ADHD Medication and Treatment Reviews

Focalin: ADHD Medication

Focalin is a stimulant ADHD medication used to treat symptoms of attention deficit hyperactivity disorder in children and adults. Learn about it uses, side effects, dosages, and warnings here.
Generic: Dexmethylphenidate HCL

What is the ADHD Medication Focalin?

Focalin (Generic Name: dexmethylphenidate HCL) is a central nervous system stimulant ADHD medication primarily used to treat attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, adolescents, and adults. Focalin may improve focus, and decrease impulsivity and hyperactive behavior, hallmark ADHD symptoms in some patients with the condition. It contains the same active ingredient as medications like Ritalin and Daytrana.

Whenever methylphenidate is produced, it’s possible to produce equal amount of four different ways of arranging the methlyphenidate atoms called isomers or enantiomers.  With methylphenidate, only one of these four isomers (the right-handed or dextro-threo methylphenidate) has benefits for the impairments of ADHD. The other three isomers actually make the features of ADHD significantly worse. Two of these detrimental isomers were removed when Ritalin was brought to the market in 1956. The single active, beneficial isomer was brought to the market as Focalin IR (the immediate-release formulation that lasts 4 to 5 hours) and as Focalin XR (the extended-release formulation that lasts 8 to 10 hours).

Research has demonstrated that  having only the active isomer and none of the detrimental isomers makes Focalin more potent with fewer side effects compared to all other methylphenidate delivery systems such as Ritalin.

Focalin can also be used to treat narcolepsy.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Focalin vs. Adderall

Focalin is the brand name for the generic drug called dexmethylphenidate; Adderall is the brand name for dextroamphetamine/levoamphetamine salts. Both are stimulant medications prescribed to treat ADHD. Dexmethylphenidate is the active part of methyphenidate, which is why Focalin is considered twice as strong — on a mg-for-mg basis — as drugs such as Ritalin and Concerta.

What Is the Best Dosage of Focalin?

Nothing predicts the optimal dose of Focalin. Each person has a preference for one ADHD stimulant over another but nothing predicts in advance which molecule will work best. The dosage is adjusted to the individualized response of each person and to their tolerance of side effects. Focalin was the first ADHD stimulant not to receive arbitrary dosage maximums from the FDA; it rather emphasizes that there is a wide range of individual responses to stimulant medications.

Focalin XR capsules are available in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg dosages, 1 or 2 times each day about 8 to 10 hours apart.

As with all medications, follow your Focalin prescription instructions exactly.

During treatment, your doctor should check vital statistics including blood, heart, and blood pressure; or evaluate height and weight.

Some patients believe that they develop a tolerance to Focalin after long-term usage. There is little evidence that this occurs. If you think that your dosage is no longer controlling your symptoms, do not try to adjust your dosage on your own. Talk to your doctor to plan a course of action.

What Are the Side Effects of Taking Focalin?

Most people taking Focalin do not experience any side effects. That said, the most common side effects associated with Focalin are as follows:

  • stomach ache
  • nausea
  • decreased appetite
  • heart racing or palpitations
  • hand tremors

Serious Side Effects of Focalin

  • serious allergic reaction
  • possible slowing of growth in children
  • eyesight changes or blurred vision
  • priapism (a penis erection that does not go away after more than four hours)

Focalin and Heart- or Blood-Pressure Related Problems

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Focalin although a casual relationship has never been found. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Focalin.

Focalin and Familial Mental Health

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Focalin may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Focalin and Circulation Problems

Discuss circulation problems with your doctor before taking Focalin, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Focalin.

Focalin and Substance Abuse

Stimulants like Focalin have a potential for abuse, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

FDA Approval

The safety of Focalin for children under age 6 has not been studied by the FDA and so it is not FDA-approved for preschoolers. It has been extensively studied, however, by other governmental agencies and found to be both effective and safe down to 3 years of age. The effects of Focalin on adults over age 65 have not been studied.

What Precautions Are Associated with Focalin?

You should not take Focalin if you or your child have:

  • untreated glaucoma
  • tics or Tourette’s syndrome
  • a history of drug abuse
  • severe feelings of tension or agitation
  • an allergy to stimulant medications or any other ingredients in Focalin
  • taken or plan to take a monoamine oxidase inhibitor (MAOI) within 14 days

If you are thinking of becoming pregnant, discuss the use of Focalin with your doctor. The FDA designates dex-MPH as a Pregnancy Risk Category C, which means that no risk of birth defects, difficulty with the pregnancy, or problems during delivery or the post-partum period have been found but cannot be absolutely ruled out either. Dex-MPH (Focalin) is passed through breast milk. Although it has never been studied, the American Academy of Pediatrics recommends that mothers do not nurse while taking methylphenidate “out of an abundance of caution.”

Store Focalin in a secure place out of reach of children, and at room temperature. Do not share your Focalin prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

What Interactions Are Associated with Focalin?

