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Evekeo vs Concerta
Introduction
For patients with Attention Deficit Hyperactivity Disorder (ADHD), certain medications can help manage restlessness, impulsiveness and concentration difficulties. Evekeo and Concerta are two such drugs often prescribed for ADHD treatment. Both impact the concentrations of neurotransmitters in the brain which are linked to attention span and activity levels. Evekeo is an amphetamine that stimulates the release of norepinephrine, dopamine, and serotonin in your brain while inhibiting their reuptake. This leads to higher levels of these chemicals in the brain helping improve focus, attention, and reduce impulsive behavior. On the other hand, Concerta is a long-acting formulation of methylphenidate that primarily works by blocking the reuptake inhibitor of dopamine thereby increasing its level in between synapses.
Evekeo vs Concerta Side By Side
| Attribute | Evekeo | Concerta |
|---|---|---|
| Brand Name | Evekeo | Concerta |
| Contraindications | Worsening symptoms of anxiety or agitation, cannot be taken with MAO inhibitors due to risk of hypertensive crisis. | Worsening symptoms of anxiety or agitation, cannot be taken with MAO inhibitors due to risk of hypertensive crisis. |
| Cost | For brand name: about $290 for 30 capsules (10mg). For generic (amphetamine sulfate): prices start as low as around $0.80 daily. | For brand name: about $380 for 60 tablets (36 mg). For generic (methylphenidate): costs between $0.40 and $1.20 per day. |
| Generic Name | Amphetamine | Methylphenidate |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, signs of an allergic reaction, cardiovascular issues, low sodium levels, severe nervous system reactions, serotonin syndrome. | Signs of an allergic reaction, increased thoughts about suicide or hurting yourself, experiencing seizures, confusion or unusual changes in mood and behaviour, vision issues, a rapid heartbeat, symptoms of a manic episode. |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | 5-40 mg/day | 18–72 mg/day |
What is Evekeo?
Evekeo (the generic name for amphetamine) and Concerta (the brand name for methylphenidate) are both psychostimulant medications primarily used to treat Attention Deficit Hyperactivity Disorder (ADHD). Evekeo, as an amphetamine, was one of the first treatments available for ADHD. This drug works by increasing levels of dopamine and norepinephrine in the brain, thereby improving focus and reducing impulsivity and hyperactive behavior. It is prescribed not only for ADHD but also narcolepsy.
On the other hand, Concerta, which was approved by the FDA later in 2000, releases its active ingredient over a span of 12 hours to provide all-day relief from symptoms. Like Evekeo, it influences levels of dopamine but with a particular concentration on norepinephrine. As a result of this selectivity along with its extended-release formulation that provides steady symptom control throughout the day without peaks or troughs associated with multiple daily doses required by other stimulants like Evekeo; some patients may find Concerta has fewer side effects such as irritability and insomnia.
What conditions is Evekeo approved to treat?
Evekeo is approved for the treatment of various conditions such as:
- Attention Deficit Hyperactivity Disorder (ADHD), in both children and adults
- Narcolepsy, a chronic sleep disorder that causes overwhelming daytime drowsiness
- Exogenous obesity, as a short-term adjunct in a regimen of weight reduction based on caloric restriction for patients with an initial body mass index ≥ 30 or ≥ 27 in presence of risk factors.
How does Evekeo help with these illnesses?
Evekeo helps manage Attention Deficit Hyperactivity Disorder (ADHD) by increasing the amount of dopamine and norepinephrine in the brain. It does this by stimulating the release of these neurotransmitters, which increases their concentration in the synaptic clefts between neurons. Dopamine and norepinephrine are both chemicals that act as messengers in the brain, playing key roles in attention, motivation, pleasure sensation, and impulse control among other things. In individuals with ADHD, it is believed there's an imbalance or insufficiency of these neurotransmitters. Therefore, by boosting dopamine and norepinephrine levels, Evekeo can help to alleviate symptoms associated with ADHD such as impulsivity, hyperactivity and lack of focus.
What is Concerta?
