Brief Answer:
Methylin is a good choice...

Detailed Answer:
Hello and thanks for writing in.

I understand that you are concerned about your grandaughter's treatment plan with Methylin. Methylin is Methylphenidate and is a stimulant medication, commonly used in the treatment of ADHD. It is available as a 2 preparations - an immediate release (plain) preparation and an extended-release (ER) preparation. The ER preparation is most commonly used since it has a longer duration of action and can be given once a day.

Now, regarding your question about the time of efficacy, Methylin ER has a average peak action at around 4 hours after taking the tablet. The duration of action lasts for about 8 hours. After 8 hours, the action does wear off gradually.

Now this doesn't necessarily mean that the medication becomes ineffective after 8 hours. It just means that the effects become progressively less significant. In my clinical experience, I have seen that many patients manage well with just a once a day dosing. It helps them stay focussed and attentive during the crucial time period of 9am to 5pm. The effects wearing off after 5 pm may not matter much as in most cases the person has finished the demanding activities (school or college or work). However, rarely, some patients may require a 2nd dose in the late afternoon, if their work demands extend late evening.

Vyvanse (Lisdexamfetamine) has a sightly longer duration of action than Methylin and there may be a slight advantage that the peaks and lows are less prominent. But clinically, there is no major or significant difference and the side effect profile and the potential for abuse may be slightly higher with Vyvanse.

So, in my opinion, Mehylin ER is a good choice and since your doctor has prescribed it, you can go ahead and give it a try. You may have to wait for at least a few weeks for the dose adjustments to be made and for the system to get adjusted to the new medication.


Regards,
Dr. Jonas Sundarakumar MBBS., DPM., MRCPsych.(U.K.)
Consultant Psychiatrist

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