Before taking Focalin, discuss all other active prescription medications with your doctor. Focalin can have a dangerous, possibly fatal, interaction with Monoamine Oxidase Inhibitor (MAOI) antidepressants.

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, or any medication containing a decongestant.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Focalin before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.


1Focalin. Food and Drug Administration (2013).,021802s028lbl.pdf

2Focalin. Food and Drug Administration (2019).

3Medication Guide Focalin. Food and Drug Administration (2019).

4Focalin vs. Adderall: What’s The Difference? (2018)

More Information on Focalin and Other ADHD Medications

Free Download: The Complete Guide to ADHD Medications
A Parent’s Guide to ADHD Medications
Free Resource: How Do We Know the Medication Is Working?

19 Focalin: ADHD Medication Comments & Reviews

  1. I have been a Focalin fan for several year, but suddenly have an issue and wonder if anyone else has experienced it. My 13 year old son has been on Focalin 30 mgs, for probably about 3 years and has done awesome. This medication seemed to have the least impact on his appetite in comparison to all of the others that we tried. He doesn’t take meds over the weekend or on school breaks. He gained 30 pounds and 5 inches over this past year and looks great. Since school started though, he quickly dropped 10 pounds as he runs out the door at 6:30 refusing to eat or drink breakfast, and has no appetite until nearly 7pm. He’s very active and plays sports after school. He’s been in a huge funk lately and I was really scared. He’s moody, irritable, overly sensitive to peer issues and lethargic. I wondered if this was teen hormones. He finally realized yesterday, that he is hungry and tired. I’m puzzled as he’s never had this reaction to the meds before. His doctor doesn’t think that his body would react so differently to the same medication, but I really wonder. I don’t think it’s depression as he perks back up when he’s off his meds and can eat.

  2. We have had tremendous success with Focalin. Our son started at 5mg when he was 6 and we moved up to 10mg at 8 1/2. He responds wonderfully.

  3. My 6 year old started today on 5 mg of Focalin, but I am noticing some facial tics. The doctor recommended to discontinue and try a non stimulant as the tics would likely happen on any of the stimulants. Intuniv is up next.

  4. My older son developed random tics on Focalin. Sometimes he’ll have it for a few weeks and it’ll go away, the same tic you mentioned. Chewing gum helped him stop the tic. I recently switched him to Vyvanse because the Focalin wasn’t lasting the whole school day and I was getting concerned that he was taking too many pills each day to stay focused (mid-day doses at school). So far the Vyvanse has been lasting for the whole day at school and he doesn’t seem as zoned out as he did on Focalin.

  5. My son, at 8, was on Focalin XR. He started at 10mg (which the pediatrician said was a low dose) and went up to 30mg. It was wonderful. Unfortunately, we had to switch to another med after about a year, because the Focalin started to wear off way too soon and the rebound effect became really bad.

  6. My 8-year-old son has been on Focalin XR for almost a year at 10mg (morning dose only), paired with 1mg of Intuniv. He seems to be doing okay at school, but the effects seem to wear off by the afternoon.

  7. My 8-year-old daughter has been on Focalin XR 10 mg for about a year now. By the end of the last school year she was on 15 mg. and doing really well. But I was concerned about how much weight she had lost. She had dropped almost 10 lbs., and while all the blood work came back okay and she was still in ‘healthy guidelines,’ I was concerned. So for the summer our neurologist brought her back down to 10 mg. And that was fine for the summer, but now that school is back in I’m finding that the 10 mg. isn’t quite “holding” (for lack of a better word) her through the day and I’m going to request that she be brought back up to 15 mg. My girl is also very active in extra curricular activities in the evenings and we are considering opening up the discussion to maybe giving her Intuniv in the evenings.

  8. My son is 11 and is on a 25 mg dosage of Focalin XR. He has done very well on it. The teachers and I have noticed that the meds have been starting to wear off late in the afternoon, which is causing some problems with missing assignments that impact his grades. His doctor is prescribing a 5 mg dose of regular Focalin to be taken after lunch that will get him through the rest of the day.

  9. We have had tremendous success with Focalin. The only troubling part is that typically the more effective the medicine, the more likely you will also experience side effects. So we have made accommodations for our son since Focalin is the most effective as noticed by family, us as parents, school, and even my son. At 85 pounds, my son takes 25mg XR with 7.5 mg (regular) at lunch for a boost that lasts through homework time.

  10. Our son was on Focalin during 1st grade. We noticed major tics in his eyes, and later on, he chewed his nails and twirled his hair. After switching to Concerta, all of that stopped.

  11. Both my kids have been prescribed Focalin XR. My son is 17 and my daughter is 12. My daughter’s creativity doesn’t seem to be impacted; however, my son, who was a very creative, outside-the-box thinker will no longer take his meds because he isn’t as creative when on them. He is more organized and less forgetful, yes, but not as creative.

