When it comes to health care, it’s important to remember that medicine is not an exact science, and receiving a diagnosis is only half the battle.
Following a diagnosis, there are usually several treatment options available for the doctor to recommend.
Each medication a doctor may consider has small but meaningful differences that will have an impact on they are used to treat people and how effective they may be for individual patients.
A great example of this is the case of Concerta vs. Adderall.
These are just two of the drugs that may be used to treat a patient with attention deficit disorder (ADD). However, they are not the same drug, and they may not be used in the same way to treat a patient with ADD.
Part of the reason why there are so many different types of medications for ADD is that the disease can take on several different forms.
The symptoms of ADD can vary from one patient to another, as can the severity of the disease. There’s also little clarity in what causes the disease. Simply defining and diagnosing ADD can be a challenge, on top of finding the right medication to treat it.
The exact cause of ADD is unknown, although most scientists feel comfortable in asserting that the disease is genetic (1). There are often misconceptions that environmental factors, including parents and teachers, may be the cause of ADD. But this is not the case (1).
ADD is the result of a chemical imbalance of neurotransmitters in the brain that regulate behavior, something that would not be affected by environmental factors (1).
While diagnosing ADD may not be an exact science, there are certain criteria and symptoms that doctors look for in patients. The primary symptoms of the disease are inattention, hyperactivity, and impulsivity (1). Each symptom has specific behavioral traits that can indicate ADD during the diagnosing process.
Despite all the variables in diagnosing ADD and the difficulty in understanding the origins of the disease, scientists do feel confident in classifying ADD as a neurological condition (1). Thus, drugs like Concerta and Adderall, among others, are potential treatments to help alleviate symptoms. Let’s look at some of the similarities and differences between Concerta and Adderall regarding treating ADD.
Concerta, which also goes by the generic name Methylphenidate, is one possible treatment option for a diagnosis of ADD, which is officially called attention deficit hyperactivity disorder (ADHD) (9). The drug serves as a stimulant for the central nervous system (8). It’s designed to have a positive effect on the chemicals and neurotransmitters that help control impulses and behavior (8).
If effective, Concerta will help to improve many of the symptoms associated with ADD. It may help a person to pay attention or stay focused on a single activity; in turn, improving behavior (9). It may also assist the patient in becoming a better listener and staying organized (9), two things those with ADD may have difficulty doing.
Concerta can also be used to treat narcolepsy, which is a sleep disorder unrelated to ADD (8). Off-label use of Concerta has also been known to happen. However, ADD remains the primary reason why a doctor would prescribe Concerta.
Like Concerta, Adderall is classified as a stimulant and is most commonly prescribed as a treatment for ADD (2). Adderall is comprised of a combination of combination of amphetamine and dextroamphetamine, which both act as stimulants on the central nervous system (3). It’s widely known as a drug that helps children with ADD to stay focused in school while also helping to alleviate any behavioral issues (2).
Also, like Concerta, Adderall is sometimes used to treat narcolepsy (2). By stimulating the central nervous system, a person who suffers from narcolepsy is better able to remain focused and attentive, much like someone with ADD. This helps prevent a person with narcolepsy from spontaneously falling asleep in the middle of the day (2).
However, it’s not pertinent to use Adderall simply to stay awake (2). The drug is intended to assist those with ADD or sleep disorders like narcolepsy, and those who don’t suffer from such conditions shouldn’t take the drug (2). Of course, off-label use of Adderall is common, as it is sometimes used to treat depression and obesity (2).
Concerta may be prescribed to treat someone with ADD. Of course, as is the case with all drugs, the prescribing physician will weigh several factors before deciding that Concerta is the right treatment. Concerta may have a bad reaction with other types of medication or people who have been diagnosed with conditions aside from ADD (6).
Concerta should not be taken by someone with Tourette’s syndrome or someone with a family history of Tourette’s syndrome (6). Suffering from any kind of tics that may resemble symptoms of Tourette’s syndrome is also a red flag regarding prescribing Concerta (6).
In addition, patients who suffer from glaucoma should not take Concerta (8). The same is true for people who experience high levels of anxiety or are easily agitated (8). Anyone who has taken a MAO inhibitor within the past two weeks should not use Concerta (8).
A doctor should also know about a patient’s medical history regarding blood pressure and heart conditions before prescribing Concerta. The drug may affect heart health of blood pressure, both of which should be monitored during treatment (6).
