Focalin Uses, Side Effects, Addiction & Overdose

Focalin (dexmethylphenidate) is a central nervous system (CNS) stimulant used to increase attention, alertness, and energy. Focalin has been shown to be addictive, particularly in people who have a history of substance abuse and addiction. Learn the risks here.
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What is Focalin?

Focalin Uses, Effects, Risks

Focalin, the brand name of dexmethylphenidate, is a central nervous system (CNS) stimulant used to increase attention, alertness, and energy. It is FDA approved to treat attention-deficit hyperactivity disorder (ADHD) in children 6 years and older, and adults. Focalin works by blocking the reuptake of the neurotransmitters dopamine and norepinephrine in the brain, increasing their activity.

Focalin is manufactured by Novartis Pharmaceuticals Corporation and is available in two forms, including an extended-release capsule or a tablet. The dosing and length of effectiveness vary between the two formulations, and it is important to recognize the differences.

Focalin XR (extended-release) capsules are available in 5 mg increments beginning at 5 mg and reaching 40 mg. Depending on your needs and ADHD symptoms, your doctor will prescribe the drug in the following amounts:

  • Adults — dosing begins at 10 mg per day, and the maximum dose is around 40 mg in one day.
  • Children 6 years and older — dosing begins at 5 mg per day, and the maximum dose is around 30 mg in one day.

Focalin tablets are available in three different dosing strengths: 2.5 milligram (mg), 5 mg, and 10 mg. Depending on your needs, your doctor will prescribe the drug in the following amounts:

  • Adults — dosing begins at 2.5 mg two times a day, at least four hours apart, and the maximum dose is around 10 mg two times a day.
  • Children 6 years and older — they follow the same dosing as adults.

A study from 2018 found that about 5.1 million people (12 and older) have misused prescription stimulants in the past year. This is about 1.9 percent of the U.S. population.

National Survey on Drug Use and Health (NSDUH)
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Side Effects of Focalin

Focalin is prescribed to treat ADHD, a set of hyperactive-impulsive or inattentive symptoms that begin before age 7. The drug is often combined with educational, psychological, and social measures to create a comprehensive treatment program for patients.

The most common side effects of Focalin include:

  • Increase in attention
  • Decrease in attentiveness
  • Stomachache or nausea
  • Decrease in hyperactivity
  • Fever
  • Loss of appetite
  • Dry mouth

Along with these, Focalin may cause more serious side effects, including:

  • Severe allergic reaction (difficulty breathing, rashes or hives, swelling of the face, throat or lips, and fever)
  • Seizures in patients who have a history of seizures
  • Blurred vision or other eyesight changes
  • Slowing of growth (height and/or weight) in children
  • Weight loss

Although the drug is effective in most people, there are some cases where use is not advised, including:

  • Glaucoma — patients with glaucoma (a condition that damages the optic nerve) should not use Focalin.
  • Agitation — patients with noted anxiety, agitation, and tension should not use Focalin, because the drug may amplify these symptoms.
  • Monoamine oxidase inhibitors (MAOIs) — patients should not use Focalin together with MAOIs, due to the risk of severe increase in blood pressure resulting in stroke.
  • Tics — patients with motor tics, or diagnosis or family history of Tourette’s syndrome, should not use Focalin.
  • Raynaud's phenomenon— if you've had blood circulation problems, you should not use Focalin.
  • Breastfeeding — Focalin may pass through breast milk, consult your doctor before taking Focalin if you are pregnant or breastfeeding.
  • Heart defects — Focalin can cause heart issues, so anyone with high blood pressure, heart or blood vessel disease, an irregular heartbeat, hardened arteries, or other heart problems should consult their doctor before taking the drug.

Contact your doctor and seek medical advice immediately if you or your child shows any symptoms of heart problems while taking Focalin including shortness of breath, chest pain, or fainting.

Icon with triangle signifying risk.

Risks of Focalin

Focalin may exacerbate pre-existing conditions in patients, including heart problems, mental illness, seizures, and others.

CNS stimulants increase heart rate, and sudden death linked to heart problems has been reported with their use. Focalin should not be used in children with serious cardiac abnormalities or impaired function.

Likewise, in adults, sudden death, heart attack, and stroke have been reported at usual doses of stimulants to treat ADHD. They also have a greater chance of developing coronary artery disease, rhythmic abnormalities, and other serious heart problems compared to children.

Focalin causes a slight increase in average heart rate and blood pressure, varying between each person. All patients taking the drug should be monitored over time for larger changes in these measures.

Stimulants, including Focalin, have been shown to enhance symptoms of psychosis and bipolar disorder. Aggression, impulsivity, and hostility have also been observed in children and teenagers with ADHD, and Focalin may contribute to these.

In patients with a history of seizures, Focalin may lower their convulsive threshold and induce seizures more often. If they occur, drug use should be stopped immediately.

In a randomized study of children ages 7 to 10, children given Focalin or control medication were followed for 14 months. On average, children who took Focalin grew 2 centimeters less and weighed 2.7 kilograms less than controls over a period of three years. Overall, this study suggests that stimulant use impacts growth in children.

