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3.2 Attention deficit hyperactivity disorder

CNS stimulants and drugs used for ADHD

NICE NG87 Attention deficit hyperactivity disorder: diagnosis and management.

Shared care protocol for prescribing and monitoring of treatment for ADHD in children, young people and adults

Not all medications used for ADHD have a UK marketing authorisation for treating symptoms of ADHD in adults. Check individual SPC for details.

 

CNS stimulants and drugs used for ADHD Preparations Comments
Atomoxetine hydrochloride

10mg,18mg, 25mg, 40mg, 60mg, 80mg, 100mg capsules

4mg/ml oral solution

 

For specialist initiation. Consider shared care after 12 weeks or once patient is stable (whichever is longer). 

Dexamfetamine sulphate

5mg, 10mg and 20mg tablets

1mg/ml oral solution sugar-free

For specialist initiation. Controlled Drug (CD)
Consider shared care after 12 weeks or once patient is stable (whichever is longer).
Guanfacine hydrochloride 1mg, 2mg, 3mg, 4mg MR tablets  Not approved for adults. For specialist initiation. Consider shared care (for children and adolescents) after 12 weeks or once patient is stable (whichever is longer) .
Lisdexamfetamine 20mg, 30mg, 40mg, 50mg, 60mg, 70mg capsules For specialist initiation. Controlled Drug (CD).                    Consider shared care after 12 weeks or once patient is stable (whichever is longer).
Methylphenidate hydrochloride

Immediate release
5mg, 10mg, 20mg tablets

Modified release 
Delmosart® XL, Xaggitin XL,      Affenid XL,        Xenidate XL:        18mg, 27mg and 36mg MR tablets 

Matoride XL:        18mg, 36mg, 54mg MR tablets

Equasym XL®:    10mg, 20mg and 30mg MR capsules 

Medikinet XL®:      5mg, 10mg, 20mg, 30mg, 40mg, 50mg and 60mg MR capsules 

Metyrol XL®,      Meflynate XL®:      10mg, 20mg, 30mg, 40mg, 60mg MR capsules        

For specialist initiation. Controlled Drug (CD). 
Consider shared care after 12 weeks or once patient is stable (whichever is longer). 
Different versions of modified release preparations may not have the same clinical effect. To avoid confusion between these different formulations prescribe by brand name and one with the lowest cost where possible.
  % dose immediate release % dose modified release

Affenid® XL

Matoride® XL

Xenidate® XL

22 78

Delmosart® XL

Xaggitin® XL

25 75
Equasym XL® 30 70
Medikinet XL® 50 50

Metyrol XL®

Meflynate XL®

50 50

 

 Alpha2-adrenergic agonist  Preparations Comments
Clonidine 25 microgram tablets

Off label use in children with ADHD and sleep disturbance, rages or tics on the advice of tertiary ADHD service (NICE CG87)

 

Continue to 3.3 Bipolar disorder and mania

 

Back to BNF Chapter 4

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