Finally, Concerta is potentially habit forming (8), so it should not be prescribed to someone who has a history of becoming dependent on drugs. Concerta should also not be shared with someone for whom the drug was not prescribed (8). Doctors prescribe a specific regimen for each individual patient, so taking another person’s prescription, even of the same drug, can be harmful.
Much like Concerta, Adderall will only be prescribed once a doctor has confirmed that a patient has ADD and would benefit from using the medication (4). Through a series of tests, doctors will typically rule out other types of mental disorders (4). This helps prevent patients, particularly young children, from taking Adderall and other drugs if they don’t need them.
In most cases, Adderall and other drugs are only part of the treatment plan for someone diagnosed with ADD (4). Often, psychological, educational, or social treatment are used to complement the use of Adderall (4). Such treatments recognize that Adderall is not necessarily a permanent solution to treating ADD.
As is the case with Concerta, there are certain criteria that may disqualify someone from being prescribed Adderall. In most instances, they are the same condition. People who suffer from glaucoma, severe anxiety, an overactive thyroid, or high blood pressure should not take Adderall (3). The drug is also not safe for those who have taken a MAO inhibitor within the past two weeks (3).
The prescribing doctor should also be told about any family history depression or mental illness, epilepsy or other conditions that cause seizures, circulation problems, or muscle twitches like those associated with Tourette’s syndrome (3). Patients with a family history of these issue or heart problems may not be good candidates to take Adderall.
Adderall, like Concerta, can be habit forming (3). A person with a history of drug abuse should not take Adderall (3). Taking more than the prescribed dosage or giving the drug to anyone other than the person to whom it was prescribed can be problematic on a few levels (4).
Concerta comes in the form of an extended-release tablet (8). It is generally taken orally once per day, as the tablet will release the stimulant into the body over the course of the day (8). It may be taken with or without food and is most effective when taken at the same time each day (9), especially in the morning. With Concerta being a stimulant, taking the medication late in the day can cause the patient to have trouble sleeping (9).
Each tablet of Concerta should be swallowed along with an 8-ounce glass of water (9). The tablet should not be crushed or chewed, as this will cause the drug to be released into the body all at once, increasing the risk of harmful side effects (9). The table should also not be cut in half unless directed to by a pharmacist (9).
Doctors can prescribe a wide variety of dosages of Concerta, depending on a variety of factors (10). The lowest dosage that doctors will typically prescribe is 18 mg once per day (10). That amount may be increased to 27, 36, 54, or 72 mg per day (10). Adults taking the drug are more likely to receive a higher dosage than children (6). Patients with other health conditions or who are more at risk of side effects may receive a smaller dosage (6).
It usually takes the drug four to six hours to reach its peak before a gradual decline that lasts over the next several hours (10). The fact that it takes Concerta a few hours to make a noticeable difference in the patient means that a short-acting stimulant is sometimes needed to help supplement the dosage of Concerta (10).
A patient’s dosage of Concerta may also be changed over the course of treatment (9). It’s common for doctors to start a patient on a smaller dosage of Concerta and gradually increase the dosage as their body adjusts to the drug (9). A doctor may also stop treatment of the drug as a way to test its effectiveness at alleviating a patient’s symptoms of ADD (8).
However, a patient should not cease taking Concerta suddenly without a doctor’s permission (9). Long-term use of Concerta can cause potentially withdrawal symptoms if the drug is suddenly stopped (9). Concerta may also become less effective if it’s used over a long period of time (9). As always, it’s best to consult with a doctor with any questions or concerns related to the effectiveness of the medication.
Unlike Concerta and some of the other medications that may be used to treat ADD, Adderall may need to be taken more than once per day. Most patients will be prescribed between one and three doses per day (2). Regardless of many doses a doctor prescribes, the first dose should usually be taken in the morning, with any subsequent doses taken four to six hours apart (2).
Much like Concerta, if Adderall is taken too late in the day, it can lead to sleeping problems at night because the brain will be over-stimulated (2). This makes it more important for patients to develop a set schedule for when they take each dose so they can avoid missing a dose (2).
Adderall comes in several dosages, ranging from 5 mg all the way up to 30 mg (4). Most patients will typically begin by taking 10 mg per day (3). At the discretion of their physician, they may increase their dose in 10 mg increments one week at a time all the way up to 60 mg per day (3). Of course, patients who are taking 60 mg of Adderall per day will spread it out over two or three doses.
