PharmaceuticalPsychostimulantADHD agentDopamine-norepinephrine reuptake inhibitor

Dexmethylphenidate

Also known as Focalin · Focalin XR · d-threo-methylphenidate

Written by enwyReviewed 5 Aug 20262 sources0 comments

Dexmethylphenidate (Focalin) is the pharmacologically active d-threo enantiomer of methylphenidate, approved for ADHD. Delivering the active isomer alone allows roughly half the milligram dose for comparable effect, with a large clinical evidence base inherited from decades of methylphenidate research.

01 Overview

Racemic methylphenidate contains d- and l-threo enantiomers, but nearly all central activity resides in the d-isomer. Dexmethylphenidate isolates that isomer, marketed as immediate-release Focalin and extended-release Focalin XR.

It is a Schedule II stimulant with efficacy and a side-effect profile essentially matching methylphenidate on a milligram-equivalent basis (about 2:1 potency). Abuse and diversion potential are those of any prescription psychostimulant.

02 Mechanism

Blocks the dopamine and norepinephrine transporters (DAT/NET), increasing synaptic catecholamines in striatal and prefrontal circuits; the d-threo isomer carries the transporter affinity.

03 Dosing

Tier	Dose	Route	Notes
IR	5–20 mg/day	Oral	Immediate-release, typically split BID; start 2.5 mg twice daily.

04 Effects

Effect	Magnitude	Evidence
Improved attentionReduced inattention and impulsivity in ADHD, comparable to racemic methylphenidate at half the dose.	n/a	Clinical
Increased alertnessHeightened wakefulness and task persistence.	n/a	Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Appetite suppressionReduced appetite that can affect growth in children.	Mild	Very common	Clinical
InsomniaDifficulty sleeping with late dosing.	Mild	Common	Clinical
Cardiovascular stimulationIncreased heart rate and blood pressure.	Moderate	Common	Clinical

06 Legal status

United States

Schedule II controlled

FDA-approved (Focalin/Focalin XR). · as of Jan 2026

United Kingdom

Class B, Schedule 2

As a methylphenidate isomer. · as of Jan 2026

07 References

Dexmethylphenidate hydrochloride in ADHDJ Am Acad Child Adolesc Psychiatry, 2002

Focalin XR FDA prescribing informationUS FDA

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.