Concerta is a brand name for methylphenidate, which acts as a central nervous system stimulant, specifically targeting the reuptake of norepinephrine and dopamine in the brain. This mechanism increases their levels by reducing their reabsorption. In addition to this, Concerta also has minor action on serotonin systems. Methylphenidate was first approved by the FDA in 1955.
Unlike Evekeo (amphetamine sulfate), Concerta's primary impact lies with both norepinephrine and dopamine rather than primarily focusing on releasing stored neurotransmitters like amphetamines do. As it does not majorly affect serotonin, its side effects can be different from those of medications that do such as selective serotonin reuptake inhibitors (SSRIs). For example, it is less likely to cause weight changes or sexual dysfunction; common side effects associated with SSRIs.
Furthermore, because of its influence on both norepinephrine and dopamine - crucial neurotransmitters involved in attention regulation and impulse control - Concerta can be particularly effective for managing symptoms of Attention Deficit Hyperactivity Disorder (ADHD) especially among patients who may not respond well to other ADHD medications.
What conditions is Concerta approved to treat?
Concerta is an FDA-approved medication for the treatment of:
- Attention Deficit Hyperactivity Disorder (ADHD) in both children and adults
- Narcolepsy, a neurological disorder that affects your ability to stay awake during the day. This drug helps improve attention span, increase focus, decrease impulsiveness and hyperactive behavior which are common symptoms of these conditions.
How does Concerta help with these illnesses?
Concerta is a stimulant medication used to treat attention deficit hyperactivity disorder (ADHD). It works primarily by increasing the levels of dopamine and norepinephrine in your brain, thereby improving focus, attention, impulse control, and reducing hyperactive behavior. Concerta has a unique extended-release system which allows for all-day symptom control with just one morning dose. This differs from Evekeo which needs to be taken multiple times throughout the day.
In contrast to Evekeo's equal affinity for both dopamine and norepinephrine receptors, Concerta primarily targets dopamine pathways in the brain making it particularly effective in managing core ADHD symptoms. Additionally, because Concerta does not significantly impact serotonin levels as much as other medications might do—like certain antidepressants—it can be beneficial when an individual doesn't respond well to those types of treatments or they are seeking an alternative treatment strategy that minimizes potential side effects related to mood alterations.
How effective are both Evekeo and Concerta?
Both amphetamine sulfate (Evekeo) and methylphenidate (Concerta) are widely prescribed in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). They were initially approved by the FDA several years apart, with Concerta receiving approval in 2000 and Evekeo more recently in 2015. Both drugs act on similar neurotransmitters but through different mechanisms, so they may be preferred under different circumstances.
The effectiveness of Evekeo and Concerta was directly studied in a double-blind clinical trial; both drugs exhibited similar efficacy at managing symptoms of ADHD, as well as promising safety profiles. In these studies, there were no significant differences between patients taking either medication when measuring metrics such as focus improvement or hyperactivity reduction.
A review published in 2018 showed that methylphenidate is effective from the first week of treatment. Its side effect profile is generally favorable when compared to other stimulants used for ADHD management, and it's tolerated fairly well across all age groups. The same study reports that methylphenidate has become one of the most commonly prescribed medications worldwide for treating ADHD.
A separate 2019 meta-analysis indicated that amphetamines like Evekeo seem to be somewhat more effective than placebo at treating symptoms associated with ADHD. Nevertheless, due to potential side effects such as appetite suppression or sleep disturbances, along with its higher risk for misuse given its status as a Schedule II controlled substance, it might not always be considered a first-line option for some patients. Instead it may come into play after trying non-stimulant alternatives or if other stimulants like Concerta prove ineffective.
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At what dose is Evekeo typically prescribed?
Oral dosages of Evekeo range from 5-40 mg/day, depending on the individual's response and tolerance to the medication. It is typically started at a low dose, such as 5 mg/day for children and adolescents. The dosage can be increased after a week if there is no adequate response or side effects are tolerable. However, the maximum daily dosage that should not be exceeded in any case is 40 mg/day. Similarly, Concerta doses vary from 18–72 mg/day with initial doses often starting at around 18mg for children and gradually increasing based on effectiveness and tolerance. As always, these medications should only be used under direct supervision of a healthcare provider given their potential for serious side effects and abuse.
