Medical Health Encyclopedia

Other Central Nervous System Stimulants

Pemoline (Cylert). Pemoline is a central nervous stimulant prescribed for children who do not respond to other drugs. However, there have been 13 reports of liver failure or death in patients taking the drug. In October 2005, the FDA concluded that "the overall risk of liver toxicity from pemoline outweighs the benefits of this drug." The rate of reported liver failure in patients taking Cylert is 10 to 25 times greater than that of the general population. The FDA recommends that doctors switch patients to another drug. The drug was withdrawn in Canada in 1999.

Dextroamphetamine. Dextroamphetamine (Dexedrine) is similar to Ritalin. Although it is commonly believed that it is both less effective and less safe than Ritalin, there is no evidence of this, and one study reported a slightly better response with dextroamphetamine. Side effects are similar. The arguments against dextroamphetamine mainly rest on widespread abuse of this drug in earlier decades. Some experts believe it may be an useful alternative for people who do not respond to Ritalin.

Non-Stimulant: Atomoxetine

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Atomoxetine (Strattera) was the first non-stimulant approved for ADHD in children and the first treatment approved for adult ADHD. The drug works by increasing levels of both norepinephrine and dopamine, which are generally lower than normal in ADHD. The most common side effect is decreased appetite. A few cases of atomoxetine-associated liver injury have been reported, and the FDA has warned physicians that the drug should be discontinued at the first signs of jaundice or liver problems. Long-term effects, such as any impact on growth, are still unknown. In 2005, the FDA warned that atomoxetine may cause suicidal thinking in children and adolescents, especially during the first few months of treatment. Parents should monitor children taking atomoxetine for any changes in mood or behavior, and immediately contact their doctor if changes occur.