Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

Suggest trial methylphenidate may convert to dextroamphetamine later depending on response ,also consider long acting am immediate in afternoon or meds like clonidine on guanfacine etc fir resistant cases

I use IR for smaller kids, when I just start medication for elementary kids. I like to use XR is patient has acceptable side effects with IR but IR wearing off before the school ends.

In most cases Children where the complications would be much lesser on an average scale. And in case of older children early to late evening would be most appropriate.

I never ever use Q 4 hour am meds.
It means having school nurses give the meds.
They’ve too much to do already and the inconsistency of levels is havoc on the kids.
Only use q4 in early pm for homework or disruptive beh at home.
Unfortunately it also negatively impacts sleep in a lot of kids necessitating some sleep meds like melatonin or clonedine

I use IR for children who can not focus in school and XR for ones who difficulty in home work

I find the IR gives more focused results and patients like how they feel and how they process. They are much more focused. Although giving the medication more frequently is not as convenient, the results are more rewarding.

I try to use XR products to avoid the potential for abuse. If patients get accustomed to IR they often do not want to use the XR any longer. I have avoided using XR and IR together by finding the right dose of XR that lasts long enough to cover the evening hours. There are plenty of choices of products today that will last the required period of time needed.

I give Xr treatment to last during school hours
Occasionally I give IR treatment if need attention or special program after 3 Pm so Ir RX helps the next few hour of attention

I begin with IR as in case there is a side effects or tolerability issue ,, parents don’t have to deal for longer period ,
Once tolerantly established as well as duration in an individual child I then switch to XR if needed
IR will be good to find out optimal dose also

Primarily I use IR meds for after school activities.& homework - pts XR has worn off but they need a few more hours of coverage.
Some patients have found them also to be helpful for the following:

1. IR dose in AM, eat a good lunch, then IR dose in afternoon- decreases weight loss because the AM dose is worn off an they eat!
2. For homework on weekends when they only need a few hours of focus and not the whole day.
3. Some of my college students have both IR and XR forms and vary them depending on their class schedule on a given day.
4. Several of my patients take an IR dose first thing in the AM because they are so distracted with morning routine, then an XR a few hours later to last through school day.
5. Occasionally used when someone is very happy with their XR dose but it ends a little too abruptly- the IR smoothies it out a little

I like long term meds they are harder to abuse

I try to use XR formulations when possible and I use IR for prn or afternoon issues

XR is so much easier to manage and tolerate. No roller coaster effects. I do have a very few high functioning adults (an attorney for one) who know when the XR will wear off and on rare occassions need something for several hours more. There IR rx lasts for months.

Extended release ensure better outcomes and compliance
It is rare that IR are beneficial in most children

Yes compliance is difficult in immediate release compared to extended release. I prefer concerta.,

In addition to using both formulations I like the concept of alternate day dosing and employing bupropion SR

I start elementary aged children on IR and then advance to XR after they have been taking it for a while. I use IR in the afternoon and evening as a prn for kids of all ages. IR seems to work better on kids of all ages who have significant emotional outbursts from the wearing off the XR formulation.

I begin with IR to assess effectiveness and tolerability. If financially feasible, will then switch to XR.

I start with IR drug-if there is a side effect, rather it happens with IR. Switch to XR once dose established

I use primarily te Xr. I only us IR if the paiient is having trouble focusing or trouble with behavior in the afternoon.

It can be nice to have IR if treatment naive and some only respond to IR. It's rare but happens.

Time release is clearly superior in efficacy and avoids roller coaster blood levels with IR

I avoid IR as much as possible due to abuse potential and diversion

I use IR for childrn.

i use IR formulation in patients that typically only need it for short period 4 hours. or later in day if XR version wears off

Typically us IR in younger children who don’t need 8 hour coverage and in older children for afternoon or early evening coverage after school sports