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Intuniv vs Concerta
Introduction
For patients dealing with attention deficit hyperactivity disorder (ADHD), certain medications that modulate the presence of compounds in the brain linked to focus, impulse control, and activity levels can be instrumental in managing symptoms. Intuniv and Concerta are two such drugs that are commonly prescribed for ADHD treatment. They each influence different neurotransmitters within the brain but both can help improve concentration, decrease impulsiveness, and curb hyperactivity associated with ADHD. Intuniv is a selective alpha-2A adrenergic receptor agonist which primarily affects norepinephrine levels by stimulating receptors in the brain - this drug is often used when stimulant medications have been ineffective or have produced undesirable side effects. On the other hand, Concerta is classified as a central nervous system (CNS) stimulant; it works by increasing levels of dopamine and norepinephrine in the brain.
Intuniv vs Concerta Side By Side
| Attribute | Intuniv | Concerta |
|---|---|---|
| Brand Name | Intuniv | Concerta |
| Contraindications | Should not be taken if using or have used MAO inhibitors within the past two weeks. May worsen symptoms of anxiety or mood swings. | Should not be taken if using or have used MAO inhibitors within the past two weeks. May worsen symptoms of anxiety or mood swings. |
| Cost | For brand name, around $300 for 30 tablets (2 mg). For generic (guanfacine ER), costs range from about $0.80 to $1.90 per day. | For brand name, around $260 for 30 tablets (18 mg). For generic (methylphenidate ER), prices can start at just under ten cents per day ($0.10) and may go up but typically doesn't exceed about two dollars a day ($2). |
| Generic Name | Guanfacine | Methylphenidate |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, especially in children; signs of an allergic reaction; vision changes; rapid heart rate; feeling like you might lose consciousness; symptoms suggestive of liver damage. | Signs of an allergic reaction; increased heart rate or changes in blood pressure; new or worsening psychiatric symptoms; circulation problems in fingers and toes; chest pain with trouble breathing; unexplained wounds on fingers and toes. |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | 1–4 mg/day | Starts at 18–36 mg/day, can be increased up to 54 mg/day for adolescents and adults, with a maximum of 72 mg/day for adults or 54mg/day for children over six years old. |
What is Intuniv?
Guanfacine (the generic name for Intuniv) is a non-stimulant medication primarily used to treat ADHD and hypertension. It was developed as an advancement over the traditional stimulant medications used for ADHD, such as methylphenidate (generic name for Concerta). Guanfacine works by impacting receptors in the prefrontal cortex of the brain, enhancing signals that help reduce symptoms like hyperactivity and impulsivity. It was first approved by the FDA in 2009 specifically for use in children with ADHD.
On the other hand, Concerta increases levels of dopamine and norepinephrine within your brain to enhance focus and attention span. While both are prescribed for managing symptoms of ADHD, they work via different mechanisms which may result in varying side effects. Guanfacine's selective action on specific receptors results in fewer typical side-effects seen with stimulants such as loss of appetite or insomnia; however it can cause drowsiness while Concerta has stronger impacts on dopamine and norepinephrine leading potentially more pronounced side effects but less likelihood causing drowsiness.
What conditions is Intuniv approved to treat?
Intuniv is approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents:
- For individuals aged 6 to 17 as part of a total treatment program that may include counseling or other therapies.
- It can be used alone, but it's often prescribed as supplement therapy to stimulant medications like methylphenidate or amphetamine-based drugs.
- Intuniv works differently than traditional stimulants. Instead of stimulating brain activity, it enhances the brain's own capacity to manage impulses and attention effectively.
How does Intuniv help with these illnesses?
Intuniv works to manage symptoms of attention-deficit/hyperactivity disorder (ADHD) by increasing the amount of norepinephrine available in the synapses of the brain. It does this by acting on alpha-2 adrenergic receptors, which results in lowered stimulation and increased impulse control. Norepinephrine is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, playing an important role in attentiveness, emotions, sleeping patterns, dreaming and learning amongst other things. It is thought that individuals with ADHD have relatively lower levels or impaired function of norepinephrine. Therefore, by increasing or optimizing norepinephrine functioning through Intuniv's action on alpha-2 adrenergic receptors can limit negative effects of ADHD helping patients manage their condition better.
