CNS stimulant
Promotes release of dopamine and norepinephrine and inhibits their reuptake, increasing synaptic concentrations and enhancing attention and alertness
Attention-deficit/hyperactivity disorder (ADHD), narcolepsy
Augmentation in treatment-resistant depression; management of cancer-related fatigue; treatment of apathy or executive dysfunction in Parkinson’s disease (PD), post-stroke cognitive impairment, and dementia
Immediate-release (IR) tablets, extended-release (XR) oral capsules
IR: 5 mg p.o. in the morning, titrated as tolerated; XR: 10 mg daily, titrated as tolerated (typical dose range 5–40 mg/day)
5–40 mg/day (individualized by clinical response and formulation)
Half-life ~9–14 hours; metabolized hepatically; IR requires multiple daily doses, XR allows once-daily dosing
Decreased appetite, insomnia, anxiety, dry mouth, headache, weight loss, elevated blood pressure and heart rate, abdominal discomfort
Potential for misuse, abuse, and dependence; cardiovascular events (rare)
Periodic assessment of blood pressure, heart rate, sleep, mood, and risk of misuse or abuse
Risk of abuse and dependence; careful assessment recommended
May be used cautiously as augmentation in mood disorders or to address fatigue, apathy, or slowed cognitive processing in PD, post-stroke, or dementia, though evidence is limited. Use with caution in elderly patients and avoid in individuals with uncontrolled hypertension, cardiac arrhythmias, or a history of substance use disorder. Regular monitoring of cardiovascular status, psychiatric symptoms, and misuse risk is recommended.