Methylphenidate

116. This medicine comes in two main forms

a) A form which only acts for 2 to 4 hours.  This form is usually prescribed as a dose before school and at lunch time.  This allows for maximum benefit during the school day.  The dosage is increased gradually until maximum beneficial effect is attained.
b) A longer lasting form which can be given at home in the morning once daily.  This form is only available for some children.
A ‘medicine holiday’ is often arranged to assess whether it really is of benefit, ideally during school term time, when there is more routine in the child’s life.

It is usual to ask for reports from the school, pre-treatment and at treatment changes, to enable a comprehensive evaluation.

Side Effects May Be

• loss of appetite - especially at the start or when dose increased
• headache - especially at the start or when dose increased
• stomach aches - especially at the start or when dose increased
• emotionality/depression or mood disturbance - especially at the start or when dose increased
• insomnia
• nervous tics
• it is not a sedative - youngsters may be quieter but should not be sedated or drowsy
• it is rarely addictive

117. As Methylphenidate is a controlled drug, it is not advisable to stockpile it at school.  It should also be kept in a locked cupboard/drawer.  Either the midday dose could be brought in by the parent each day, or a 5 day supply of that dose could be brought in (properly labelled) by the parent each Monday morning.  When the medicine is given it should be recorded on the appropriate medication sheet and signed (see Form Med 1 and Form Med 2).