ADHD – dexamfetamine — RACP Paediatrics MCQ

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ModerateNeurologyADHD – dexamfetamineRACP Paediatrics

A 9-year-old with ADHD has tried methylphenidate (two formulations) with inadequate response and significant appetite suppression. What is the most appropriate next medication?

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Correct answer: B — Dexamfetamine

Dexamfetamine is the second-line stimulant option when methylphenidate has failed or is not tolerated. It has a different mechanism and some children respond better to one stimulant class than another. Lisdexamfetamine (a prodrug of dexamfetamine) is another option. If both stimulants fail, non-stimulants (atomoxetine, guanfacine) should be considered.

Reference: Australian Therapeutic Guidelines – 2024 – Psychotropic; RACP Paediatric Curriculum – Neurodevelopment