Focalin is just Ritalin but more potent. It’s available as a generic and may mean fewer tablets for patients. Focalin XR only recently went generic.

Clonidine is a good option in kids with ADHD who also have tics, who experience excessive anxiety or insomnia on stimulants, or in whom substance misuse is a concern.

Unlike stimulants, atomoxetine has no abuse potential, causes less insomnia and anxiety, and is unlikely to worsen tics.

Newer formulations of an old drug come with a high price tag. Stick to the usual amphetamine products like mixed amphetamine salts unless liquid or ODT dosing is absolutely necessary.

ADHD treatment algorithm for children and adolescents

Generally, in treating kids with ADHD, you should start with psychostimulants, since they are the most effective options. Second-line agents include alpha-agonists, followed by atomoxetine, viloxazine, and bupropion

Over the course of a career, most of us realize that pediatric psychopharmacology is more art than science, and that much of the knowledge we’ve acquired over the years has come from our work with patients after completing residency and fellowship. Here are some hard-won tips and pearls that you might find useful in your practice.