Ritalin and Concert – the most popular drugs in Israel for the treatment of hyperactivity. But to some they do not help or cause side effects. Is there an alternative?

“Ritalin” and its analogue of “Concert” have become the most popular drugs for hyperactivity syndrome and attention disorders. However, about a quarter of patients they do not help, and sometimes side effects, especially in children, forced to stop taking. Common side effects include headache, nervousness, loss of appetite, nervous tics and weight loss.

But there are other means that a neurologist or a psychiatrist can prescribe if Ritalin does not give the desired effect.

Adderal, Attent

Adderall is a stimulant that is popular in the US for the treatment of attention deficit groups. In Israel, it is sold under the name Attent. Similar to Ritalin, this amphetamine increases the production of dopamine in the brain, which improves attention and concentration.

There are fast-acting and prolonged versions of the drug: the usual Adderall lasts 6 hours, and the Adderall XR lasts 12 hours.

Unlike Ritalin, this remedy has fewer side effects, in particular, because of its lower dosage. They appear less frequently and less pronounced. The dosage is selected individually, in most cases – 40 mg, similarly to Ritalin, but in the United States used in higher doses.

Attent with a 6-hour action is included in the state health basket, and it is prescribed to children with the ineffectiveness of Ritalin and concerts.

The long-acting drug XR is not included in the health basket.

Dexedrine

It includes, like Adderall, dexamphetamine, and does not have any particular advantages compared with the mentioned medicine.

Vyvanse

Contains amphetamine derivatives. It is activated after cleavage in the blood, therefore it is not suitable for drug addicts.

Since absorption is gradual, its concentration in the blood does not increase abruptly. This helps avoid side effects caused by the rapid increase in concentration. If the child cannot swallow the capsule, it can be opened and the contents dissolved in water.

Due to the slow increase of the effect, the effect of the drug is more delicate, and side effects are less common.

Focalin

It is an isomer of the active ingredient Ritalin, but with a different structure of the molecule. Changing the structure allows you to reduce the dose compared to Ritalin 2 times. As a result, side effects are less pronounced.

The usual form of the drug is 4 hours, the form of XR, like Ritalin LA with a slow release of the active principle – 12 hours.

Daytrana

Stickers with methylphenidate (active ingredient Ritalin). The substance is absorbed directly into the blood and does not decompose by the liver, as when taking pills. (The decomposition products themselves cause side effects, and this process also causes an increase in the dose.)

The label allows you to enter into the patient’s smaller doses. The skin accumulates the substance and slowly releases it into the blood, so the concentration in the blood increases slowly, which prevents side effects.

The sticker can be removed at any time, thereby adjusting the duration of the action. This is important, for example, for eating, because Ritalin suppresses appetite.

The label is designed for up to 12 hours, causing a small number of side effects. The label is attached for 9 hours, after removal, the action is maintained for 2-3 hours.

Atomoxetine

Sold under the brand Strattera. It relates to norepinephrine reuptake inhibitors, that is, to a class of drugs other than Ritalin.

Medicines of this class are also used as an antidepressant. They need to be taken daily, but the effect, like that of antidepressants, appears only after 3 weeks.

Benefits of medicine: does not suppress appetite, can be taken at any time of the day, does not cause, like Ritalin and concert, nervous tics, on the contrary, helps get rid of existing ones.

But there are some downsides: the medicine is effective only in 60% of the recipients, it is necessary to take it constantly, including weekends and holidays, and it affects the behavior more than the concentration.

Guanfacine

Originally intended for the treatment of hypertension and for this purpose is sold in the United States under the brand name Tenex and other generic brands. Based on this drug, Intunice was created to treat ADHD.

A direct effect on the syndrome is insignificant, but the remedy eliminates tics, reduces impulsive behavior and improves sleep. Therefore, doctors often prescribe the drug in parallel with stimulants.

How to choose the right drug?

Drug selection is not easy, there are 11 dosages of methylphenidate alone, and other drugs have their own dosage options.

Selection of the type of medication and dose takes a long time and is accompanied by communication between the doctor and the patient. A common patient error is stopping treatment if the first drug prescribed does not help. Sometimes the result is achieved by changing the dose, it also affects the side effects. The physician should explain this to the patient and set it up for a long process of fitting the drug to the body.

In Israel, they usually begin treatment with Ritalin at a dose of 10 mg. These pills are easily cut and patients can take by quarters. Then go to long-acting Ritalin LA or a concert depending on the desired duration of the effect.

If the medicine does not help or causes severe side effects, the doctor selects another, also from the group of stimulants. Each drug has its own characteristics, and the patient may not give the desired response to the classic options – Ritalin or a concert. In most cases, then switch to Focalin, Vyvanse or Attent.