ADHD in Children Q&A by Dr. Phillips

What are the pros and cons of the ADHD patch in comparison to the other medications used to treat ADHD?

Answer:

The ADHD "patch" you are describing is called Daytrana, and it's manufactured by Shire. The medication that this new system delivers is methylphenidate, which is the same basic medication available in tablet forms such as Ritalin and Concerta. It is the delivery system that makes this product unique.

The clear advantage of the product is its ability to allow each patient to determine the duration of action of the medication on a day-to-day basis. The patch is to be applied approximately two hours before the medication's effect is desired, and the effectiveness continues for up to three hours after the patch is removed. The delivery of the medication is smooth throughout the time of wearing of the patch. The patch can be worn during swimming, bathing, or exercise. Parents can visually confirm that the patch is in place (that the medication is "being taken") and, unlike pills that can be sold or shared with others, the patch, once applied, cannot be removed and used again by others.

The company's recommendation is to wear the patch for nine hours, but the key is that the patch can be removed at any time before nine hours. This can be very helpful on days when the school schedule is shortened or on nonschool days, if the child (or especially teen!) sleeps in and applies the patch much later than the usual school-day application. The patch can be removed earlier to lessen the chances for decreasing the appetite at dinnertime or interfering with going to sleep that night. The basic side effects of the methylphenidate medication are the same as with the oral forms.

The downsides of the system involve the need for very careful and accurate application of the patch each day, at a different site on the body (usually the hip area below the waistline) and the fact that redness is to be expected at the site for up to 48 hours after patch removal. Also, heat applied to the patch (like heating pads, electric blankets, heated water beds, etc.) must be avoided, as this could alter the rate of delivery of the medication into the system. And there exists the possibility of the development of a local allergic reaction to the adhesive, or possibly to the medication itself.

So, discuss this unique system with your child's doctor and see if it might be right for you and your child.

Thank you for your question.


Last Editorial Review: 2/20/2007