Attention Deficit Hyperactivity Disorder is a very sensitive issue. If not well handled, it could cause lower performances in school, higher levels of disorganization and even affect the relationships we have with others. As such, it is very important to keep this condition under control. Therapy sessions go a long way in the treatment of ADHD. However, they can only do so much. In line with efforts from the pharmaceutical industry to improve the lives of those with ADHD, a few drugs have been used for this condition’s treatment. These drugs decrease the symptoms of the disease and allow users to live a more comfortable life overall. They include the following.

  • Provigil
  • Concerta
  • Focalin
  • Ritalin
  • Adderall

Below, we discuss each of these drugs and analyze their efficiency. Findings show that Provigil is the preferred option for ADHD treatment.

History and Brief Description of these drugs

  • Provigil is the brand name for the chemical compound that treats ADHD. This pharmaceutical is referred to as modafinil. The drug was first developed from adrafinil, a drug first manufactured in France. In recent times, however, adrafinil’s use has greatly decreased as people see more benefits from Modafinil’s use. In 1998, modafinil first gained approval of the FDA to treat narcolepsy. From then, the drug’s use amongst those with ADHD has increased as a result of its efficiency and added benefits. The drug treats work shift sleep disorder and can also be used to cure excessive daytime sleepiness associated with obstructive sleep apnea. Provigil also enhances cognitive functions, making it used by a significant part of the population to improve their concentration spans and overall productivity in and out of the workplace.
  • Ritalin and Concerta are different brand names of the drug methylphenidate. They have both been used in the treatment of. Methylphenidate was first licensed in 1955 and has been utilized by the population since 1960. It appears, however, that improvements on the drug’s working in relation to ADHD treatment were deeply sought. The research on other drugs that could potentially be better is a possible reason for the manufacture of Provigil. Apart from ADHD treatment, methylphenidate also affects the working memory, episodic memory, and inhibitory control.
  • Focalin is a brand name for the drug dexmethylphenidate. This drug stimulates the Central Nervous system during its working. Increased stimulation leads to higher concentration levels. As such, subjects using the drug can avoid distractions for longer periods of time and remain relatively focused. This causes the drug to be used to treat ADHD. However, this drug’s benefits in terms of concentration, mental acuity and overall cognitive function are low. As such, treatment to ADHD could result in slower or dragged out improvements.
  • Vyvanse, also sold as Tyvense, Elvanse or Vanvanse is scientifically called Lisdexamfetamine. This member of the amphetamine class is administered to patients with Attention Deficit Hyperactivity Disorder so as to increase their focus by heightening their attention span. Additionally, vyvanse treats binge eating disorder. The drug improves users’ working memory, long-term episodic memory and inhibitory control. This amphetamine has been shown to have a positive effect against the development of disorders. However, results for clinical trials found only modest effects in these benefits. Scientists have drawn the conclusion that the drug only contributes a low extent to the improvement and/or healing of these conditions.

 

Uses and Various Applications

Apart from Attention Deficit Hyperactivity Disorder, modafinil treats narcolepsy, shift work sleep order and excessive daytime sleepiness associated with obstructive apnea. Provigil has also been proven to treat multiple sclerosis. This conclusion was made after a group of multiple sclerosis patients reported decreased neurological fatigue from Provigil’s use.

During a clinical trial, Cephalon – producers of modafinil- performed a test on 72 people who had various degrees of multiple sclerosis. Patients took Provigil for nine weeks and used standardized scales to report their fatigue levels on their own. Overall, the participants who were taking Provigil said they experienced significantly lower fatigue levels as compared to those taking the placebo. Additionally, those who were using the drug felt more active.

Additionally, Provigil has been used in the treatment of depression, fibromyalgia, chronic fatigue syndrome, myotonic dystrophy, opioid-induced sleepiness, spastic cerebral palsy and Parkinson’s disease. Provigil has also been used to treat primary biliary cirrhosis. In this and other cases, Provigil improves the body’s reactions to fatigue and daytime somnolence symptoms. This results in higher activity and more energy to focus.

Beyond healthcare facilities, the drug has been used in the following areas.

  • The Military – Provigil’s use not only prevents fatigue but also improves concentration to incredible levels. As a result, troops have used the drug during combat situations. In such cases, military men are undergoing sleep deprivation. Lack of sleep is a recurring factor in long missions where troops can go for days or weeks without sleep. Provigil’s use has been endorsed officially by the French government. In administrative records, The Foreign Legion used the drug for covert operations. India’s Air Force has also confirmed that modafinil use is part of their contingency plans. In the United States, the country’s military has approved of Provigil’s use in selected Air Force missions.
  • Astronauts – Provigil has been used by space explorers on long-term missions at the International Space Station. Since astronauts experience poor quality of sleep, modafinil helps to improve sleep time as well as with circadian rhythms.

Focalin’s sole use has been to treat ADHD. The drug’s stimulating effects cause increased wakefulness and higher activity in the Central Nervous System. As such, people who have ADHD experience higher levels of concentration with ease and can avoid distractions. Additionally, these individuals are able to practice more self-control on their behavior. However, the benefits of this drug vary from individual to individual. This means that this drug could possibly have very little effects towards ADHD treatment for some users.

Ritalin and Concerta work by activating the dopamine receptor D1. This begins the stimulation process that results in benefits to one’s cognitive functions. Taking this drug also causes the indirect activation of adrenoceptor α2. The overall effect of these two processes is improvements in an individual’s working memory and episodic memory. Additionally, these drugs increase stamina and endurance.

Vyvanse is also an amphetamine. Its application causes the same results as Ritalin and Concerta. Despite these drugs being used to treat ADHD, high doses of amphetamines can cause a decline in both athletic performance and cognitive functions. Further, the advantageous effects these drugs have to the brain are minimal. This means improvements from ADHD conditions are not as vast as with the use of other drugs.

