Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in the United States. It starts in early childhood and can follow you into adulthood. It usually becomes apparent around school age as it starts to get in the way of completing tasks and doing well in school. But it can also cause other problems like social issues, isolation, anxiety, depression, and sleep issues.
While there is no cure for ADHD, it can be treated with behavioral therapies and medications. Many of the leading medications approved to treat ADHD are central nervous stimulants that can increase the levels of rewarding and motivating chemicals like dopamine. Two of these drugs are sold under the brand names Concerta and Vyvanse. Both of these drugs are long-acting stimulant medications used to treat ADHD. But how do they compare, and which one is better for treating attention problems? Learn more about Concerta and Vyvanse and how they compare.
What Is Concerta?
Concerta is a brand name for a drug called methylphenidate, which is also sold under the brand name Ritalin. Methylphenidate was first synthesized in the 1940s and was later patented in 1954. It was first sold as Ritalin in the United States and was marketed for the treatment of narcolepsy, fatigue, depression, and behavioral problems in children.
Concerta is used to treat ADHD symptoms in adults and children that are at least 6 years old. Concerta is different from Ritalin because it provides an extended-release form of methylphenidate and only needs to be taken once per day. Because it’s only taken once a day, it may be preferred by older adolescents and adults over Ritalin. Concerta is a prescription drug that requires a doctor’s recommendation to use.
Methylphenidate is a central nervous system stimulant, which means it works to increase activity in your brain and nervous system. This can be helpful for people with attention problems like ADHD, but it may not be safe for everyone, especially people who are taking other medications like MAOI inhibitors and those with issues that cause muscle spasms or seizures.
How Does Concerta Work?
As a stimulant, methylphenidate works to increase nervous system activity by interacting with some key chemicals in the brain. They specifically work with the two neurotransmitters dopamine and norepinephrine. Dopamine is a neurotransmitter that’s tied to mood and pleasure, and motivation. Norepinephrine works to increase your heart rate and blood pressure, which can lead to increased alertness and energy levels. Methylphenidate increases the levels of these chemicals in your brain by blocking reuptake, which is a process when a chemical is removed from your system and recycled to prevent an excessive buildup. In people with ADHD, this buildup may be helpful.
It’s thought that low levels of dopamine are the cause of some ADHD symptoms. Dopamine is important for reward and motivation, so low levels of it may make it difficult to get through certain tasks without getting distracted. As an extended-release drug, Concerta is specially formulated to release small amounts of a large dose over time after you take the pill. This ideally relieves ADHD symptoms over a day rather than just a few hours.
What Is Vyvanse?
Vyvanse is a brand name for a drug called lisdexamfetamine, which is also a central nervous stimulant medication that’s used to treat ADHD. It’s a derivative of amphetamine, which is another stimulant used to treat ADHD and sold under the brand name Adderall. Like Concerta, Vyvanse is approved to treat ADHD in adults and children who are at least 6 years old. It’s also approved to treat binge eating disorders because it can suppress your appetite like some other stimulants.
Vyvanse is also taken once per day, but it’s not an extended-release formula. Instead, it’s a naturally long-lasting drug, and its focus-increasing effects can last up to 14 hours.
How Does Vyvanse Work?
Lisdexamfetamine is actually an inactive substance on its own. However, it’s a prodrug, which means it can convert into other chemicals as it’s broken down in the body, and those chemicals have active effects. It breaks down into another chemical called dextroamphetamine. Dextroamphetamine is also sold on its own under the name Dexedrine for the treatment of ADHD. Dextroamphetamine has a long half-life of up to 10 to 12 hours. That means it takes your body that long to reduce the drug’s concentration in your bloodstream by half. This long half-life contributes to Vyvanse’s long duration of action.
Main Differences and Similarities Between Vyvanse, Concerta
One of the main differences between Vyvanse and Concerta is their different natures when they enter the body. Concerta is immediately active, while Vyvanse is a prodrug that becomes active when it’s broken down into other chemicals. Concerta is an extended-release drug that’s designed to deliver medication over several hours. While
Vyvanse is a long-acting drug. It’s not designed to release the drug gradually over that time, so the experience may be different, and the effects may be weaker after several hours. The extended-release formulation of Concerta may make it more dangerous when abused. Biting or crushing the drug may compromise its ability to release the drug over time, and instead deliver a high dose all at once.
Which Is Better for ADHD?
Neither drug is clearly more effective than the other, but you may respond to one better than the other. When you start taking a prescription drug, it’s important to realize there is no magic bullet for ADHD. In many cases, patients need to work with their doctor to find the right medication and dose for their needs. Two different people may respond to Vyvanse and Concerta differently.
You may experience uncomfortable side effects and fewer positive effects on one and find that the other offers more benefits. For that reason, it’s important to work with your doctor and let them know how effective the medication is at addressing your ADHD symptoms. You should also make a note of new, persistent, or worsening symptoms. You may be able to adjust your dose or switch medications to avoid uncomfortable side effects.
What Are the Side Effects of Concerta and Vyvanse?
Stimulants like Concerta and Vyvanse have several common side effects, most of which are mild and well-tolerated at normal therapeutic doses. Both drugs have a similar side effects profile. Some of the most common side effects include:
- Decreased appetite
- Dry mouth
- Sleep problems
- Increased sweating
- Weight loss
In some cases, stimulants like Concerta and Vyvanse can cause some more disturbing symptoms.
Stimulants like the ones included in Vyvanse and Concerta have been associated with psychosis. Stimulant psychosis is a set of psychotic symptoms that are temporarily induced in people that take stimulants in high doses. This can include hallucinations and delusions. For most people, stimulant psychosis goes away when the drug wears off, but people that are at high risk for psychotic disorders like schizophrenia may be more vulnerable to longer-lasting psychosis when taking stimulants.
Do Concerta and Vyvanse Have Misuse Potential?
Methylphenidate and lisdexamfetamine are both Schedule II drugs in the United States. That means the federal government recognizes that these controlled substances have significant abuse potential along with some legitimate medical uses.
Prescription stimulant drugs are often misused and abused for several purposes. Recreational users seek a stimulating high similar to the effects of cocaine. While Concerta and Vyvanse can cause pleasurable stimulating effects, they don’t cause the intense pleasure that cocaine or methamphetamines can. Higher doses that can cause a euphoric high can also cause unpleasant symptoms like anxiety, tremors, heart palpitations, and insomnia.
The Food and Drug Administration (FDA) warns that doctors should be cautious about prescribing Concerta to patients with a history of substance use disorders. They also reported that Concerta was shown to have a higher abuse potential than placebos. However, it also had the same or lower abuse potential when compared to immediate-release methylphenidate.
The FDA also offers similar warnings for Vyvanse and suggests that patients be assessed for their history of drug abuse and substance use problems before taking Vyvanse. Both drugs can cause chemical dependence after a long period of consistent use, especially if you engage in recreational use.
Chemical dependence can cause tolerance and the potential for uncomfortable withdrawal symptoms. When you try to cut back or quit, you may experience depression, fatigue, nausea, and other symptoms. These uncomfortable symptoms may make it difficult to stop using a drug.
ADHD medications are often misused as performance-enhancing substances. Stimulants have been used on college campuses as a way to increase alertness and mental capacity to increase test scores and study ability.
Stimulants can help you remain alert and awake through long study sessions and all-nighters, but it’s unclear whether stimulants can give a cognitive boost to people that don’t have ADHD or attention problems. However, misusing the drug in this way can increase your risk for negative side effects, overdose, and chemical dependency.