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Adderall vs Concerta
Introduction
For patients dealing with Attention Deficit Hyperactivity Disorder (ADHD), certain drugs that modify the concentration of neurotransmitters in the brain, substances tied to attention and activity levels, can be paramount in managing symptoms. Adderall and Concerta are two such medications commonly prescribed for ADHD. Both impact different neurotransmitters in the brain but have similar effects on improving focus and reducing impulsivity in patients with ADHD. Adderall is an amphetamine that boosts levels of dopamine and norepinephrine, thus improving attention span while decreasing hyperactivity and impulsive behavior. Conversely, Concerta is a methylphenidate-based drug that also affects dopamine and norepinephrine concentrations but has a longer-lasting effect due to its extended-release formulation.
Adderall vs Concerta Side By Side
| Attribute | Adderall | Concerta |
|---|---|---|
| Brand Name | Adderall | Concerta |
| Contraindications | Should not be taken with MAO inhibitors within the past 14 days. May intensify symptoms of anxiety or agitation. | Should not be taken with MAO inhibitors within the past 14 days. May intensify symptoms of anxiety or agitation. |
| Cost | Approximately $760 for Adderall XR (20 mg), 30 capsule supply. Generic versions cost between $.75 - $3 per day. | Approximately $400 for 60 tablets of Concerta (27 mg). Generic versions range from $50-$200 for a month’s supply. |
| Generic Name | Amphetamine Salt Combo XR | Methylphenidate ER |
| Most Serious Side Effect | Increased risk of mental/mood changes, signs of blood circulation problems, rapid heartbeats causing chest pain. | Signs of allergic reaction, angina, increased blood pressure, psychosis, circulation problems, neurological issues. |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | Adults start at 5 mg once or twice daily, up to a usual maximum of 40-60 mg daily. Children 6-12 years start at 5 mg once or twice daily, up to a maximum of 30mg/day. | Initiated at 18-36 mg/day, taken orally once daily in the morning. Maximum recommended dose is 54 mg/day for children and adolescents, and up to 72 mg/day for adults. |
What is Adderall?
Adderall, the brand name for a mix of amphetamine salts, was first approved by the FDA in 1996. It marked a significant advancement in stimulant medication used for conditions such as ADHD and narcolepsy. Adderall works by increasing levels of dopamine and norepinephrine in the brain, effectively enhancing concentration and focus over extended periods.
On the other hand, Concerta (the proprietary name for Methylphenidate) is another major player amongst stimulants prescribed primarily for treating ADHD symptoms. Like Adderall, it increases dopamine and norepinephrine levels but does this more gradually through its unique slow-release mechanism, providing stable therapeutic effects with less risk of side effects.
While both drugs increase concentrations of these neurotransmitters to improve attention span and manage hyperactivity or impulsive behaviors better than earlier classes of medications could offer, they differ in their onset and duration times as well as potential side effects; hence each may be more suitable depending on individual patient needs.
What conditions is Adderall approved to treat?
Adderall is approved for the treatment of various attention disorders:
- Attention Deficit Hyperactivity Disorder (ADHD), in both children and adults
- Narcolepsy, a neurological disorder that causes excessive daytime sleepiness
- In some cases, it's used off-label to help with weight loss or to enhance cognitive performance.
Concerta also treats ADHD but is different from Adderall as it has a unique time-release system providing symptom control for up to 12 hours. It should not be used off-label for non-prescription purposes due to its potency and potential side effects.
How does Adderall help with these illnesses?
Adderall works to manage attention deficit hyperactivity disorder (ADHD) by increasing the levels of dopamine and norepinephrine in the synapses of the brain. It achieves this by promoting their release from neurons while also blocking their reuptake, thereby maintaining higher levels for a longer period. Dopamine and norepinephrine are neurotransmitters that play critical roles in attention, motivation, pleasure, and reward pathways among other things. They are thought to be imbalanced or deficient in individuals with ADHD. Therefore, by boosting these neurotransmitters' concentrations, Adderall can limit the negative effects of ADHD such as lack of focus or impulsivity and help patients better manage their condition.
