Last week a mother brought her son in for a routine four month evaluation for children on stimulant mediation.

 

The 10-year-old boy was doing fine on his current medication. But they had heard that there was a brand new, totally different medication for attentionally deprived children.
 

“Dr. Samson,” she said. “Why haven’t you suggested this new medication for ADD patients?”

 

“It is called…” she paused and rifled through her purse, fishing out a crumpled bit of paper from which she read, “…wynate. My friend said it was great and really helped her son!”
 

She was referring to Vyvanse.

 

This is an amphetamine-related product introduced in the past year. It was designed to reduce the annoying side effects of appetite suppression and insomnia by modifying the molecule of the amphetamine drug. It was also proposed to provide a more even effect during the day and have less impact on behavioral side effects.
 

The jury is still out on whether it accomplishes all of the above goals. However, there is little reason to change the medication in a patient who is currently well controlled and free of unwanted side effects.
 

In this child’s case I encouraged the mother not to introduce a new drug. When a new drug is started one must go through the time consuming search for the optimum dose if, in fact, the new medication is effective. In reality this was not truly a new medication for this child, but a “modification” of an old one. Nevertheless, if Vyvanse lives up to its claims it should prove helpful in providing us with another alternative.
 

This would be a good time to take an overall look at the most commonly used medications currently available for the treatment of ADD (ADHD).