Attention deficit hyperactivity disorder, or ADHD, affects an estimated 10 percent of children in the United States. ADHD can make it difficult for children and adults to learn, focus, and interact socially, and it can cause delayed development.
Adderall and Concerta are two popular prescription medications used for the treatment of ADHD, and while there are many similarities between the stimulant drugs, there are also some key differences.
Overview
Adderall and Concerta belong to a class of prescription drugs called stimulants. Adderall is made up of two active ingredients: amphetamine and dextroamphetamine. By contrast, the active ingredient of Concerta is methylphenidate hydrochloride.
Both drugs work by acting on certain chemicals in the brain, dopamine and norepinephrine, which are neurotransmitters that may be involved with the development of hyperactivity and impulsiveness.
Both Adderall and Concerta are considered Schedule II controlled substances by the U.S. Drug Enforcement Administration (DEA) due to their high potential for abuse and addiction.
Conditions Treated
Both Concerta and Adderall are used for the treatment of attention deficit hyperactivity disorder, also known as ADHD. Adderall is also approved by the FDA for the treatment of narcolepsy.
Attention Deficit Hyperactivity Disorder
ADHD is one of the most commonly diagnosed neurodevelopmental disorders in children, and its prevalence has risen dramatically over the past several decades. Although the primary period of diagnosis for ADHD occurs during childhood, it is also possible to be diagnosed as an adult. Most people with ADHD find that their symptoms continue from childhood into adulthood, but others may see an improvement in their symptoms with age.
In recent years, three disorders which were previously classified separately were combined under the category of ADHD.
Individuals who present with hyperactive-impulsive behaviors are diagnosed with hyperactive-impulsive ADHD.
People who are not hyperactive but who have difficulty concentrating or paying attention are typically diagnosed with inattentive ADHD.
Those who exhibit symptoms that are characteristic of both the hyperactive-impulsive presentation and the inattentive presentation may be diagnosed with combined type ADHD.
Common signs and symptoms of ADHD include:
- Daydreaming
- Making careless mistakes
- Difficulty resisting temptation
- Talking excessively
- Inattention
- Impulsivity
- Squirming or fidgeting
- Forgetting or losing things regularly
- Difficulty getting along with others
- Hyperactivity
- Difficulty paying attention
- Difficulty controlling impulsive behaviors
Both Adderall and Concerta are approved for the treatment of ADHD and used as treatment options in adults and children. Adderall can be taken by children as young as three years of age, while Concerta is not intended for use in children under the age of six.
Cost
Adderall and Concerta can be expensive ADHD medications in their brand name forms; however, both medications are also available as generic drugs.
When purchased as a generic tablet, Adderall can be purchased at a monthly cost of $10 or less. By contrast, the brand name versions of Adderall cost approximately $262 for a monthly prescription regardless of whether the immediate or extended-release version of the drug is purchased. The generic version of Adderall is covered by nearly all commercial insurance plans as well as Medicaid and Medicare.
Brand name Concerta is usually more costly than brand name Adderall; a one-month prescription of Concerta typically costs about $396. The generic version of Concerta, methylphenidate hydrochloride, can be obtained for less than $20 for a monthly prescription. While the brand name version of Concerta may not be covered by commercial health insurance, the generic version of the drug is usually covered.
Side Effects
Both Adderall and Concerta are associated with numerous side effects, some of which may require medical attention.
Adderall
Common side effects of Adderall that normally do not require medical attention include:
- Dry mouth
- Anxiety
- Restlessness
- Stomach pain
- Weight loss
Common serious side effects of Adderall that may require immediate medical attention include:
- Frequent urge to urinate
- Bloody or cloudy urine
- Bladder pain
- Fast, pounding, or irregular heartbeat or other heart problems
- Lower back or side pain
- Difficult, burning, or painful urination
Less common side effects of Adderall that may require immediate medical attention include:
- Vomiting
- Fever
- Headache
- Diarrhea
- Joint pain
- Muscle aches and pains
- Hoarseness
- Chills
- Shivering
- Runny nose
- Sore throat
- Cough
- Allergic reactions
- Trouble sleeping
- Nausea
- Unusual tiredness or weakness
- Loss of appetite
- Sweating
Rare side effects of Adderall may also include:
- Slowing of growth (both height and weight) in children
- Eyesight changes or blurred vision
- Seizures, particularly in patients with an existing history of seizures
- Blockage of the esophagus, stomach, small or large intestine in patients who already have a narrowing in any of these organs.
