PHARMACOTHERAPY REVIEW CNS STIMULANTS for treatment of ...

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V. RECOMMENDATIONSAmong the rapid acting/short duration products, generic versions of a 4 drugamphetamine/dextroamphetamine mixture, dextroamphetamine and methylphenidateexist that provide a full spectrum of doses for once or twice daily administration. Nobrand name rapid acting/short duration CNS stimulants are recommended for preferreddrug status as they do not offer any significant or compelling clinical advantage relativeto safety and/or effectiveness over their multisource versions.Among the slower onset/long duration products, generic versions ofdextroamphetamine sulfate and methylphenidate exist that provide a full spectrum ofdoses for once a day administration. Pemoline (Cylert) is also available in three strengthsas a generic tablet formulation, but the use of this agent is strongly discouraged. Nobrand name slower onset/long duration CNS stimulants are recommended for preferreddrug status as they do not offer any significant or compelling clinical advantage relativeto safety and/or effectiveness over their multisource versions.The rapid onset/long duration products offer no appreciable safety or effectivenessadvantage over the rapid onset/short duration or slower onset/long duration productsand there are no generic alternatives to these brand name products. There is littleobjective clinical evidence relative to safety and/or efficacy to support the contention thattherapeutic adherence and clinical outcomes are significantly better with the use of therapid onset/long duration products v. slower onset/long duration or even rapidacting/short duration formulations. It is recommended that no brand name rapidonset/long duration products be recommended for preferred drug status.6
APPENDIX ADSM-IV-TR DIAGNOSTIC CRITERIA FORAttention-Deficit/Hyperactivity Disorder7
Page 1 and 2: PHARMACOTHERAPY REVIEWCNS STIMULANT
Page 3 and 4: D. CNS Stimulants Indicated to Trea
Page 5: Product Group Onset of Action (min)
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Page 39 and 40: the American Medical Association (J
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