 

Side Effects

Modafinil

Provigil’s side effects have been considered minimal across the board. Teva Pharmaceuticals released a report showing one-third of participants in clinical trials experienced headaches after Provigil’s use. 11 percent of the individuals reported having nausea and less than 10 percent of the participants reported other adverse side effects. The effects included the following.

  • Nervousness
  • Diarrhea
  • Insomnia
  • Anxiety
  • Dizziness
  • Gastrointestinal problems.

More serious effects have included severe skin rashes and other allergy-related side effects.

However, these issues are very rarely experienced amongst Provigil users. The use of Modafinil has only resulted in six cases of severe reactions being reported since the beginning of its marketing in the United States up to 2007. Additionally, these cases have been few and far in between – therefore there have been no sudden outbreaks. Qualified medical practitioners and pharmaceutical experts gave give their approval concerning Provigil use, citing the drug as safe and harboring very few, if any, side effects.

Vyvanse

Using this pharmaceutical product could lead to both hypertension and hypotension. Additionally, the drug could cause erectile dysfunction, abdominal pain, appetite loss, nausea, weight loss, blurred vision, excessive grinding of the teeth, nose bleeds, profuse sweating, tics and drug-induced nasal congestion.

Vyvanse has also been known to cause mood swings, insomnia, and self-confidence. Those who use this drug heavily have also experienced delusions and paranoia, which could be detrimental for someone with ADHD.

Focalin

Using Focalin brings about various effects on an individual. Physically, the use of this drug could cause appetite loss, dry mouth, anxiety, nausea, nervousness, insomnia, abdominal pain and weight loss. Focalin is also known to cause irritability, dizziness, lethargy, tics, blurred vision, dry eyes and changes in blood pressure.

Adverse psychological side effects of this drug include depression, confusion, and bruxism. It can also worsen psychosis in psychotic patients and could adversely affect patients with bipolar disorder.

Ritalin and Concerta

These two drugs cause a loss of appetite, dry mouth, anxiety, nausea, abdominal pain, weight loss, blurred vision, chest pain and hyperhidrosis. The drugs can also cause palpitations and changes in blood pressure. Hypersensitivity has also been recorded as a side effect of both Ritalin and Concerta.

Psychological effects include emotional instability, confusion, and depression.

 

Cases of Overdose

As of 2017, the FDA has not filed any death that was caused from the sole use of Provigil. To confirm that the death from overdosing on the drug is impossible, scientists have conducted clinical trials in line with excessive dosages. During tests, participants took up to 1200mg of Provigil per day for 21 days. The known occurrences of one-time 4500mg did not appear to cause life-threatening effects. Only adverse effects were observed inclusive of palpitations, insomnia, anxiety, irritability, confusion, nervousness and nausea.

Overdosing on Focalin is possible. It causes the following adverse effects on the user’s body: confusion, hallucinations, delirium, hyperthermia, sweating, vomiting, agitation, tremors, hyperreflexia, muscle twitching, euphoria, flushing, headache, tachycardia, heart palpitations, cardiac arrhythmias, hypertension, mydriasis, and dryness of mucous membranes.

In some cases, overdosing on this drug has led to circulatory system collapse which could cause death.

Severe doses from Vyvanse have proven fatal. Apart from death, the drug has caused kidney failure, circulatory collapse, cardiogenic shock, cerebral hemorrhage, rapid muscle breakdown, painful urination, tremors, inability to urinate, dilated pupils and the production of excessively acidic bodily fluids.

Excessive doses of Concerta and Ritalin cause hyperthermia, sweating, flushing, headache, tachycardia, heart palpitations, cardiac arrhythmias, and hypertension. Additionally, these amphetamines could cause vomiting, agitation, tremors, hyperreflexia, muscle twitching, euphoria, confusion, and hallucinations.

Some Ritalin and Concerta overdoses have caused circulatory collapse, which could lead to death if not treated immediately.

 

Addiction

Modafinil is a Schedule IV controlled drug. The FDA classified it as such because the drug has a low potential for abuse. This is because Provigil has minimal dopaminergic effects. Since the drug has low levels of euphoria, it is not abused. The drug has very low addiction and dependence liabilities.

Concerta, Ritalin, Vyvanse and Focalin are all highly addictive. Further, Adderall is very addictive – labelled as a Schedule II controlled drug by the FDA. This is as a result of its high rate of causing dependency on those who use the drug.

 

Summary

The following table summarizes the analysis of these drugs that treat ADHD.

Area of Difference Provigil Other Study Drugs
Additional Benefits Apart from the treatment of ADHD, this drug gives numerous additional benefits such as increased wakefulness These drugs are generally centered towards ADHD and have few additional benefits
Addiction The low dependency levels of this drug mean it is not likely to be abused The risks for addiction are very high. Due to the high euphoria levels from these drugs, they are likely to be abused.
Side Effects Provigil has minimal side effects Side effects from the use of these drugs could easily worsen your condition or get you admitted in a hospital
Withdrawal Provigil’s withdrawal symptoms are of low occurrence and end in 30 days The withdrawal symptoms from these drugs can easily impair an individual for months
Cases of overdose No documented case of a fatal overdose due to purely modafinil’s overuse Fatal incidents from the overdose of some of these drugs have been observed

From the above summary, it is quite clear that Provigil is the best choice for the treatment of ADHD. Its stimulating effect, combined with its additional benefits, minimal side effects and low addiction levels means it can be used progressively and under safe environments. As such, individuals who use Provigil would be more likely to recover to greater extents from their ADHD.