Two pills mixing equals dangerous

Drug Interactions

Focalin can affect the metabolism of other drugs, and it should not be taken with:

  • Blood pressure medication
  • Anticoagulants (blood thinners)
  • Anticonvulsants (seizure medication)
  • MAO inhibitors (isocarboxazid, phenelzine, selegiline, tranylcypromine, linezolid, methylene blue, moclobemide)
  • Select antidepressants (tricyclics and selective serotonin reuptake inhibitors)
  • Stimulants or amphetamines (including other medications used to treat ADHD such as Adderall, Concerta, or Ritalin

Focalin versus Ritalin

Focalin and Ritalin both contain the active ingredient dexmethylphenidate hydrochloride, but in different forms. Focalin is the more active chemical composition compared to Ritalin; however, both drugs are used to treat ADHD.

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Focalin Withdrawal

When someone uses a drug for an extended period of time, they become physically and psychologically dependent on it. The body needs the drug to function normally, and if use is stopped, withdrawal can set in.

Withdrawal is a set of symptoms that occur when the body goes into shock due to the absence of the drug after long-term use or abuse.  Symptoms of withdrawal from stimulants include:

  • Fatigue
  • Changes in appetite
  • Vivid, unpleasant dreams
  • Insomnia
  • Psychomotor agitation (restlessness, fidgeting, fast-talking, etc.)
  • Severe depression
Icon with triangle signifying risk.

Focalin Overdose

When someone is dependent on a drug, they may use higher doses to compensate for tolerance that has built up over time. This increase in dosing can eventually lead to an overdose. Symptoms of a Focalin overdose include:

  • Agitation
  • Tremors
  • Muscle twitching
  • Vomiting
  • Sweating and flushing
  • Headache
  • Increased blood pressure
  • Convulsions (may be followed by coma)
  • Euphoria
  • Delirium and hallucinations
  • Confusion
  • Tachycardia (increased heart rate)
  • Palpitations or arrhythmias
  • Dilated pupils

Overdoses are extremely dangerous, and if any of these symptoms occur, contact emergency medical services immediately.

Pill bottle and skull

Focalin Addiction & Abuse

Focalin, like other central nervous system stimulant medications, can be addictive, and it is classified by the Drug Enforcement Administration as a Schedule II controlled substance. These are drugs defined as, “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence.”

Addiction Symptoms

Addiction is characterized by a set of behaviors surrounding drug use. Someone who is addicted to Focalin might be unable to stop using it, may continue to do so despite knowing it is harmful and may have cravings when not taking it.

Stimulants are often misused to promote alertness and focus, particularly in academics. They can also be combined with other drugs. Some people also take them to get high.

Focalin has been shown to be addictive, particularly in people who have a history of substance abuse and addiction.

Signs of addiction and abuse include:

  • Increase in self-confidence and sociability
  • Difficulty sleeping
  • Euphoria
  • Reduced appetite
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Addiction Treatment Options

The safest way to stop using a drug is under the care of a medical professional. Tapering is a method that decreases a drug dose over time to prevent shock to the body’s systems. This gradual process helps the brain and body adjust to the absence of a drug and prevents uncomfortable side effects.

Treatment options are available to help you or a loved one overcome addiction to Focalin. Effective methods for treating stimulant addiction include cognitive-behavioral therapy (CBT) and contingency management.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy is a program centered around learning how to identify problematic behaviors in addiction and correct them. During this program, patients learn to think ahead about likely problems and how they may handle them. Examples of specific techniques are provided by the National Institute on Drug Abuse. They include:

  • Exploring the positive and negative outcomes associated with continued drug use
  • Self-monitoring, which helps you recognize cravings early on and identify situations that might put you at risk for drug use
  • Developing strategies for coping with cravings to avoid high-risk situations

Contingency Management (CM)

Contingency management (CM) is a treatment approach that gives tangible rewards to patients to reinforce positive behaviors. It is likely that the reward given during CM stimulates the reward pathway similar to drug use, making this a useful method. Thus, it is extremely effective in encouraging patients to continue treatment and promoting abstinence from drugs.

Overcoming addiction to Focalin is difficult to do alone. Find treatment today.

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Resources

Drug Enforcement Administration. “Drug Scheduling.” DEA, https://www.dea.gov/drug-scheduling

Food and Drug Administration. “Focalin.” FDA, https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021278s015lbl.pdf

U.S. Food and Drug Administration. “Focalin XR.” FDA, Jan. 2017, https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021802s033lbl.pdf

Food and Drug Administration. “Ritalin (methylphenidate hydrochloride.)” FDA, Jan. 2019, https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/010187s071s082,018029s041s051lbl.pdf

Mayo Clinic. “Dexmethylphenidate (Oral Route).” Mayo Clinic, Feb. 2020, https://www.mayoclinic.org/drugs-supplements/dexmethylphenidate-oral-route/description/drg-20067099

Substance Abuse and Mental Health Services Administration. “2018 National Survey on Drug Use and Health Annual National Report.” SAMHSA, Aug. 2019, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

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Updated on: December 1, 2020
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Addiction Group Staff
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