Similarly, Concerta is used to treat ADHD but it primarily increases only norepinephrine's concentration along with a minor influence on dopamine levels. The increased availability of these chemicals helps improve symptoms associated with ADHD including attentiveness and impulse control. However, it's important to note that both drugs have different release mechanisms; while Adderall has an immediate effect after ingestion due to its instant-release property (there is also extended-release form available), Concerta maintains a steady level throughout the day due to its slow time-released property which may result in lesser side-effects like jitters or crashes often experienced when using stimulant medications.
What is Concerta?
Concerta is a brand name for methylphenidate, which is a central nervous system stimulant. It works by increasing levels of norepinephrine and dopamine in the brain by blocking their reabsorption into neurons. It also inhibits the action of another neurotransmitter, serotonin, at serotonin receptors. Methylphenidate was first approved by the FDA in 1955. As Concerta is not an amphetamine, it does not directly increase the release of dopamine and norepinephrine from neurons like Adderall. Its indirect action on these neurotransmitters means that its side-effect profile is also different to that of amphetamines, particularly in that it is less likely to cause a euphoric high and has a lower risk of misuse and addiction (common side effects of amphetamines such as Adderall). The effects on dopamine and norepinephrine can be beneficial for the treatment of attention deficit hyperactivity disorder (ADHD), especially in patients who do not respond well to the “typical” amphetamine-based stimulant drugs such as Adderall.
What conditions is Concerta approved to treat?
Concerta is a medication approved by the FDA for the treatment of conditions such as:
- Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents, and adults
- Narcolepsy, a condition characterized by excessive sleepiness and sudden attacks of sleep.
How does Concerta help with these illnesses?
Dopamine is a neurotransmitter that plays vital roles in the brain's reward system, motor control, motivation and working memory. Similar to norepinephrine, dopamine levels can significantly impact cognitive functions such as attention and focus. Concerta works by increasing the availability of dopamine in the brain, thereby enhancing alertness and productivity. This mechanism makes it an effective treatment for disorders like Attention Deficit Hyperactivity Disorder (ADHD). Its action on other neurotransmitters may also contribute to its effectiveness as a stimulant medication. Unlike Adderall which has immediate-release properties, Concerta releases gradually over time providing a long lasting effect without the need for multiple doses within the day. Hence it might be preferred when sustained attention throughout the day is required or when patients have difficulty adhering to multiple daily dosing schedules.
How effective are both Adderall and Concerta?
Both Adderall (a combination of amphetamine salts) and Concerta (methylphenidate) have established histories of effectiveness in treating Attention Deficit Hyperactivity Disorder (ADHD), and they were initially approved by the FDA only a few years apart. Since they act on different neurotransmitters, they may be prescribed under differing circumstances. The effectiveness of Adderall and Concerta in alleviating symptoms of ADHD was directly studied in several clinical trials; both drugs exhibited similar efficacy in managing these symptoms as well as similar, promising safety profiles.
A 2002 review demonstrated that Adderall is effective at reducing symptoms associated with ADHD from the first dose onwards, its side effect profile is comparable to other stimulant medications used for this condition, and it is generally well-tolerated across age groups. It has become one of the most widely-prescribed treatments for ADHD due to its rapid onset and extended duration of action.
On the other hand, a 2018 review indicated that Concerta seems to be more effective than placebo in treating ADHD while being similar in efficacy to other common stimulants like Adderall. Nonetheless, individual response can vary greatly between patients depending on multiple factors including genetics – therefore some people may respond better to Concerta or vice-versa. Notably though, methylphenidate-based treatments like Concerta tend not to induce as much appetite suppression compared to amphetamines such as Adderall.
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At what dose is Adderall typically prescribed?
Oral dosages of Adderall for adults typically start at 5 mg once or twice daily and can be increased in increments of 5 mg every week. The usual maximum dose is 40-60 mg daily. Children aged 6-12 years may be started on a dosage of 5 mg once or twice daily, which can also be gradually increased in weekly increments of 5mg per day up to a maximum of 30mg/day if needed. It's important to note that the response and tolerance level for each patient will vary, thus adjustments should only take place under medical supervision.
