Comparative Pharmacology
Head-to-head clinical analysis: CONCERTA versus DESOXYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CONCERTA versus DESOXYN.
CONCERTA vs DESOXYN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Methylphenidate is a central nervous system (CNS) stimulant. It blocks the reuptake of norepinephrine and dopamine into presynaptic neurons, increasing their levels in the synaptic cleft. It also acts as a dopamine agonist by stimulating the release of dopamine from storage sites.
Desoxyn (methamphetamine) is a sympathomimetic amine that promotes release of catecholamines (primarily dopamine and norepinephrine) from presynaptic nerve terminals, blocks their reuptake, and inhibits monoamine oxidase (MAO) activity. It produces CNS stimulation and peripheral alpha- and beta-adrenergic effects.
18-72 mg orally once daily in the morning, starting at 18-36 mg/day and titrating in 18 mg increments weekly; maximum 72 mg/day.
Adults: 5-60 mg/day orally in divided doses, typically starting at 5 mg twice daily; maximum 60 mg/day.
None Documented
None Documented
Terminal elimination half-life of methylphenidate from CONCERTA is approximately 3.5 hours (range 2.5-5.5 hours) in adults; in children, mean half-life is 3-4 hours. The extended-release formulation provides a prolonged clinical effect due to the OROS delivery system, not prolonged half-life.
Terminal elimination half-life: 9–14 hours (mean 12 hours) in adults; prolonged in alkaline urine (up to 25–30 hours). Clinically, twice-daily dosing maintains steady state after 2–3 days.
Primarily renal (77%-87% as unchanged drug and metabolites); metabolic elimination accounts for 13%-23%, with minor biliary excretion (<2%).
Renal: ~90% as unchanged drug and metabolites (primarily 4-hydroxyephedrine and 4-hydroxynorephedrine) within 48 hours; urinary pH-dependent: acidic urine increases elimination. Biliary/fecal: minor.
Category C
Category C
CNS Stimulant
CNS Stimulant