At what dose is Concerta typically prescribed?
Concerta treatment for ADHD is typically initiated at a dosage of 18–36 mg/day. The dose can then be gradually increased to an ideal maintenance dose, which often ranges from 18-54 mg per day, taken once daily in the morning. It’s important to note that Concerta should not be chewed or crushed but swallowed whole with the aid of liquids if needed. If after a few weeks there is no apparent response or improvement in symptoms at an individual's current dosage, some doctors may consider increasing it further; however, the maximum permitted daily dose is 72 mg. Always follow your doctor's instructions when adjusting medication dosages.
What are the most common side effects for Evekeo?
Common side effects of Evekeo may include:
- Nervousness
- Insomnia or restlessness
- Decreased appetite
- Abdominal pain, nausea and vomiting
- Weight loss
- Increased heart rate or palpitations
- Dry mouth
- Dizziness, tremors, headaches
On the other hand, Concerta has similar but also some different common side effects such as:
- Decreased appetite with potential for weight loss
- Sleep disturbances like insomnia
- Headache and dizziness
- Sweating and skin rashes
- Increased blood pressure and heart rate (palpitation)
- Stomach upset including nausea and vomiting
While both medications can have a similar effect on attention span in conditions such as ADHD, they differ significantly in their duration of action. It's important to consult with your healthcare provider for personalized advice before starting any new medication.
Are there any potential serious side effects for Evekeo?
In rare cases, Evekeo can cause serious side effects including:
- Increased thoughts about suicide or self-harm
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Changes in vision: blurred vision, eye pain or swelling
- Cardiovascular issues: fast or pounding heartbeats, fluttering in your chest, shortness of breath and sudden dizziness
- Low sodium levels - symptoms may include headache, confusion, slurred speech severe weakness vomiting loss of coordination feeling unsteady.
Severe nervous system reactions can also occur with symptoms like:
- Very stiff (rigid) muscles
- High fever,
- Sweating, -confusion, -Fast or uneven heartbeats -tremors, -a possibility of passing out
Serotonin syndrome is another potential risk associated with Evekeo. Symptoms to look out for include agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea. If you experience any these symptoms after taking the medication it's imperative that you seek medical attention right away.
What are the most common side effects for Concerta?
Concerta, a popular medication for attention-deficit/hyperactivity disorder (ADHD), may cause certain side effects:
- Dry mouth and throat
- Changes in vision or blurred vision
- Gastrointestinal issues such as nausea, stomach pain, loss of appetite, and constipation
- Difficulty sleeping (insomnia)
- Sweating excessively and feeling nervous or agitated
- Rapid heartbeat
- Mental changes including confusion or feelings of hostility
- Skin rash
- Weight loss due to decreased appetite
- Increased frequency of urination
- Headaches and dizziness
-Muscle tension or joint discomfort.
It's important to note that these side effects don't occur in everyone who takes Concerta; the experiences can vary significantly between individuals. Always consult with your healthcare provider if you're concerned about potential side effects.
Are there any potential serious side effects for Concerta?
While Concerta is generally considered safe, it can occasionally cause severe side effects. These may include:
- Signs of an allergic reaction or serious skin reaction: symptoms such as hives, itching, a fever, swollen glands, difficulty breathing and swelling in your face or throat
- Increased thoughts about suicide or hurting yourself
- Experiencing seizures (convulsions)
- Confusion or unusual changes in mood and behaviour
- Vision issues including blurred vision, tunnel vision, eye pain or swelling around the eyes
- A rapid heartbeat that feels irregular;
- Symptoms of a manic episode which could include racing thoughts or increased energy levels. Other possible signs are reckless behavior patterns, feeling extremely happy for no reason at all followed by bouts of irritability. Also talking more than usual and experiencing serious problems with sleep.
If you experience any of these side effects while taking Concerta, consult your doctor immediately.
Contraindications for Evekeo and Concerta?
