Timing of ADHD medications is a bit of an art.  ADHD medications are used to help children pay attention and ultimately perform better in school and for other activities.  Use of these medications is definitely not without controversy.  While I won’t address that controversy today, I will use ADHD medications to demonstrate appropriate timing, dosage forms, and why we use certain combinations but try to avoid others.

Here’s the scenario.  A 10 year old boy is taking generic Adderall XR 20 mg once daily in the morning.  His mother is concerned with late afternoon and evening activities in which he still needs to pay attention.  He has a really difficult time particularly with activities after 4-5 PM.

The mother decides that giving a second dose of the Adderall XR would be the most appropriate to try to help her son.

In this case, pharmacokinetics plays a huge role and it greatly impacts the family as now the 10 y/o is no longer sleeping very well at night.  In this scenario, a much more appropriate way to resolve the situation would be to add a low dose immediate release formulation where the duration of action is much shorter.  It would also be recommended to give it a little bit early to avoid problems with sleep.  Trial and error will likely be the course of action with the timing of the immediate release dose, but early afternoon would seem to make the most sense initially.

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