Methylphenidate
Concerta · Methylin
CNS Stimulant (Methylphenidate-based)Schedule IIGeneric availableTDM data
Methylphenidate is a CNS stimulant. Its mode of therapeutic action in ADHD is not known.
Compare Methylphenidate →FDA-Approved Indications
- ADHD (adults; pediatric 6+)
- Narcolepsy (adults; IR/ER formulations)
Common Off-Label Uses
- Narcolepsy
- Treatment-resistant depression (augmentation)
- Apathy in dementia
- Cancer-related fatigue
What Sets This Drug Apart
- DAT/NET reuptake inhibitor (not a monoamine releaser like amphetamines) — different mechanism of action despite similar clinical effects
- Most formulation options of any stimulant: IR (4-6h), ER (8h), OROS Concerta (12h), transdermal patch, liquid — allows precise duration matching
- Non-CYP metabolism (carboxylesterase CES1A1) — minimal drug-drug interaction potential, advantage when polypharmacy is a concern
- Efficacy slightly lower than amphetamines in head-to-head NMA data (Cortese 2018), but better tolerability profile in children/adolescents
- FDA-approved for ADHD and narcolepsy; available in both d-threo (dexmethylphenidate) and racemic forms
Boxed Warning
ABUSE, MISUSE, AND ADDICTION