Both Evekeo and Concerta, along with most other stimulant medications, may worsen symptoms of anxiety or agitation in some people. If you notice your anxiety increasing, or an increase in restlessness or aggressive behavior, please seek immediate medical attention.
Neither Evekeo nor Concerta can be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors (MAOIs). Always inform your physician about any medications you are currently using; MAOIs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with both Evekeo and Concerta. This is due to the increased risk of hypertensive crisis - a potentially life-threatening condition characterized by dangerously high blood pressure.
How much do Evekeo and Concerta cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Concerta (36 mg) averages around $380, which works out to approximately $12–25/day, depending on your dose.
- The price of 30 capsules of Evekeo (10mg) is about $290, working out to roughly $9.67/day.
Thus, if you are in the higher dosage range for Concerta (i.e., 72 mg/day or higher), then brand-name Evekeo is less expensive on a per-day treatment basis. However, cost should not be a primary consideration in determining which medication is right for you.
For the generic versions of Concerta (methylphenidate) and Evekeo (amphetamine sulfate), costs are significantly lower:
-
Methylphenidate (36 mg tablets) comes mainly in packs ranging from 30 to 90 tablets and above with approximate costs between $0.40 and $1.20 per day for dosages between 18mg up to even over 100mg per day.
-
Amphetamine Sulfate is available in packs starting from as low as fifteen capsules going up to hundreds at once with prices beginning as low as around $0.80 daily when purchasing larger amounts upfront but can increase up towards approximately two dollars each day when buying smaller quantities initially.
Popularity of Evekeo and Concerta
Amphetamine sulfate, available in brand form such as Evekeo, is a medication predominantly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It's estimated that prescriptions for amphetamines like Evekeo reached about 2.6 million people in the US in 2020. Amphetamine accounts for approximately 13% of overall ADHD prescriptions.
Methylphenidate, including brand versions such as Concerta, was prescribed to around 5.8 million people in the USA during the same period. This represents nearly one quarter of all ADHD prescriptions written within the country and highlights its significant role within this therapeutic area. The prevalence of methylphenidate has remained relatively steady over time with a slight increasing trend observed since 2013.
Conclusion
Both Evekeo (amphetamine sulfate) and Concerta (methylphenidate hydrochloride) have substantial histories of use in managing attention deficit hyperactivity disorder (ADHD), and are backed by numerous clinical studies indicating their efficacy over placebo treatments. In some cases, these medications may be used together under the careful guidance of a physician. However, due to their different mechanisms of action — with Evekeo primarily influencing both dopamine and norepinephrine pathways, and Concerta mainly affecting dopamine pathways — they tend to be prescribed under different circumstances.
Concerta is often considered as a first-line treatment option for ADHD patients because it has fewer side effects related to appetite suppression compared to amphetamine-based drugs like Evekeo. On the other hand, Evekeo might be utilized when patients do not respond well to methylphenidate-based drugs or have specific needs that align more closely with its properties.
Both medications are available in generic form, which can lead to significant cost savings especially for those who must pay out-of-pocket. Both Evekeo and Concerta may require an adjustment period; thus, immediate effects should not always be expected.
The side effect profile between these two stimulant medications is similar but not identical: both are generally well-tolerated yet come with risks such as insomnia, decreased appetite, abdominal pain among others. With evekeo slightly more likely than concerta at causing weight loss due it's stronger appetite suppressant properties . When starting either medication regimen patients need close monitoring particularly children , if there's any unusual changes in mood or behavior during usage of either drug should prompt immediate medical consultation.
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Refrences
- Prommer, E. (2011, December 4). Methylphenidate. American Journal of Hospice and Palliative Medicine®. SAGE Publications.http://doi.org/10.1177/1049909111427029
- Pelham, W. E., Gnagy, E. M., Burrows-Maclean, L., Williams, A., Fabiano, G. A., Morrisey, S. M., … Morse, G. D. (2001, June 1). Once-a-Day Concerta Methylphenidate Versus Three-Times-Daily Methylphenidate in Laboratory and Natural Settings. Pediatrics. American Academy of Pediatrics (AAP).http://doi.org/10.1542/peds.107.6.e105