsivity, and manage hyperactivity.
• The tablet dissolves in your mouth and doesn’t require water, making it very convenient.
• It is grape-flavored, which makes it easier for children to take.
• Cotempla XR-ODT works quickly and provides symptom control throughout the day.
• This medication is suitable for children aged 6 to 17.

Cons

• Cotempla XR-ODT can cause serious side effects, including heart and psychiatric issues.
• There is a risk of abuse or dependence because it is habit-forming.
• It may lead to circulation problems in your fingers or toes.
• Children taking Cotempla XR-ODT need their growth monitored closely.
• It is unsafe to use Cotempla XR-ODT with MAO inhibitors taken within the last 14 days.

Wrap Up

Methylphenidate is a widely used medication for ADHD. It helps improve focus and impulse control by increasing brain chemicals like dopamine and norepinephrine. The FDA approves it for children six and older.

You’ll find it in different forms, such as immediate-release tablets, extended-release capsules, and even a skin patch. It works well for most people, with benefits lasting up to two years. However, it can cause side effects like appetite loss, sleep problems, and, in rare cases, heart issues.

Choosing the right option depends on your needs, and there are several medications available to help manage symptoms effectively. Always consult your doctor for personalized advice.

FAQs on Methylphenidate ADHD Medication

How should Methylphenidate be taken for optimal effectiveness?

Methylphenidate should be taken as prescribed, typically starting at 5-10 mg twice daily, with weekly dose adjustments by your doctor to find the most effective amount.

Can Methylphenidate cause dependency or be misused?

Yes, methylphenidate can cause dependency and be misused. It is classified as a Schedule II substance by the DEA due to its high potential for abuse and dependence.

What should be done if a dose of Methylphenidate is missed?

If a dose of Methylphenidate is missed, continue with the next scheduled dose as usual; missing a single dose may slow performance but does not affect memory consolidation or retention.

Can Methylphenidate be taken alongside other medications?

Methylphenidate can interact with vasopressors, blood thinners, antipsychotics, anti-seizure medications, and certain antidepressants (SSRIs or tricyclics). Consult your doctor before combining it with these medications.