Methylphenidate is a classic treatment for ADHD in children. Its immediate-release (IR) form lasts between 2 and 4 hours, whereas long-acting, or extended-release (XR), lasts about 8 hours. On its own, immediate-release methylphenidate can be used as a bridge to help children with evening symptoms and homework completion, but this needs to be taken every 4 hours, thus resulting in multiple daily doses.
Systematic literature reviews found IR stimulants to be more widely misused or diverted than XR stimulants, which could be a factor in selecting long-acting treatments that do not need supplementation.
For which patients would it be appropriate to use IR formulations?
What are the key attributes (or benefits) of IR and XR formulations that you consider for individual patients?