Younger patients, meaning those between the ages of six and 12, are more likely to begin by taking 5 mg per day (3). They will then increase their dose at 5 mg per week but will retain the maximum daily dosage of 60 mg (3).
Not all patients will reach the maximum dosage of 60 mg (2). It’s common for doctors to adjust the dosage they prescribe until they discover the right amount for each individual patient (2). It’s also common for doctors to stop treating with Adderall so they can determine if symptoms of ADD are still present without the medication (2). But much like Concerta, a doctor may advise gradually reducing the dosage instead of stopping Adderall suddenly (2).
As mentioned earlier, there are a number of symptoms that accompany patients with ADD, particularly children. Inattention is one of the primary symptoms and can manifest in failing to pay attention to details, not listening when spoken to, difficulty staying organized, and not following through on tasks, among other indicators (1).
Hyperactivity is also a sign of ADD. This may manifest in fidgety behavior, the inability to stay seated when appropriate, excessive talking, or difficulty remaining engaged in quiet activities (1). Impulsivity is also a common trait for those with ADD and can manifest in the form of interrupting others or not waiting for one’s own turn in an activity (1).
Obviously, if any of these symptoms persist for an extended period, they can make it difficult to function properly, particularly for children. Young kids with ADD can often have difficulty completing school work, behaving properly in school, and even getting along with others, as their impulses can disrupt themselves and others over the course of the day.
Concerta has been shown to have a positive impact on many of the symptoms that may plague someone with ADD. As a stimulant, it may sound surprising to hear that Concerta can reduce hyperactivity and impulsivity, as they tend to make people more active and alert (7). However, with the proper dose, stimulants like Concerta can have the desired effect on patients with ADD (7).
Concerta works to stimulate chemicals in the brain like dopamine and noradrenaline that help to control a person’s attention and behavior (7). The chemical imbalances associated with ADD cause these parts of the brain to be less active than they should be (7). Thus, by Concerta stimulating these parts of the brain, the chemical imbalance within the brain can be normalized (7).
There’s no guarantee that Concerta will have the desired effect in every person with ADD. However, by stimulating parts of the brain that may play a role in hyperactivity and behavioral issues, Concerta can play a role in helping a child reduce their impulsivity and inattentiveness (7). This can result is more focus and better listening and organizing skills (9).
Adderall is designed to curb many of the same symptoms of ADD as Concerta and in very much the same way. As a stimulant, Adderall helps to activate neurotransmitters like dopamine and noradrenaline (5). When these chemicals are brought back into balance with the rest of the brain, it can help control impulses and help a person stay focused on a single task for an extended period (5).
As is the case with Concerta, there are no guarantees that Adderall will be effective for all people. This is in large part because the science isn’t completely understood (5). However, there’s enough evidence to suggest that Adderall can be effective in helping to control many of the impulsive, inattentive, and behavior issues those with ADD often exhibit.
Obviously, the greatest benefit of Concerta is the ability to help curb the symptoms of ADD. The disease not only interferes with one’s life on a daily basis, but it can also be frustrating, especially for children who may not understand why they can’t control their impulses. By curbing many of the symptoms of ADD, Concerta can help those with the disease stay focused and feel more comfortable in social situations.
In addition to the obvious benefit, the extended-release nature of Concerta can also be helpful to patients who are prescribed the drug. The extended-release tablet allows the drug to be released over the course of several hours (8). This helps Concerta to remain effective in patients throughout the day without suffering highs and lows that can cause some of the symptoms of ADD to manifest at times and disappear at other times.
Concerta is also taken just once per day, as opposed to Adderall, which may have up to three doses for a patient to take (2). This makes it easier for a patient to make it part of his or her daily routine. Taking Concerta at the same time each day without missing a dose helps to enhance its effectiveness (8), so being able to stick to a regular schedule can be a great benefit to the patient.
Adderall has many of the same benefits as Concerta with regard to helping curb the symptoms of a frustrating disease that can offer interfere with a patient’s day-to-day life. Adderall is also one of the most commonly prescribed medications for treating ADD (2). This gives the drug a certain degree of credibility for helping both children and adults keep their impulsive behavior under control.
