Tag Archives: amphetamine

Quick Hits: FDA Approves New Antibiotic, ADHD Med, and Opioid Use in Depressed Patients

The FDA has approved Baxdela (delafloxacin), a fluoroquinolone antibiotic that is used to treat acute bacterial skin and skin structure infections (ABSSSI). The drug is available as a tablet or intravenous injection. Labeling for the drug includes a “black box” warning due to serious adverse and potentially irreversible reactions that have been associated with fluoroquinolones, such as tendinitis and tendon rupture, peripheral neuropathy and central nervous system effects. In trials, the most common adverse reactions in patients observed were nausea, diarrhea, headache, elevations of the enzyme transaminase, which can indicate liver damage, and vomiting. Posted June 19, 2017. Via Melinta Therapeutics.

A new once-daily treatment for attention deficit/hyperactivity disorder (ADHD) has won FDA approval. Mydayis, a stimulant for patients 13 years and older, contains the same active ingredients as Adderall (amphetamine/dextroamphetamine), but lasts for up to 16 hours compared to up to 6 for Adderall and 12 for Adderall XR. Adderall and Adderall XR are both available as a generic. Like other stimulant medications, such as methylphenidate (Ritalin, Concerta, Daytrana), Mydayis has a “black box” warning because it has a high chance for abuse and can cause physical and psychological dependence. Posted June 20, 2017. Via Shire.

Patients with low back pain who also suffer from depression are more likely to be given opioids that are prescribed at higher doses. This is problematic, since patients with depression are at a higher risk of misuse and overdose of opioids. Researchers examined data on opioid prescriptions from 2004-2009 and found that those with low back pain who also had depression were twice as likely to be prescribed an opioid than those without depression. And over a year, they typically got more than twice the usual dose, according to the study published in the journal Pain Reports. The authors noted more study is needed to determine the risks and benefits of prescribing such powerful painkillers to those who are depressed. Posted June 20, 2017. Via University of Rochester Medical Center.

80% of Kids Undergoing ADHD Treatment Receive Stimulant Meds

An increasing number of children are visiting their doctor for treatment of attention deficit/hyperactivity disorder (ADHD), and along with it, the number of prescriptions for drugs, particularly stimulants, used to treat the condition.

New data from the Centers for Disease Control and Prevention found that in 2013, an average of 6.1 million visits to a physician, pediatrician or psychiatrist by children between the ages of 4 and 13 were for diagnosed ADHD. That accounts for 6% of all doctor visits by that population. In 2003, that figure was 4%.

Whether more kids actually have ADHD or are being misdiagnosed with the disease is up for debate.

The CDC data brief also found that 8 out of 10 ADHD doctor visits for those aged between 4 and 12 resulted in a prescription for a stimulant drug, such as Adderall (amphetamine/dextroamphetamine), Ritalin (methylphenidate) and Focalin (dextroamphetamine). A similar rate was found for ADHD visits for those aged between 13 and 17.

The new research also showed that boys were twice as likely to visit a doctor for ADHD as girls. The figure for boys is 147 visits per 1,000 compared with 62 per 1,000 for girls.

Drug Classifications, Schedule I, II, III, IV, V

The FDA has been overseeing drugs in the US since the beginning of the 20th century. In 1970 the FDA released the following drug classifications, or drug schedules, under the Controlled Substance Act (CSA). The drug classificaton schedules organize drugs into groups based on risk of abuse or harm. Those drugs with high risk and no counterbalancing benefit are banned from medical practice and are Schedule I drugs.

From the Drug Enforcement Administration Office of Diversion Control:

Definition of Controlled Substance Schedules

Drugs and other substances that are considered controlled substances under the Controlled Substances Act (CSA) are divided into five schedules.  An updated and complete list of the schedules is published annually in Title 21 Code of Federal Regulations (C.F.R.) §§ 1308.11 through 1308.15.  Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood of causing dependence when abused.  Some examples of the drugs in each schedule are listed below.

Schedule I Controlled Substances

Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.

Some examples of substances listed in Schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4-methylenedioxymethamphetamine (“Ecstasy”).

Schedule II/IIN Controlled Substances (2/2N)

Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.

Examples of Schedule II narcotics include: hydromorphone (Dilaudid), methadone (Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet), and fentanyl (Sublimaze, Duragesic).  Other Schedule II narcotics include: morphine, opium, and codeine.

Examples of Schedule IIN stimulants include: amphetamine (Dexedrine, Adderall), methamphetamine (Desoxyn), and methylphenidate (Ritalin).

Other Schedule II substances include: amobarbital, glutethimide, and pentobarbital.

Schedule III/IIIN Controlled Substances (3/3N)

Substances in this schedule have a potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.

Examples of Schedule III narcotics include: combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin), products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine), and buprenorphine (Suboxone).

Examples of Schedule IIIN non-narcotics include: benzphetamine (Didrex), phendimetrazine, ketamine, and anabolic steroids such as Depo-Testosterone.

Schedule IV Controlled Substances

Substances in this schedule have a low potential for abuse relative to substances in Schedule III.

Examples of Schedule IV substances include: alprazolam (Xanax), carisoprodol (Soma), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), and triazolam (Halcion).

Schedule V Controlled Substances

Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.

Examples of Schedule V substances include: cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC, Phenergan with Codeine), and ezogabine.

 

Drugs Commonly Prescribed for ADHD Management

Many drugs are used to manage the symptoms of ADHD. Often the health care provider will change the dosage or the drug based on the patient’s response. For clarity, we have listed the common drugs by category of drug, generic name, brand name(s).

Psychostimulants (category of drug) 

The generic name is listed first, with brand names following.

Methylphenidate (generic name) – Brand names: Ritalin, Methylin, Metadate, Concerta

Dextroamphetamine and Amphetamine – Brand names: Adderall

Dexmethylphenidate – Brand names: Focalin
Dextroamphetamine – Brand names: Dexedrine, DextroStatt, LiquADD, ProCentra 
Lisdexamfetamine – Brand names: Vyvanse
Methylphenidate Transdermal – Brand names: Methylphenidylacetate hydrochloride, Daytrana

Nonstimulants (category of drug) 

Atomoxetine
Brand names: Strattera
Antidepressants (category of drug) 
Amitriptyline – Brand names: Elavil, Endep, Vanatrip
Desipramine -Brand names: Norpramin, Pertofrane
Notriptyline – Brand names: Aventyl, Pamelor
Imipramine – Brand name: Tofranil
Bupropion – Brand names:

Other

Clonidine – Brand names: Catapres, Kapvay, Nexiclon Duraclon
Guanfacine – Brand name: Intuniv
Bupropion – Wellbutrin, Zyban
                                                                                                    Suzanne B. Robotti