A Closer Look at Transdermal ADHD Treatment
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder, and treatment often involves a comprehensive program that can include medication. While oral medications are common, the ADHD patch offers an alternative method of delivery. So, what is the ADHD patch? It's a prescription transdermal system that delivers a stimulant medication through the skin directly into the bloodstream. This method is part of a treatment program to control symptoms like difficulty focusing, controlling actions, and remaining still.
The primary benefit of a patch is that it bypasses the digestive system, which can be advantageous for individuals who have trouble swallowing pills. It provides a steady, continuous release of medication throughout the day. The two main types of ADHD patches available are Daytrana, which contains methylphenidate, and Xelstrym, which contains dextroamphetamine.
How the ADHD Patch Works
The ADHD patch is a central nervous system (CNS) stimulant. The active ingredient, such as methylphenidate in the Daytrana patch, is absorbed through the skin when the patch is applied. It works by changing the amounts of certain natural substances in the brain, like dopamine and norepinephrine, which are involved in focus and attention.
Typically, a patch is applied to the hip area once a day, usually in the morning about two hours before the desired effect is needed. It is generally worn for a specific duration, but the wear time can be adjusted by a doctor to manage effectiveness and side effects. This flexibility allows for a tailored duration of action, as the medication's effects begin to decline after the patch is removed.
Available ADHD Patches: Daytrana and Xelstrym
Daytrana (methylphenidate transdermal system): Daytrana was the first ADHD patch approved by the FDA. It contains methylphenidate, the same active ingredient found in oral medications like Ritalin and Concerta. It is approved for use in children and adolescents ages 6 to 17. Daytrana is available in various strengths. A doctor will determine the appropriate starting dose and may adjust it as needed.
Xelstrym (dextroamphetamine transdermal system): Xelstrym is a newer amphetamine-based patch that was FDA-approved in 2022. It contains dextroamphetamine and is approved for treating ADHD in adults and children aged 6 and older. Unlike Daytrana, which is restricted to the hip, Xelstrym can be applied to the hip, upper arm, chest, upper back, or flank. It is available in various strengths.
Comparison: ADHD Patch vs. Oral Medications
Choosing between a patch and oral medication involves considering several factors related to lifestyle, individual needs, and potential side effects.
| Feature | ADHD Patch (e.g., Daytrana) | Oral Stimulants (e.g., Ritalin, Adderall) |
|---|---|---|
| Delivery Method | Transdermal (through the skin) | Oral (swallowed pill or liquid) |
| Onset of Action | Slower; approx. 2 hours | Faster; often within 1 hour |
| Duration Control | Flexible; can be removed early to stop medication delivery | Fixed duration based on immediate or extended-release formula |
| GI System | Bypasses the stomach, potentially reducing some GI side effects | Passes through the digestive system |
| Key Advantage | Good for those who can't swallow pills; steady medication level | Faster onset; long history of use |
| Unique Side Effects | Skin irritation, redness, or permanent loss of skin color (chemical leukoderma) at the application site | N/A |
Potential Side Effects and Important Considerations
Like all CNS stimulants, ADHD patches carry risks and potential side effects. Common side effects for both patch and oral forms include decreased appetite, trouble sleeping (insomnia), weight loss, nausea, and mood swings. The patch has specific side effects related to its application site, such as redness, itching, and small bumps. A more serious, though rare, skin-related side effect is chemical leukoderma, a permanent loss of skin color at or away from the patch site.
Serious warnings for methylphenidate patches include the potential for misuse and dependence, as they are controlled substances. There are also risks of serious cardiovascular events, increased blood pressure and heart rate, and psychiatric adverse reactions like new or worsening psychosis or mania. It is critical to discuss a patient's full medical history, including any heart conditions, mental health issues, or circulation problems, with a doctor before starting treatment. The patch should not be exposed to direct heat sources like heating pads, as this can increase medication absorption and risk of overdose.
Conclusion
The ADHD patch represents a significant alternative in the management of ADHD, offering a unique delivery system with distinct advantages, particularly for children who struggle with oral medications. By delivering a steady stream of medication like methylphenidate (Daytrana) or dextroamphetamine (Xelstrym) through the skin, it provides consistent symptom control with the added flexibility of early removal. However, patients and caregivers must be aware of the potential side effects, especially those unique to the transdermal system like skin irritation and the rare risk of permanent skin discoloration. As part of a comprehensive treatment plan that may include therapy and educational support, the ADHD patch can be an effective tool when used under the guidance of a healthcare professional.
For more detailed safety information, you can consult the FDA's Medication Guide for the methylphenidate transdermal system.