  12. Focalin XR works very well for me. I was recently diagnosed with ADHD as a middle-aged woman and use 5 mg of Focalin XR daily, often supplemented with 2.5 mg of regular Focalin in the afternoon if I know I’m going to have a long evening or it’s been an unusually stressful day. If I have to get up very early or know I will be up late, I take an additional 5 mg of XR in early afternoon.

    From the first dose, there was a clarity and quietness of mind that I had never experienced before. I tried Vyvanse and found that it made me feel jittery and gave me a “roller coaster effect” of feeling odd then better.

    Higher doses of Focalin XR make me feel a little hyper and talkative. For well over 6 months now, I’ve done just fine at the 5 mg level.

  13. I have recently been diagnosed with adult ADHD at age 20 and my doctor prescribed a starting dose of 2.5 mg twice a day of Focalin. I find it to be somewhat effective, however it does not last me the whole day and I find that I get kind of “foggy headed” and although my concentration is increased my motivation has decreased. I think this would be a great option for someone who is very hyperactive because it definitely is very calming. My ADHD is primarily the inattentive kind so this may not be the medication I stick with but overall I have had very little side effects other than “foggy headedness”.

  14. I am a 30 year old female who has suffered with ADHD,
    Bi Polar disorder, PTSD, Anxiety, and Depression my whole life (ptsd came in my teens and 20’s after extremely tragic events). I have a therapist and then a Dr. for my medication which I believe is mostly at its best after many trials of trying other medications just to find out a few days or even weeks that again I would be suicidal, extremely depressed and lethargic or broken completely out all over my body with welts the size of pancakes, turned out to be hives. So we went back to my former regimen the best one so far. (Side note: I now realize the meds help of course but they aren’t magic; therefore, I can’t expect them to do all the work I must learn how I am supposed to handle my ups and downs and mania episodes and then severe depression that is crippling. So again I go to therapy and it’s amazingThe concoction of my meds is as follows-Depression, PTSD & Anxiety
    (Lexapro 20mg – AM; Xanax 1mg 4x a day as needed)
    Bipolar Disorder & High Blood Pressure-getting better
    (Lamictal 200 mg – evening; Propanol 20 mg – am & pm)
    (Vyvanse 70 mg – am :when I’m getting ready for work
    It takes about an hour to get in my system)
    (Focalin 10 mg – noon because I get to work at 5am and
    work 10 hours and by noon the Vyvanse has worn
    down and I need a boost to make the rest of the day
    still be able to go home and do Wife Home things)
    Insomnia (Lunesta 3 mg – before bed)

    This combo for my ADHD helps but I had gotten off the
    Focalin for a couple months thinking I didn’t need it, also was having some side effects that appeared; becoming easily irritable, would worsen my episodes of mania
    when they happened, and increased insomnia.
    this was before I changed my work schedule to 4 10’s once
    That happened I new I needed it so I learned to control my irritable moods with more sleep and to get the sleep I was
    prescribed Lunesta for when I needed it and this all also helped my mania but if I know an episode is beginning I
    do not take my Focalin if I’m home so I don’t hyper focus
    or stay up all night as a busy bee.
    All in all I am glad I added the Focalin back into my meds
    because it is a lifesaver most days and if I am so focused
    that I forget to take it no later than 1 in the afternoon then
    I don’t because obviously I can finish my day without it if
    I had not thought to take it.

  15. My son just switched from Adderall xr to focalin 5 mg he is 6 1/2 . He’s been out of nowhere doing things he did when he was 3 or 4 like soaking the toilet paper or drawing in the wall. I asked him why he’s been acting out so much and he said he has nightmares every night. Also he’s screaming he’s starving the second he’s out of school. He never acted like this with the Adderall. We didn’t even want to change his meds we just wanted to go to regular Adderall instead of xr but the Dr said there was a 3 month back order on Adderall and prescribed focalin. I think we’re going to call the Dr and see if we can go back to Adderall xr at maybe a higher dose or see if it’s only their pharmacy that’s back ordered because this is not working for my son.

    1. Adderall and Focalin are different types of stimulants. Adderall is an amphetamine and Focalin is a methylphenidate with some dex in it. Since most people do well on one type or the other, but not both, this outcome makes sense. He likely does better with amphetamines. Why did you change the Adderall if it was working? There are other amphetamines to try, like Vyvanse and Evekeo.

      ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

  16. I just took my niece to see her LPG Pediatric Neurology , she prescribed Dexmethylphenidate for her ,and I am a bit concerned , my niece just turned 5 , she isn’t but only 36 lbs and we can deal with her ADHD and Sensory disorder , we would like her to be able to concentrate , but are worried about the side effects of this drug, and don’t want to risk this sweet little girls life, does anyone have any suggestions on what else could be safer for her , I am frightened for her , I haven’t even gotten the script filled yet .Just so up in the air with what people have told me .

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