I often see parents in my office who feel like they’re at their wit’s end. The school has called again. Homework is a nightly battle. You love your child fiercely, but managing their ADHD can feel like trying to navigate a constant storm. You’re looking for something that can help bring some calm and focus to their world. Sometimes, that conversation leads us to consider treatments like Dextroamphetamine patches.
This approach can feel a little different than just swallowing a pill, and it’s natural to have questions. So, let’s sit down and talk through it, just like we would in the clinic.
What Are Dextroamphetamine Patches?
At its core, dextroamphetamine is a medication we call a stimulant. Now, that word can be confusing. For a person with Attention-Deficit Hyperactivity Disorder (ADHD), it doesn’t “rev them up.” Instead, it helps the parts of the brain responsible for focus, attention, and impulse control communicate more effectively. It helps quiet the background noise so they can concentrate.
The patch, often known by its brand name XELSTRYM, is simply a different way to deliver this medication. It provides a steady, consistent dose through the skin over several hours. This can be a great option for kids (and adults!) who have trouble swallowing pills or for whom a smooth, all-day effect is beneficial.
Before We Start: Our Safety Checklist
Before we decide if this is the right path, I need to know a bit about your (or your child’s) health history. It’s a team effort, and your insights are crucial. We need to talk openly if any of these are part of your story:
- Heart Health: Any history of high blood pressure, heart disease, a past heart attack, or a stroke.
- Mental Health: A history of anxiety, panic attacks, depression, suicidal thoughts, or other mental health conditions like Tourette’s syndrome.
- Circulation Issues: Problems like Raynaud’s disease, where fingers and toes get cold or numb.
- Other Medical Conditions: Things like glaucoma, seizures, or kidney or liver disease.
- Substance Use History: Any past struggles with alcohol or drug dependency.
- Allergies: Any known allergic reaction to dextroamphetamine, other stimulants, or even the adhesives in bandages or patches.
- Pregnancy or Breastfeeding: If you are pregnant, planning to become pregnant, or are currently breastfeeding.
This isn’t to be nosy; it’s to make sure we’re choosing the safest, most effective treatment possible.
How to Use the Patch Correctly
Using the patch is straightforward once you get the hang of it. Think of it like a high-tech sticker.
- Apply it two hours before you need it to start working. For a school day, this might mean putting it on right after waking up.
- Find a good spot. Choose a clean, dry, hairless area of skin on the hip, upper arm, chest, flank (side of the torso), or upper back.
- Rotate the spot every day. Don’t put a new patch where an old one was. This gives the skin a break and prevents irritation. Avoid areas that are oily, injured, irritated, or right on the waistline where clothes could rub it off.
- Press and hold. Once you’ve placed the patch, press down firmly with the palm of your hand for about 30 seconds to make sure it’s sealed well.
- Wash your hands after applying it.
- Remove it after 9 hours. Don’t wear it longer. To dispose of it, fold the sticky sides together and throw it away in a trash can with a lid, safely away from kids and pets.
What if it falls off? You can apply a new patch to a different spot. Just remember to take the new one off at the original, scheduled time. Don’t extend the wear time.
What if you forget to put it on in the morning? You can still apply it later. But again, stick to the original removal time to avoid it interfering with sleep.
Important Interactions to Be Aware Of
This medication doesn’t always play well with others. It’s vital that I have a complete list of everything you or your child takes—prescriptions, over-the-counter meds, herbs, and supplements. Here are the big ones to watch out for.
| Medication Group | Why It’s a Concern & What to Do |
|---|---|
| DO NOT TAKE With These Medications | |
| MAOIs (like Carbex, Marplan, Nardil) | This is a dangerous combination that can cause a severe, life-threatening spike in blood pressure. You must stop taking an MAOI for 14 days before starting this patch. |
| Other Stimulants | Combining stimulants can overtax the heart and increase the risk of side effects. We need to choose one primary treatment. |
| Discuss With Me Before Combining | |
| Antidepressants (especially SSRIs/SNRIs) | Can increase the risk of a rare but serious condition called Serotonin Syndrome. We need to monitor you closely for symptoms like confusion, rapid heartbeat, and muscle twitching. |
| Blood Pressure Medications | This patch can increase blood pressure, potentially making your blood pressure medicine less effective. We’ll need to check your BP regularly. |
| Medications that change urine pH (like Sodium Bicarbonate, Ascorbic Acid/Vitamin C) | These can affect how quickly your body gets rid of the medication, either increasing or decreasing its effect. It’s a bit of a balancing act. |
Possible Side Effects: When to Call Me
Every medication has potential side effects. Our goal is to find a dose that gives us the benefits without too many downsides. Here’s a breakdown of what to look for.
| What You Might See | My Advice (When to Call) |
|---|---|
| Call My Office or Seek Urgent Care Right Away | |
| Signs of an Allergic Reaction (hives, rash, swelling of face/tongue) | This is an emergency. Remove the patch and seek immediate medical help. |
| Heart Changes (fast/irregular heartbeat, chest pain, dizziness) | Call me immediately. We need to check on your heart. |
| Sudden Severe Mood/Behavior Changes (hallucinations, severe anxiety, thoughts of self-harm) | This is very serious. Call me or go to the nearest emergency room. |
| Signs of a Stroke (sudden numbness, weakness, confusion, trouble speaking) | Call 911. This is a medical emergency. |
| Let’s Chat if These Continue or Are Bothersome | |
| Loss of appetite / Weight loss | Very common. Try having a good breakfast before applying the patch and a healthy dinner after it comes off. If weight loss continues, we need to talk. |
| Trouble sleeping | Make sure you’re removing the patch after 9 hours and not too late in the evening. If it persists, let me know. |
| Headache, Nausea, or Stomach Pain | These often get better as the body adjusts. If they stick around for more than a week or two, give my office a call. |
| Irritation at the patch site | Make sure you’re rotating sites daily. A little redness is common, but if it’s blistering or very painful, let’s talk. |
Take-Home Message
I know this is a lot of information. If you remember anything, let it be these key points:
- Partnership is Key: This is a controlled substance, and for good reason. We will work together closely, with regular check-ins to monitor progress and safety.
- Application Matters: Always apply the patch to a clean, dry, rotated site and remove it after 9 hours to ensure it works correctly and doesn’t interfere with sleep.
- Heat is a Factor: Avoid direct heat on the patch (heating pads, hot tubs, saunas) as it can cause too much medicine to be released at once.
- Monitor Mood and Heart: Keep an eye out for any changes in mood, behavior, or any heart-related symptoms like a racing pulse or chest pain. These are our most important safety signals.
- Keep it Safe: Store and dispose of Dextroamphetamine patches securely, out of reach of children, pets, or anyone for whom it is not prescribed.
Starting a new medication can feel like a big step, but you’re not doing it alone. We’re in this together. We’ll find the right balance to help you or your child feel more focused, in control, and ready to thrive. You’ve got this.