- Chest pain
- Cold or numb fingers or toes that turn white or blue
- Auditory hallucinations
- Shortness of breath
- Fainting
- Increased violence or violent thoughts
- Priapism (erection lasting longer than four hours)
Concerta
Side effects of Concerta range from common to less common. Common side effects associated with the use of Concerta include:
- Decreased appetite
- Trouble sleeping
- Stomach ache
- Headache
- Anxiety
- Irritability
- Dry mouth
- Dizziness
- Increased sweating
- Nausea
- Weight loss
Less common side effects associated with Concerta include:
- Slowing of growth (both height and weight) in children
- Eyesight changes or blurred vision
- Seizures, particularly in patients with an existing history of seizures
- Blockage of the esophagus, stomach, small or large intestine in patients who already have a narrowing in any of these organs.
- Chest pain
- Cold or numb fingers or toes that turn white or blue
- Auditory hallucinations
- Shortness of breath
- Fainting
- Increased violence or violent thoughts
- Priapism (erection lasting longer than four hours)
Most people experience side effects when they first begin using Adderall or Concerta or when they increase their dose of the stimulant medications. Some people find that their side effects decrease as their bodies adjust to the medication, but others may experience side effects throughout their time using the drug.
If you experience side effects that are prolonged or severe in nature, make sure to contact your healthcare provider for medical advice, or seek medical attention immediately.
Warnings for Use
Adderall and Concerta are both classified as Schedule II controlled substances as a result of their high potential for abuse and addiction. The potential for abuse and addiction is especially high in people who use either medication without a prescription, as the drugs are not treating a medical condition and will provide a different effect than when used properly.
When taken on a regular basis or over a long period of time without a medical need, it is common for people to develop a physical or psychological dependence on Adderall and Concerta.
Symptoms of dependence may include:
- Anxiety
- Vomiting
- Muscle weakness
- Depression
- Sweating
- Nausea
- Nightmares
- Body aches
Common signs of an addiction to Adderall or Concerta include:
- Feeling unable to cut back on substance use
- Not feeling alert without the medication
- Expending significant time and money to obtain and use the medication
- Not being able to work without taking the medication
- Needing larger doses to achieve the desired effect
Withdrawal
Because of the body’s tendency to quickly develop a dependence on Adderall and Concerta, withdrawal symptoms may be experienced when patients stop using either medication abruptly.
If you’ve been taking either Adderall or Concerta for more than two weeks, you should only stop taking your medication or reduce your dose under the supervision of a medical professional.
Withdrawal symptoms associated with the discontinuation of Adderall and Concerta can include:
- Changes in mood
- Anxiety
- Agitation
- Sleep disturbances
- Increased appetite
- Shaking
- Sweating
- Cravings
- Fatigue
- Depression
- Strange dreams
Medical Concerns
When abused long-term, both Adderall and Concerta can cause serious damage to the heart and cardiovascular system.
Long-term Adderall or Concerta abuse can result in the following adverse effects:
- Feeling jittery or on edge
- Trouble breathing/shortness of breath
- Heart disease
- Constipation
- Dizziness
- Weight loss
- Headaches
- Abdominal pain
- Insomnia
- Tremors
- Heart palpitations
- Dry mouth
Some people may not be able to use Adderall or Concerta safely depending on their medical history. Others may need to exercise extreme caution.
You should not take Adderall or Concerta if you:
- Have glaucoma
- Have a history of agitation, anxiety, or tension
- Take a type of antidepressants called MAOIs
- Have a history of Tourette’s syndrome
- Have previously experienced an allergic reaction to the medication
Tell your doctor before taking Adderall or Concerta if you have any of the following medical conditions:
- Symptomatic cardiovascular disease
- Moderate to severe high blood pressure
- A history of drug addiction or abuse
- Advanced atherosclerosis
- Hyperthyroidism
Summary
Adderall and Concerta are central nervous system prescription stimulants that are used to treat adult ADHD and pediatric ADHD.
Both ADHD drugs are classified as Schedule II controlled substances by the DEA due to their high risk of abuse and addiction. Although the drugs can cause similar side effects, some people may find that one drug works better for them than the other.
Both Adderall and Concerta are available in both brand name and generic forms. Adderall also comes in two formulations: an immediate-release format and a timed-release tablet, Adderall XR.
Be sure to consult with a medical professional about any health conditions or family history before starting Adderall or Concerta.
Regardless of which medication you are prescribed for your mental health, you can receive significant cost savings regardless of your insured status by using a pharmacy discount card from Pharmacists.org.
Sources:
https://www.addictioncenter.com/stimulants/adderall/Â
https://americanaddictioncenters.org/adderall/long-term-effectsÂ
https://www.cdc.gov/ncbddd/adhd/data.htmlÂ
https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/CONCERTA-pi.pdf#page=30Â
https://www.webmd.com/drugs/2/drug-19857/concerta-oral/detailsÂ
https://www.healthline.com/health/adhd/concerta-adderall#comparison
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