The Daytrana Patch

Q:

"How does the Daytrana skin patch work? What side effects does it cause?"

Dr. Larry Silver specializes in treating children with attention deficit disorder (ADHD).
A:

The patch contains methylphenidate, the same stimulant found in Ritalin and Concerta. It’s available in 10, 15, 20, and 30 mg doses. As with stimulant pills, your doctor should start with the lowest dose and increase it until the most effective one is found.

The patch should be applied to an area of clean, dry skin that’s free of lotions, powders, and so on. Do not touch the exposed adhesive after removing the backing from the patch. Hold the patch firmly in place for 30 seconds after applying. If you place the patch on the hip, as the manufacturer recommends, be sure you don’t place it directly under a waistband — friction can cause it to loosen.

After application, the patch takes anywhere from 30 minutes to two hours to begin working, and lasts for about nine hours. If symptoms don’t need to be controlled for this long, the patch can be removed and discarded. Patches should not be reused.

The patch can cause any of the side effects that are normally associated with methylphenidate, including appetite loss, sleep problems, nausea, vomiting, and tics.

In addition, some patients experience skin irritation at the patch site. Mild redness is considered normal, and can be minimized by ensuring that the patch site is free of cuts or irritation and placing the patch in a different spot each day (that is, alternating hips). If contact dermatitis (swelling, itching, severe redness, small bumps) develops and does not improve within 48 hours, or spreads beyond the patch site, stop using the patch and consult a dermatologist.

Larry Silver, M.D., is the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities. He is also a clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C.
 
 
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