Intuniv XR (guanfacine). The risk of hypertensive encephalopathy upon abrupt discontinuation of Intuniv XR (guanfacine) has been included in the Warnings and Precautions section of the Canadian product monograph.

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ADHD requires a multimodal treatment approach and effective pharmacological management is often a component of this treatment.

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The Ontario Ministry of Health is changing the way doctors prescribe most drugs used to treat ADHD as of November 1, 2011.

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A new safety information announcement, which warns of the risk of increased blood pressure and increased heart rate with the use of Strattera (atomoxetine), has been published on the Health Canada website.

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CADDRA would like to add its support to a new position paper on newer medications published by the Canadian Psychiatric Association. Download the PDF of "Access to Newer Medications" here. The paper points out that expensive long-acting newer medications for ADHD may be cost effective in the long term. "These medications result in improved school and work performance by improving adherence and reducing abuse potential." Currently most of these medications are not covered by all Canadian public plans because of their cost.

 

Quebec's Conseil du Médicament, now the L’Institut national d’excellence en santé et en services sociaux (INESSS), reviewed long-acting generic medication Novo Methylphenidate ER-C under its mandate to promote clinical excellence and the efficient use of resources in the health and social services sector in Quebec.

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CADDRA has developed a new and convenient information guide on provincial drug coverage for long-acting, first-line medication in Canada. Data is provided on the regulations and requirements associated with the inclusion of long-acting medications on individual provincial formularies.

 

Vyvanse is now listed on the Ontario Formulary as per other long acting medications. Full details of the relevant regulations are in  Update Y, Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 (effective June 08, 2011).

 

Long-acting medication, Vyvanse, has received Health Canada approval for use in all age groups. Until now, it was officially approved for children only in Canada.

The starting dose is 20-30mg and the maximum Health Canada sanctioned dose for all ages is 60mg. CADDRA recommends off-label use of up to 60mg in children, up to 70mg in adolescents and adults.

 

Physicians are invited to provide feedback on their experiences with the new generic methylphenidate-based product with a progressive delivery system, Novo-Methylphenidate ER-C, a medication approved by Health Canada in March as a generic for ConcertaTM. CADDRA received some anecdotal reports from families and physicians of behavioural changes in patients when Concerta was switched to the generic formulation. While we are aware these changes could also be attributed to other factors, we have decided to provide doctors with a way of providing feedback on their experiences with the generic – both positive and negative – through an online comment form. Physicians are also reminded that adverse medication reactions must be reported to the Health Canada through the Canada Vigilance Program.

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Two new treatments for ADHD are now available in Canada: a new medication, an amphetamine-based  pro-drug, lisdexamfetamine (VyvanseTM) and Novo-Methylphenidate ER-C, a methylphenidate-based long acting product, just approved by Health Canada as a generic for ConcertaTM.

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A new screening tool for physicians to identify potential cardiac risk factors for sudden death in children starting stimulant medication is included in the joint position paper on cardiac risk assessment before the use of stimulant medications in children and youth published this month by the Canadian Paediatric Society, the Canadian Cardiovascular Society and the Canadian Academy of Child and Adolescent Psychiatry. (J Can Acad Child Adolesc Psychiatry 18:4 November 2009).

The starting doses of Biphentin have been revised as follows: The mg/kg/day initial dose recommendations have been eliminated. In other words, there is no reference to an initial dose of 0.3mg/kg/day for children or 0.25 mg/kg/day for adults.

 

A recent US-based study on the potential risks of stimulant medication used to treat Attention Deficit Hyperactivity Disorder (ADHD) to children has received considerable press and raised questions for many affected by ADHD or caring for children, youth and adults with ADHD

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