Therapeutic Note(s)

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28:20:00 C.N.S. STIMULANTS
Stimulant medication should only be used when diagnostic criteria for narcolepsy or attention deficit disorder have been met and when stimulant medication has been demonstrated to produce clinical benefits. The use of conventional-release medication should almost always precede the use of extended-release preparations.
Notes: Patients greater than or equal to 6 years of age diagnosed with ADHD according to DSM-IV criteria and where symptoms are not due to other medical conditions which affect concentration, and who require 12-hour continuous coverage due to academic and/or psychosocial needs, and who meet the following: 1) Patients who demonstrate significant and problematic disruptive behaviour or who have problems with inattention that interfere with learning; AND 2) Prescribed by or in consultation with a specialist in pediatric psychiatry, pediatrics or a general practitioner with expertise in ADHD; AND 3) Have been tried on methylphenidate immediate release (IR) or methylphenidate slow release (SR) or Dexedrine IR or Dexedrine SR (Spansules), and have experienced unsatisfactory results due to poor symptom control, side effects, administrative barriers, or societal barriers. Administrative barriers include: - inability of a school to dose the child at lunch; - the school lunch hour does not coincide with the dosing schedule; - poor compliance with noon or afternoon doses; - the patient is unable to swallow tablets. Societal barriers include: - the patient or patient's caregiver(s) has(have) a history of substance abuse or diversion of listed immediate-release alternatives; - the patient or patient's caregiver(s) is/are at risk of substance abuse or diversion of listed immediate-release alternatives.