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What is DAYTRANA ?

Is it a Good Choice for You ?

Last summer Shire Pharmaceuticals came out with their new version of
methylphenidate, called DAYTRANA. It is the first and only transdermal medication
approved to treat the symptoms of Attention Deficit
Hyperactivity Disorder (ADHD).

DAYTRANA is methylphenidate (generic name for Ritalin)

in a patch, which makes it a very convenient delivery
system (one a day dosing).

The response from parents has been mixed.

Parents, and patients, like the convenience of a patch. And

they also like the fact that children don’t have to swallow a

But the patch can cause side-effects. Skin rashes, sleeplessness, stomach aches
and motion sickness are commonly cited. Some parents also complain that they
have to fight with their kids to put the patches on, and that it leaves a “goo” after
taken off.

You can learn more about DAYTRANA and see the product video at its website.

As always, parents should know that DAYTRANA is a Schedule II controlled

substance. It was generally well tolerated in clinical studies, but some subjects had
side effects. As with other products containing methylphenidate the common side
effects reported in children who received DAYTRANA were decreased appetite,
insomnia, nausea, vomiting, weight loss, tics, and affect lability (mood swings). It is
the same list of side effects one would see with Ritalin in any of its forms.
And Daytrana was given the dreaded BLACK BOX WARNING
LABEL from the FDA.

The manufacturer warns that Methylphenidate should never be taken by children

with significant anxiety, agitation, or extreme temper outbursts; glaucoma; tics or
Tourette's syndrome, or family history of Tourette's syndrome; or current/recent
use of MAO inhibitors (a type of antidepressant).

The manufacturer warns that abuse of methylphenidate may lead to dependence.

The manufacturer advises that you tell your healthcare professional if your child
has had problems with alcohol or drugs or has had depression, abnormal
thoughts/behaviors, visual disturbances, seizures, high blood pressure, or heart
conditions including structural abnormalities.

As always, tell your doctor immediately if any of these unlikely but serious side
effects occur: blurred vision, uncontrolled movements (twitching, shaking),
uncontrollable outbursts of words or sounds (e.g., Tourette's syndrome),
unexplained weight loss, mental/mood/behavior changes (e.g., agitation,
aggression, mood swings, depression, abnormal thoughts, hallucinations).

Often times people with a genetic Tourette’s Syndrome are initially diagnosed with
ADHD, as many of the symptoms are the same and often children will present at
the doctor’s office with impulsivity and school problems (looks like ADHD) but their
TS symptoms of tics, or twitches, or OCD haven’t shown up yet. Once the doctor
prescribes a stimulant, in just a short time the tics, twitches, or OCD of Tourette’s
will kick in.

Your doctor or pharmacist should already be aware of any possible drug

interactions and may be monitoring you for it. Do not start, stop or change the
dosage of any medicine before checking with them first.
Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid,
moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2
weeks before or after treatment with this medication. In some cases, a possibly
fatal drug interaction may occur. If you are currently using any of these
medications, tell your doctor or pharmacist before starting this medication. Or
better yet, just don’t use this medication.

Before using this medication, tell your doctor or pharmacist of all prescription and
nonprescription herbal products you may use, especially of: "blood thinners" (e.g.,
warfarin), clonidine, guanethidine, drugs that can increase blood pressure (e.g.,
epinephrine, phenylephrine), anti-seizure drugs (e.g., phenobarbital, phenytoin,
primidone), tricyclic antidepressants (e.g., imipramine, desipramine), SSRI
antidepressants (e.g., fluoxetine, sertraline), other stimulant medications (e.g.,

Also report the use of drugs which might increase seizure risk (decrease seizure
threshold) when combined with methylphenidate such as bupropion, isoniazid
(INH), phenothiazines (e.g., thioridazine), or theophylline, among others. Consult
your doctor or pharmacist for details.

Check the labels on all your medicines/herbal products (e.g., cough-and-cold

products, diet aids) because they may contain ingredients that could increase your
heart rate or blood pressure (e.g., pseudoephedrine, phenylephrine, ephedra/ma
huang). Ask your pharmacist about the safe use of these products.

Here are my thoughts about DAYTRANA

I am not opposed to Daytrana, or Ritalin, or Methylphenidate in any of its forms,

provided that the “alternative” options have been tried, and have failed. I’m
referring to diet interventions, Attend (amino acids, essential fatty acids, etc), and
perhaps EEG Biofeedback training.

There are risks to DAYTRANA.

Is methylphenidate over-prescribed? Is it over-used? Probably. But the reason why
Ritalin is used so much is that it works. Think about it. No one would use it if it
didn’t make a positive improvement in the life of their child.

But Ritalin, DAYTRANA, and all the other forms of methylphenidate (in fact, all the
other forms of prescription treatments for ADHD) come with the problem of
potential side effects. And some of these side effects are severe.

So, please try our recommended eating program plus the specific Attend
treatment strategies first. Consider EEG Biofeedback training if you can afford it.
Try these “alternatives” first if you can and see if they work. If they do not work for
you or your child, then by all means consider the use of prescription stimulants.

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• Sign up for our free weekly e-newsletter on ADHD with Douglas Cowan,
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• The Different Types of ADHD and specific targeted treatments for each

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This information is for educational purposes only. It is not intended to replace medical advice from your
physician or health care provider. Always consult your physician about ADHD.