What is Concerta?
Concerta, a brand name for methylphenidate, is a central nervous system stimulant. It works by affecting chemicals in the brain and nerves that contribute to hyperactivity and impulse control. This medication was first approved by the FDA in 2000 and it's mainly used for treating attention deficit hyperactivity disorder (ADHD) in adults as well as children aged six years old or older.
Similar to bupropion from our comparison earlier, Concerta does not inhibit reuptake of serotonin but instead focuses on dopamine and norepinephrine, which are crucial neurotransmitters involved in focus and attention regulation. Consequently, its side-effect profile may differ from those medications targeting serotonin pathways – sedation or sexual dysfunction is less likely with Concerta use while loss of appetite or weight loss could be expected due to stimulation effect.
In contrast to Intuniv that uses alpha-2 adrenergic receptor agonist mechanism mainly acting on prefrontal cortex improving working memory tasks & reducing distractibility without significant systemic effects like increased heart rate or blood pressure; Concerta has broader influence over various parts of brain thus potentially offering more pronounced ADHD symptom relief especially for those who do not respond well to typical non-stimulant drugs such as Intuniv.
What conditions is Concerta approved to treat?
Concerta is an FDA-approved medication for the treatment of:
- Attention Deficit Hyperactivity Disorder (ADHD) in children over 6 years, adolescents and adults
- Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness, hallucinations, and sudden attacks of sleep.
How does Concerta help with these illnesses?
Concerta, like Intuniv, is a medication used to treat attention deficit hyperactivity disorder (ADHD), but it works by affecting different neurotransmitters in the brain. Concerta primarily increases the levels of dopamine and norepinephrine available in the brain, thereby improving focus and reducing impulsivity and hyperactive behavior. This action on dopamine also plays a role in Concerta's effectiveness as an ADHD medication. Since it does not significantly affect serotonin levels, it is sometimes prescribed when a patient does not respond well to typical non-stimulant ADHD medications such as Intuniv or may be combined with these types of drugs for more comprehensive symptom control.
How effective are both Intuniv and Concerta?
Guanfacine (Intuniv) and methylphenidate (Concerta) are two medications that have shown efficacy in managing symptoms of attention-deficit/hyperactivity disorder (ADHD), although they were approved by the FDA several years apart and work on different neurotransmitters. Guanfacine is an alpha-2 adrenergic receptor agonist while methylphenidate acts primarily as a dopamine-norepinephrine reuptake inhibitor.
A 2007 study compared guanfacine to placebo, showing it was significantly more effective than placebo in reducing core ADHD symptoms, with most patients tolerating the medication well. The ideal dose for optimal efficacy appears to be between 1 mg/day to 4 mg/day.
On the other hand, Concerta has been one of the most widely prescribed drugs for ADHD due to its demonstrated effectiveness. A meta-analysis from 2018 indicated that methylphenidate seems to improve teacher-rated ADHD symptoms among children aged 5–18 years compared with placebo or no intervention but did not confirm similar levels of improvement based on reports from parents or self-reporting individuals.
While both drugs can cause side effects such as sleepiness and fatigue, Concerta may lead to decreased appetite more often than Intuniv. Conversely, Intuniv may sometimes induce low blood pressure and slow heart rate; thus it needs careful monitoring especially when used in combination with other antihypertensive drugs.
Both medications have their place in treating ADHD depending upon individual patient characteristics including comorbidities like anxiety disorders where guanfacine might be preferred over stimulant treatment options like Concerta due its calming effect via prefrontal cortical network enhancement which helps control impulsivity along with hyperarousal state seen commonly in anxiety spectrum disorders.
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At what dose is Intuniv typically prescribed?
Oral dosages of Intuniv for children and adolescents range from 1–4 mg/day, but studies have indicated that starting with a dosage of 1mg/day is sufficient in managing ADHD symptoms. Dosage can be increased by your medical provider every week if there are no significant response or side effects observed. On the other hand, Concerta is typically started at a dosage of 18 mg/day for children and adolescents, which can potentially be increased weekly by increments of 18 mg up to a maximum dose of 54-72mg/day based on individual patient needs and responses. The increment should not exceed an increase of more than 18mg per day each week.
