Teenagers And Adults With ADHD Need Longer-Acting Medications: Concerta And Foquest Can Work Better Than Biphentin
Question: Our son was diagnosed with ADHD when he was in grade two. He couldn’t swallow pills at the time, so our doctor started him on Biphentin. It has worked well for all these years; his learning has improved, and he is one of the top students in his class. He is in grade 11 now. In the last few months, his medicine is not working any more. He is able to pay attention in morning classes, but not after lunch. When he has to do homework, he cannot focus for more than a few minutes. This makes him very frustrated; he wants to do well and go to university. He has tried drinking coffee, which helped a bit, but this affected his sleep. His doctor increased the dose of Biphentin, unfortunately that gave him headache. He wants to stop the Biphentin. We know that he still needs medicine, but we don’t know how to help him.
I am glad to hear that your son has done well until recently. High school is a challenging time, when he needs to focus attention for longer periods during school and doing assignments. Drinking coffee can help because it has caffeine, a natural stimulant. Unfortunately, it can affect sleep for some people.
Biphentin is an excellent medicine for Attention Deficit Hyperactivity Disorder (ADHD). It is made with methylphenidate or Ritalin, a stimulant medicine invented many decades ago. It comes as capsules with little beads inside, and can be mixed with food, ideal for children who can’t swallow. About 40 percent of Ritalin is fast-acting, absorbed within half to one hour. The remaining Ritalin is absorbed over the next few hours. Many parents find that Biphentin works for about 6 to eight hours. It is a good medicine for children; they can pay attention in school and doing their homework shortly after coming home.
However, high school and university students have more homework, and have to study until late in the evening. Many find that Biphentin doesn’t work long enough. If the dose is further increased, they can have side effects in the morning, including headache and being over-focused. Instead, a smaller dose of Biphentin can be added in early afternoon; this can extend the effectiveness of medicine into the evening, although it can affect sleep.
In addition, there are two other Ritalin-based medications that can work longer: Concerta and Foquest. Concerta has been around for over ten years. It comes as pills, with 22 percent of fast-acting Ritalin on the outside. The remaining medicine is absorbed over 8 to ten hours. Many parents find that Concerta is effective for around 10 hours, helpful for homework and study in evening.
Foquest is a new Ritalin-based medicine. Like Biphentin, it comes as capsules with beads inside. It is based on a new multi-layer technology: 20 percent of Ritalin is absorbed right away; the remaining medicine is absorbed gradually, layer by layer. It can be effective for 12 to 14 hours; this is ideal for high school and university students, as well as adults who need to keep focus much longer than children. Foquest was approved for adults last year. About two months ago, Health Canada has extended the approval to children 6 years and over.
Every person with ADHD is unique; each has different degree of difficulty focusing, or being impatient and frustrated, or disorganized, or hyperactive, or impulsive. Therefore, everyone responds differently to medicine. Most children and adults with ADHD, I find, will respond to either Ritalin-based or Dexedrine- based medicine. Within each group, there are several long-acting medications that can be effective. The important thing is to find out which stimulant works best, with as little side effect as possible.
As your son responded so well to Biphentin, a Ritalin-based medicine, he likely will find Concerta or Foquest very helpful. Your doctor needs to find out which one works better, and adjust the dose carefully.