Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Dexmethylphenidate(click to collapse)
1/4 selected
Dexmethylphenidate
Focalin
CNS Stimulant (Methylphenidate-based) · C-II
FDA-approved indications
- ADHD (adults; pediatric 6+)
Off-label uses
- Narcolepsy
Half-life2 to 4.5 hours
Decision GuideWhen to pick each / when to consider an alternative
Dexmethylphenidate
Consider when
- Methylphenidate non-response at lower doses — pure d-threo isomer is pharmacologically active form; 2× potency allows half the dose of racemic MPH
- Focalin XR for extended coverage — ER formulation with bimodal release; provides 10–12 hour coverage at half the racemic dose
- Reducing l-threo methylphenidate side effects — theoretically fewer peripheral NE-mediated cardiovascular effects from eliminating inactive l-isomer
Consider an alternative when
- Cost advantage of racemic methylphenidate — generic MPH ER is typically cheaper; clinical superiority of d-MPH over racemic MPH is not established
- Maximum amphetamine-class efficacy needed — effect sizes for amphetamines exceed methylphenidate class in adults (Lancet 2018)
- Cardiovascular disease — same class warnings as all stimulants; Schedule II controlled substance
- Active substance use disorder — same abuse potential as racemic methylphenidate; non-stimulants may be preferred
- +1 more
| Axis | Dexmethylphenidate stimulant |
|---|---|
| Boxed Warnings | |
Mania / hypomania induction | |
Abuse / addiction liability | |
| CNS | |
Activation / insomnia | |
Seizure risk | |
Tics / Tourette's exacerbation | |
| Metabolic | |
Appetite suppression / anorexia | |
| Pediatric | |
Growth suppression (pediatric) | |
| Autonomic | |
Sweating | |
| Cardiac | |
Serious CV / sudden death (ADHD labeled axis) | |
Blood pressure elevation | |
Heart rate / tachycardia | |
| Vascular | |
Peripheral vasculopathy / Raynaud's | |
| GI | |
Nausea / GI (general) | |
| GU | |
Priapism | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
MAOI co-administration contraindication | |
CYP interactions / DDI profile | |
| Safety | |
Overdose toxicity | |
| Pregnancy | |
Lactation / breastfeeding safety | |