At what dose is Concerta typically prescribed?
Concerta treatment generally begins at a dosage of 18–36 mg/day for individuals who are new to taking this medication. The dose can then be increased up to 54 mg/day, taken once daily in the morning, which is the standard maintenance dose for adolescents and adults. If necessary, after assessing patient's reaction and tolerance to Concerta, the maximum dose can be raised up to 72 mg/day for adults or 54mg/day for children over six years old. This should only occur if there is no positive response to treatment with lower doses after an adequate trial period of several weeks. As always, it is crucial that patients follow their healthcare provider's instructions closely regarding dosing schedules and adjustments.
What are the most common side effects for Intuniv?
Common side effects of Intuniv include:
- Drowsiness or fatigue
- Dry mouth
- Nausea, stomach pain, constipation
- Decreased appetite and potential weight loss
- Low blood pressure, slower heart rate
- Headache
On the other hand, Concerta can cause symptoms such as:
- Insomnia (difficulty sleeping)
- Decreased appetite leading to weight loss
- Stomach ache/Discomfort in the digestive tract
- Increased heart rate and blood pressure
-Anxiety or nervousness
-Dry Mouth
-Sweating
-Nausea
-Rash
Both medications have their own unique set of potential side effects. It's important to discuss these with your healthcare provider before choosing a medication for treatment.
Are there any potential serious side effects for Intuniv?
While Intuniv is generally safe and effective for use, it's important to be aware of potential serious side effects. These may include:
- Increased thoughts about suicide or self-harm, especially in children
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Vision changes such as blurred vision or other visual impairments
- A rapid heart rate (tachycardia), palpitations or chest discomfort
- Feeling like you might lose consciousness due to low blood pressure when standing up from a lying/sitting position
- Side effects relating to the nervous system including drowsiness, sedation and sleep disturbances
- Symptoms suggestive of liver damage: yellowing eyes/skin (jaundice), dark urine, severe stomach/abdominal pain and persistent nausea/vomiting.
If any of these symptoms occur while on Intuniv treatment consult with your doctor immediately.
What are the most common side effects for Concerta?
When taking Concerta, patients may experience the following side effects:
- Dry mouth and throat
- Stuffy nose
- Ringing in the ears
- Blurred vision can occur but is less common
- Gastrointestinal issues such as nausea, vomiting, stomach pain, or loss of appetite. In some cases constipation may also be experienced.
- Sleep problems including insomnia could be a side effect due to its stimulant properties.
- Physical symptoms like tremors and sweating along with feelings of anxiety or nervousness might arise.
- An increased heart rate is a potential side effect that needs careful monitoring.
- Some people might experience mental state changes such as confusion or agitation and in rare cases hostility.
- Skin reactions like rashes are possible but uncommon.
- Weight loss can happen due to decreased appetite caused by Concerta.
-Increased urination frequency isn't typically linked with Concerta use. -On occasion individuals may experience headaches, dizziness, -Muscle or joint pain although these aren’t common side effects associated with this medication.
It's important to note that everyone reacts differently to medications so not all users will experience these symptoms. It's always best practice to discuss any concerns about potential side effects with your healthcare provider before starting new medication.
Are there any potential serious side effects for Concerta?
While Concerta is a commonly used medication to manage ADHD symptoms, it's important to be aware of potential serious side effects. These include:
- Signs of an allergic reaction such as hives, itching, difficulty breathing or swelling in your face or throat
- Increased heart rate or changes in blood pressure
- New or worsening psychiatric symptoms such as behavior problems, aggression, paranoia or hallucinations
- Circulation problems in fingers and toes (feeling numbness, pain, skin color change from pale to blue)
- Chest pain accompanied by trouble breathing
- Unexplained wounds on fingers and toes
These signs require immediate medical attention. It's crucial that if you're taking Concerta and experience any of these adverse effects, consult your healthcare provider promptly.
Contraindications for Intuniv and Concerta?
Both Intuniv and Concerta, along with most other ADHD medications, may worsen symptoms of anxiety or mood swings in some individuals. If you observe an increase in such symptoms, please seek immediate medical attention.
