As sustained methylphenidate becomes available in the United Kingdom,
there is likely to be considerable demand related to the difficulties that
frequently arise with standard methylphenidate due to the need for midday
doses at school, as well as the pronounced ‘on/off’ therapeutic effects
sometimes seen with multiple doses. This article briefly discusses longer
acting stimulants, reviews the available literature, anticipates possible
problems in the use of slow release methylphenidate, and presents clinical
guidelines for its use.