Aside from its more general treatment of ADD, one of the top benefits of Adderall is that it’s an instant-release medication (5). This is one way that Adderall is distinct from Concerta, which is an extended-release tablet. With an instant release drug like Adderall, the patient will begin feeling the effects of the drug within one to three hours, with the drug peaking around three hours after the patient takes the dose (5).
Once a patient begins to learn what kind of effect Adderall has on them, they can start to plan their doses appropriately. For instance, knowing the drug will start to kick in within an hour will enable them to take their first dose of the day to coincide with when they need to be attentive and focused. Knowing this can have obvious advantages for ADD patients being treated with Adderall.
Like all other drugs, Concerta is not without potential side effects. However, it the medication was prescribed, it means that a doctor weighed the potential side effects against the benefits of taking the medication and determined that it’s worthwhile for the patient to start using the drug. Nevertheless, it’s always important to be cognizant of the potential side effects of a medication.
The most common side effects of Concerta are insomnia, nausea, lack of appetite, and dry mouth (8). As mentioned, insomnia is more likely if the drug is taken late in the day, making it a side effect that’s easy to avoid. It’s also possible to experience weight loss, vomiting, or headaches while taking Concerta (9). If any of these side effects persist, a doctor or pharmacist should be consulted as soon as possible.
One innocuous occurrence to be aware of with Concerta is the appearance of the drug’s empty tablet shell in your stool (9). This is an odd side effect but perfectly harmless. Your body will have already absorbed the medication but left the empty shell to be removed as waste (9).
As mentioned earlier, Concerta has been known to have an impact on a patient’s heart health and blood pressure. Thus, it’s important to notify a doctor right away upon experience numbness, changes in skin color, or other symptoms that could signal blood flow problems (9). The same is true for unusual wounds, an irregular heartbeat, uncontrolled twitching, changes in vision, or abnormal mood swings (9).
Serious allergic reactions to Concerta are rare but possible (9). Symptoms include a rash, swelling of the tongue or throat, severe dizziness, and trouble breathing and require immediate medical attention (9). Immediate medical help is also necessary for patients experiencing signs of a heart attack or stroke, or those who experience fainting or a seizure.
Adderall, like all drugs, is not without potential side effects, many of which are similar to those possible with Concerta. Using Adderall as directed and taking the appropriate dose should help to minimize side effects (2). However, as with all drugs, it’s important to be aware of the potential side effects of a medication.
The most common side effects associated with Adderall include loss of appetite, stomach pain, dry mouth, vomiting, dizziness, headache, nervousness, and trouble sleeping (2). As mentioned, trouble sleeping may be brought about by taking Adderall too late in the day, making it important to take each dosage at the appropriate time.
If any of these symptoms persist, including insomnia, it’s important to notify a medical professional as soon as possible (2). It’s also common for Adderall to raise a patient’s blood pressure (2). The prescribing doctor will be aware of this and will monitor blood pressure closely while a patient is taking Adderall.
Some of the more serious side effects of Adderall that require immediate medical intervention include bloody urine, painful urination, frequent urination, bladder pain, and an irregular heartbeat (3). The same is true for signs of an allergic reaction, which include rash, swelling of the tongue or throat, trouble breathing, and severe dizziness (2).
Adderall is also a potentially addictive substance, particularly if it’s not taken as directed or used recreationally (4). Even taking a larger dose than prescribed can lead to an addiction (4). Signs of Adderall abuse include a rash, insomnia, and abnormal personality changes, while serious abuse of Adderall can mimic the symptoms of schizophrenia (4).
Based on the information available, Concerta and Adderall share many similarities, and both have the potential to be an effective form of treatment for ADD. However, there are distinctions between the two that are important to consider when deciding what drug is best for a particular patient.
The biggest difference is that Concerta is an extended-release drug that’s taken once per day, while Adderall is fast-acting and may be taken up to three times per day. Concerta will likely have a steady and reliable effect over the course of a day, whereas Adderall may have more highs and lows but can be more targeted for short-term benefits.
Adderall also has more of a reputation, both good and bad. It has a longer track record of being used to treat ADD than Concerta. Of course, Adderall has also gained notoriety for being a recreational drug that leads to addiction and abuse, even though both drugs are potentially habit forming. For some people, that reputation could make them lean one way or another.
At the end of the day, the two drugs work in similar ways and are also quite similar regarding the risks and potential side effects. Under the right circumstances, either drug can curb the symptoms of ADD. However, like most medications, there is no guarantee with how it’ll impact each individual patient.