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ADHD study finds dose most important for Adderall XR and Focalin XR

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The Adderall/Focalin question has long faced newly diagnosed ADHD (attention deficit hyperactivity disorder) patients and their parents. So can science, with the precision of its methods and the weight of its authority, decide the matter?

A new study of  Focalin XR (dexmethylphenidate) and Adderall XR (mixed amphetamine salts) in which participants spent time on both drugs allowed researchers to directly compare the drugs' benefits and side effects. The study has found that dose matters more than which drug is used.

"Implement lifestyle change alongside medication."

Mark Stein, PhD, ABPP, directs the Child and Adult ADHD Clinics and ADHD Clinical Research at the University of Illinois. Stein and his team sought to compare the effects of Focalin XR and Adderall XR at different doses in this eight-week study involving 56 children and adolescents with ADHD.

The study was a crossover study, meaning that each participant spent four weeks using each medication. The study was double-blind, meaning, in this case, that participants spent a randomized week on a placebo during each testing phase. Participants took the medications at doses of 10, 20,  or 25–30 mg per day.

Ongoing impairment and the effectiveness of the medication were measured using three scales Involving input from parents, teachers, and clinicians.

The common stimulant-related side effects of insomnia and decreased appetite were measured with the parent-completed Stimulant Side-Effects Rating Scale.

The study found:

  • Both Focalin XR and Adderall XR caused significant overall reductions in ADHD symptoms.
  • Also, there was a strong correlation between increasing the dose and an improvement in hyperactivity and impulsivity symptoms.
  • By contrast, relief of inattentive symptoms did not strongly correlate with an increased dose.
  • About 80 percent of participants enjoyed a significant symptom response to Focalin XR, about 79 percent responded in a significant way to Adderall XR, as measured by the ADHD Rating Scale-IV (the parent/teacher-completed scale).
  • On average, an increase in dose of both drugs led to increases in insomnia and decreased appetite side effects.
  • About 43 percent of participants responded only to one of the drugs, whereas the rest responded to both.

The general conclusion of the study is that dose matters more for children and adolescents than which drug is used. Individuals' particular responses to each drug may vary slightly, but in most cases, patients and their parents should focus their energy on finding the right dose rather than on deciding between Focalin XR and Adderall XR.

This study was published in the Journal of Child and Adolescent Psychopharmacology on December 2, 2011.

Reviewed by: 
Review Date: 
December 19, 2011
Last Updated:
October 2, 2012