Methylphenidate
Stimulant — ADHD
Indications
ADHD (children ≥6 yrs and adults)
Adult dose
IR: start 5 mg BD–TDS; titrate weekly to usual 20–60 mg/day. MR (e.g. Concerta XL): 18 mg OD, titrate to 36–72 mg.
Paediatric dose
Children ≥6 yrs: start 5 mg OD–BD, titrate weekly. Max 60 mg/day (or up to 90 mg unlicensed under specialist).
Common side effects
Reduced appetiteInsomniaHeadacheTachycardiaMild BP riseAnxiety
Serious side effects
Cardiovascular events (sudden cardiac death — screen)Psychotic symptomsTics worseningGrowth retardation in childrenSeizures (lower threshold)Priapism
Contraindications
Severe CV diseasePhaeochromocytomaHyperthyroidismGlaucomaConcurrent MAOI
Monitoring
- Baseline & 6-monthly: HR, BP, weight, height (children), psychiatric symptoms
- Cardiac history & exam; ECG if risk factors
Notable interactions
- MAOIs
- Antihypertensives (effect reduced)
- TCAs (raised levels)
- Anaesthetics — stop on day of surgery
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.