A slow-release amphetamine, active for most of a waking day. In adults with the attention and impulse-control condition it treats, it produces the largest symptom reduction of any drug compared against it, and it is the only medicine approved for severe binge eating. Benefits stop when the drug stops. Sleep shortens, appetite falls, pulse and blood pressure sit higher. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Seated blood pressure | 110–125 / 65–80 mm Hg | Cumulative hypertension, the most consistent risk |
| Resting heart rate | 55–70 beats per minute | Sympathetic load; a rise signals excess dose |
| Body weight and BMI | Stable within 2% of pre-treatment weight | Silent energy and lean-mass loss |
| Ferritin | 50–100 ng/mL | Dopamine cofactor; low stores blunt response |
| HbA1c | 4.8–5.4% | Glucose dysregulation in binge eating and obesity |
| Fasting lipid panel with ApoB | ApoB below 80 mg/dL | Cardiovascular risk compounds with pressure rise |
| TSH with free T4 | TSH 0.5–2.0 mIU/L | Mimics stimulant effects; absolute exclusion |
| hs-CRP | Below 1.0 mg/L | Contextualises ferritin and cardiovascular risk |
| ECG QTc interval | Below 440 ms in men, 460 ms in women | Conduction abnormalities raise stimulant danger |
Cadence: Blood pressure, pulse and weight at each titration step, four weeks after a stable dose, then every three to six months; blood panel annually; symptom and functional review at three months, then yearly.