Neither Intuniv nor Concerta should be taken if you are using, or have been using monoamine oxidase (MAO) inhibitors within the past two weeks. Always inform your healthcare provider about any medications you are currently taking; MAOIs will require a period of around 2 weeks to be completely cleared from your system to prevent dangerous interactions with both Intuniv and Concerta. It's also important to note that abruptly stopping these ADHD medications can cause withdrawal symptoms such as elevated blood pressure, increased heart rate and severe headache. Therefore, it is strongly advised not to discontinue these medicines without consulting your doctor.
How much do Intuniv and Concerta cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Intuniv (2 mg) averages around $300, which works out to approximately $10/day.
- The price for 30 tablets of Concerta (18 mg) averages around $260, working out to roughly $8.60/day.
Therefore, if you're in the higher dosage range for Intuniv (for example, 4 mg/day), then brand-name Concerta is less expensive on a per-day treatment basis. However, cost should not be your primary consideration when deciding which drug is best suited for you.
For their generic counterparts—guanfacine ER and methylphenidate ER—the costs are significantly lower:
-
Guanfacine ER is available in packs from 30 tablets onwards with an average cost ranging from about $0.80 to $1.90 per day for dosages of 1mg/day up to even more typical doses like 3 or 4mg/day.
-
Methylphenidate ER can be purchased in quantities starting at packs of fifteen and going up as high as one hundred capsules (20 mg each). Depending on where it's purchased and the dosage taken daily, prices can start at just under ten cents per day ($0.10) if purchasing larger quantities upfront and may go up but typically doesn't exceed about two dollars a day ($2).
Popularity of Intuniv and Concerta
Guanfacine, sold under brand names such as Intuniv, was prescribed to about 1.6 million people in the US in 2020. Guanfacine is often used for attention deficit hyperactivity disorder (ADHD) and high blood pressure. It accounted for nearly 4% of ADHD prescriptions in the US that year. The prevalence of guanfacine has been steadily increasing since its approval by the FDA for treating ADHD in 2009.
Methylphenidate, including brand versions like Concerta, was prescribed to roughly 8 million people in the USA during the same period. This stimulant accounts for just over a third of all ADHD prescriptions and has seen consistent use over recent years due to its efficacy and safety profile when used appropriately. However, it's worth noting that methylphenidate carries a risk for dependency if misused or abused.
Conclusion
Both Intuniv (guanfacine) and Concerta (methylphenidate) have a long-standing use in the management of Attention Deficit Hyperactivity Disorder (ADHD). Multiple clinical studies and meta-analyses show that both are more effective than placebo treatments. In some situations, these medications may be combined for an enhanced effect or to control symptoms better, but this is subject to careful consideration by a healthcare provider as they could interact with each other.
Their mechanisms of action differ significantly: Intuniv works mainly by stimulating receptors in the prefrontal cortex improving impulse inhibition, whereas Concerta primarily increases the levels of dopamine and norepinephrine in your brain which aids concentration.
Concerta is often considered a first-line treatment option for ADHD due to its well-established efficacy, while Intuniv might be used as an adjuvant therapy to methylphenidate-based drugs like Concerta or when patients are unable or unwilling to tolerate stimulant side effects.
Both drugs come in generic forms which can lead to significant cost savings especially for individuals who must pay out-of-pocket expenses. The effects of both medicines may not be immediately noticeable; it may take some time before you see improvements.
As far as side effects go, both drugs share similar profiles such as drowsiness, dry mouth, constipation and appetite changes. However, unlike Concerta - which can cause insomnia - one potential side effect of Intuniv is sleepiness which could potentially benefit those with co-existing sleep difficulties. Patients should closely monitor their mental state during treatment commencement and consult with their doctor if they note any negative mood changes or unusual behavior patterns.
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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
- Connor, D. F., Findling, R. L., Kollins, S. H., Sallee, F., López, F. A., Lyne, A., & Tremblay, G. (2010, July). Effects of Guanfacine Extended Release on Oppositional Symptoms in Children Aged 6–12 Years with Attention-Deficit Hyperactivity Disorder and Oppositional Symptoms. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11537790-000000000-00000