Comparing and Contrasting Concerta and Adderall

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Concerta and Adderall are two very common prescription medications used to treat attention deficit hyperactive disorder (ADHD) and excessive sleepiness associated with narcolepsy.

They are both stimulants and work to treat ADHD by reducing hyperactivity and impulsive actions and increasing alertness in individuals with ADHD or narcolepsy. This article provides an overview of the differences between Concerta and Adderall.

What Is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a developmental condition of inattention and distractibility, with or without accompanying hyperactivity. Individuals with ADHD struggle with impulsivity, forgetfulness, and lack of focus in every area of their life, including school, work, relationships, and family life. 

There are three different subtypes of ADHD that are characterized by specific predominating symptoms:

  1. Predominately hyperactive-impulsive: This includes restless behaviors, fidgeting, talking constantly, blurting out inappropriate comments, and impatience.
  2. Predominately inattentive: Trouble following directions, easily distracted, difficulty organizing thoughts and learning new things, trouble focusing on a single task, daydreaming and not listening.
  3. Combined: Symptoms don’t exclusively fall within the inattention or hyperactive-impulsive behavior, but rather a combination of symptoms from both of the categories is exhibited.

Abusing Concerta and Adderall

Unfortunately, Concerta and Adderall are considered drugs of abuse due to their stimulating effects. Both of these medications, as well as other prescription medications in the amphetamine class, are often termed “smart drugs” and “study drugs.”

Both medications are controlled substances meaning that they are regulated by the Drug Enforcement Administration (DEA) because they do have the potential for misuse and abuse. 

“Smart drugs” and “study drugs” are more than a chemical escape hatch from reality. Individuals commonly abuse them as a way to boost the brain’s ability to think under stress, stay alert, be productive for long hours, and keep track of large amounts of information.

Are Concerta and Adderall Addictive?

Yes, stimulants work to re-wire the brain by releasing more neurotransmitters, specifically dopamine, that increase alertness in both the mind and the body.

Dopamine helps you focus, but it also triggers feelings of pleasure. Too much can make you feel intense excitement and happiness, and eventually, you may desire to increase the dosage in order to mimic this feeling of euphoria.

Over time, the brain and body become used to this, and when you stop taking these medications, your body will crash. You will feel sluggish, irritable, depressed, disconnected, and may even struggle with sleep and concentration problems. In other words, your body and brain will go into withdrawals once you stop taking the study drugs.  

Withdrawal Symptoms

Since these drugs are technically drugs of abuse when taken incorrectly, they can have withdrawal effects when they are suddenly discontinued. The effects include the following:

  • Depression, irritability, or other changes in mood
  • Difficulty sleeping
  • Fatigue
  • Nausea
  • Stomach pain
  • Vomiting

Occasionally, symptoms of stimulant withdrawal can make you seem hungover or intoxicated. Again, this happens more often with people who don’t use these medications as directed.

Concerta

Methylphenidate is the active ingredient in Concerta and is considered a stimulant but is different from amphetamine which is the active ingredient in Ritalin (another medication used to treat ADHD).

The FDA classifies methylphenidate as a Schedule II controlled substance. So while it has therapeutic value, it also has a potential for abuse.

Methylphenidate is often confused with amphetamine not only because it sounds similar phonetically but also because it has the same dopamine and norepinephrine releasing properties as amphetamine. On a urine drug screen, individuals taking medications with the active ingredient methylphenidate such as Concerta will not test positive for amphetamines.

Methylphenidate has a lower addiction potential compared to amphetamine, and therefore many physicians believe that Concerta is less addictive than Adderall. 

Dosage

Concerta dosage depends on whether an individual is currently taking a form of methylphenidate. Depending on the current dosage, the starting dose of methylphenidate will be titrated appropriately.

If the individual is already on a higher dose of methylphenidate, then the starting dose of Concerta will be higher as well because the individual most likely already has a tolerance.

Tolerance occurs when an individual no longer responds to a drug or medication in the way they initially did at the starting dosage. Therefore it takes a higher dose of the drug or medication to achieve the same effect as when the individual initially started.

If an individual is not currently taking a form of amphetamine, then the initial dose of Concerta is 18 mg per day for both children and teenagers and 18 mg per day or 36 mg per day for adults. This is generally a lower dose compared to an individual currently on methylphenidate since these individuals are new users and have not developed a tolerance. 

Concerta is available in extended-release tablets. The medicine enters into your system slowly, and the effects can last up to 12 hours. One pill in the morning is meant to help manage your ADHD symptoms throughout the entire school or workday.

Adderall

Adderall is the brand name for a mix of two stimulants called amphetamine-dextroamphetamine. The main difference between Adderall and Concerta, besides the active ingredients, is the form of release.

Concerta is only available in extended-release tablets, whereas Adderall is available in two different forms: an immediate-release version (Adderall, although sometimes referred to as “Adderall IR”) and an extended-release version (Adderall XR).

Adderall IR treats ADHD symptoms for about five to eight hours, whereas Adderall XR typically lasts for 10 to 12 hours.

Side Effects

Both Adderall and Concerta are stimulant-based medications and therefore will have common side effects. The most common side effects of Adderall and Concerta include the following:

  • Headaches
  • Loss of appetite
  • Trouble sleeping
  • Weight loss
  • Nausea
  • Irritability
  • Anxiety
  • Abdominal pain

Unfortunately, both Concerta and Adderall, like all other stimulants, can potentially lead to an increased chance of stroke, heart problems, circulation problems in the fingers and toes, and blurred vision. Like with any medication, you should always consult with your physician before taking ADHD medication.

If side effects do occur, it is important to discuss this with your healthcare provider immediately. 

If you or a loved one are struggling with addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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  1. https://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-treatment-with-medications