Concerta, on the other hand, has different dosage instructions. For children aged between six to twelve who are starting medication for ADHD for the first time, it is recommended they begin with an initial dose of about18 mg taken orally once daily in the morning. This dosage can then increase by approximately18-36mg per day at weekly intervals based on patient response and tolerability until an optimal response is achieved.
At what dose is Concerta typically prescribed?
Concerta treatment is typically initiated at a dosage of 18-36 mg/day, taken orally once daily in the morning. Depending on individual patient response and tolerability, the dose can be increased by increments of 18 mg at weekly intervals. The maximum recommended dose for Concerta is 54 mg/day for children and adolescents aged between 6 to 17 years old, and up to 72 mg/day divided into two doses for adults. It's important to note that if there is no significant improvement after a few weeks of therapy with Concerta at appropriate doses, re-evaluation may be necessary to confirm the diagnosis or explore other treatment options.
What are the most common side effects for Adderall?
Adderall and Concerta, both used to manage symptoms of ADHD, have some similar side effects. Some common ones for Adderall include:
- Nervousness
- Restlessness
- Difficulty falling asleep or staying asleep
- Uncontrollable shaking of a part of the body
- Headache
- Changes in sex drive or ability
- Dry mouth
- Stomach pain
- Nausea
- Weight loss
Meanwhile, potential side effects with Concerta may include:
- Insomnia (difficulty sleeping)
- Decreased appetite leading to weight loss
- Abdominal pain/cramps
- Increased blood pressure and heart rate
- Dizziness
- Sweating
- Nervousness/anxiety
- Mild skin rash
It's important to note that these medications can also cause more severe side effects. Always consult your healthcare provider for advice about potential risks and benefits before starting any new medication regimen.
Are there any potential serious side effects for Adderall?
While both Adderall and Concerta are stimulants used to treat ADHD, they do have different side effects. For Adderall, some of the severe but rare side effects include:
- An increased risk of mental/mood changes (such as agitation, aggression, mood swings, depression or suicidal thoughts)
- Signs of blood circulation problems in fingers or toes such as numbness, pain or cold feelings
- Unusual wounds on fingers or toes
- Rapid heartbeats causing chest pain and shortness of breath
- Symptoms indicating a high serotonin level like hallucinations and muscle twitching
For Concerta users:
- Should watch for allergic reactions which may cause hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- A sudden increase in heart rate leading to dizziness.
- Vision problems accompanied by headache and buzzing in your ears.
In all cases if you experience any serious symptoms contact healthcare providers immediately.
What are the most common side effects for Concerta?
When comparing Adderall to Concerta, one should be aware of the potential side effects associated with Concerta. These may include:
- Dry mouth or throat irritation
- Nausea, stomach discomfort and loss of appetite
- Difficulty sleeping (insomnia)
- Increased sweating or feeling jittery
- Faster than normal heart rate
- Mood changes such as feelings of agitation or anxiety
- Unusual weight loss due to suppressed appetite
- Headache and dizziness are common complaints
-A possible rash on skin areas exposed to sunlight. -Muscle tension leading to pain in joints.
In some cases, blurred vision and urinary retention can also occur. Always contact your healthcare provider if you experience any unexpected symptoms after starting a new medication.
Are there any potential serious side effects for Concerta?
While Concerta is generally well-tolerated, it may cause serious side effects in some instances. Be sure to seek medical attention if you experience:
- Signs of allergic reaction: difficulty breathing; hives; swelling of your face, lips, tongue, or throat
- Angina (chest pain), shortness of breath, or fast/irregular heartbeats
- Increased blood pressure: severe headache, blurred vision, pounding in your neck or ears
- Psychosis: hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia
- Circulation problems: numbness/pain/cold feeling in the hands or feet; unexplained wounds and skin color changes
- Neurological issues such as seizures (convulsions), motor tics (muscle twitches) and changes in visions.
If any of these symptoms occur while taking Concerta, consult a healthcare professional immediately.
Contraindications for Adderall and Concerta?
Both Adderall and Concerta, along with most other stimulant medications, may intensify symptoms of anxiety or agitation in some people. If you notice your anxiety worsening, or an increase in aggressive behavior or thoughts, please seek immediate medical attention.
Neither Adderall nor Concerta should be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors within the past 14 days. Always inform your physician about all the medications you're currently on; MAOIs will require a period of about two weeks to clear from the system to prevent dangerous interactions with both Adderall and Concerta.
How much do Adderall and Concerta cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Concerta (27 mg) averages around $400, which works out to about $13–$27 per day depending on your dose.
- The price for Adderall XR (20 mg), a 30 capsule supply is approximately $760, working out to roughly $25.33/day.
If you are taking higher dosages of Concerta (i.e., 54 mg/day or higher), then brand-name Adderall XR can be less expensive on a per-day treatment basis despite its high unit cost. However, it's essential to remember that cost should not be the main factor in determining which medication is best suited to your needs.
When considering generic alternatives:
- Methylphenidate ER (generic for Concerta) costs are significantly lower with approximate prices ranging from $50-$200 for a month’s supply depending on dosage and location.
- Amphetamine salt combo XR (generic for Adderall XR) also comes at a reduced cost compared to branded versions, priced between $.75 - $3 per day based on usual doses.
As always, ensure you discuss all options and considerations with your healthcare provider before deciding on any medication regimen.
Popularity of Adderall and Concerta
Adderall, available in generic form as well as under its brand name, is a combination of amphetamine salts that was prescribed to about 5.6 million people in the US in 2020. Adderall accounted for approximately 28% of stimulant prescriptions used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in the United States. It has been generally increasing in prevalence since it received FDA approval back in the mid-1990s.
On the other hand, Concerta which contains methylphenidate as an active ingredient, was prescribed to around 2.3 million individuals within the USA during 2020. In terms of overall ADHD medication prescriptions, Concerta represents roughly 11%. Over recent years, there's been a gradual increase observed with regards to Concerta usage rates; however these figures have largely plateaued over the past decade.
Conclusion
Both Adderall (amphetamine salts) and Concerta (methylphenidate) have long-standing records of usage in patients with attention deficit hyperactivity disorder (ADHD), backed by numerous clinical studies indicating that they are more effective than placebo treatments. They may be used together under the careful supervision of a physician, although this is not common practice due to potential risks associated with combined stimulant treatment.
Adderall works primarily by increasing the activity of norepinephrine and dopamine in the brain, while Concerta acts mainly on dopamine. Hence, these drugs tend to be prescribed depending on individual presentations of ADHD symptoms along with patient response and tolerability.
Both medications are available in generic forms - a significant cost saving for out-of-pocket payers. Both Adderall and Concerta require an adjustment period where effects might not be immediately noticeable as dosage often needs titration to achieve optimal therapeutic effect.
The side-effects profiles between both drugs share similarities but also differ somewhat due to their different mechanisms; both can cause loss of appetite, insomnia, dry mouth among others but Adderall is sometimes noted for its higher propensity towards side effects such as anxiety or irritability compared to Concerta's controlled-release mechanism which delivers medication more evenly across the day. It’s obligatory for patients starting these medications to closely monitor any new or worsening symptoms particularly mood changes or cardiovascular complaints- seeking immediate medical help if necessary.
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Refrences
- Fitzgerald, K. T., & Bronstein, A. C. (2013, February). Adderall® (Amphetamine-Dextroamphetamine) Toxicity. Topics in Companion Animal Medicine. Elsevier BV.http://doi.org/10.1053/j.tcam.2013.03.002
- Katzman, M. A., & Sternat, T. (2014, August 14). A Review of OROS Methylphenidate (Concerta®) in the Treatment of Attention-Deficit/Hyperactivity Disorder. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40263-014-0175-1
- Weisler, R. H. (2005, June). Safety, efficacy and extended duration of action of mixed amphetamine salts extended-release capsules for the treatment of ADHD. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.6.6.1003
- Morkem, R., Patten, S., Queenan, J., & Barber, D. (2017, July 27). Recent Trends in the Prescribing of ADHD Medications in Canadian Primary Care. Journal of Attention Disorders. SAGE Publications.http://doi.org/10.1177/1087054717720719
- May, D. E., & Kratochvil, C. J. (2010, January). Attention-Deficit Hyperactivity Disorder. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11530540-000000000-00000