Concerta vs. Adderall

SHR00340Both drugs, Concerta, and Adderall are classified as psychostimulant medicines which are being used for ADHD. They have a similar mechanism of action and that is the inhibition of dopamine and norepinephrine reuptake. Adderall is in use since 1996 and Concerta is a slightly newer drug which was approved in 2000 for ADHD treatment for children. Since then, it was approved for adolescents (2004) and adults (2008). Even though Concerta is a newer drug, its active ingredient is on the market longer than Adderall, since 1955.

Some would say that Adderall is better and more popular drug, but they are very similar when comparing some characteristics. Which one is better? Let’s find out.

Concerta vs. Adderall Comparison Chart

They are both classified as psychostimulants, they both are prescribed for ADHD and narcolepsy and they have the same mechanism of action. One important thing is the active ingredient which is different and the manufacturer.

Concerta Adderall
Drug type Psychostimulant Psychostimulant
Approved uses ADHD / narcolepsy ADHD / narcolepsy
Ingredients Methylphenidate ER Mixed Amphetamine Salts: 75% Dextroamphetamine + 25% Levoamphetamine
Formats ER (Extended-release) IR (Immediate release) or XR (Extended release)
Dosages ER: 18 mg/27 mg/36 mg/54 mg IR: 5 mg/7.5 mg/10 mg/12.5 mg/15 mg/20 mg/30 mg or XR: 5 mg/10 mg/15 mg/20 mg/25 mg/30 mg
Manufacturer Janssen Pharmaceuticals Shire Pharmaceuticals
Legal Status Schedule II (US) Schedule II (US)
Mechanism of action Functions by inhibiting catecholamine reuptake – specifically as a dopamine reuptake inhibitor (DRI). It blocks dopamine and norepinephrine transporters – increasing their extracellular concentrations.  It also acts as a 5HT1A receptor agonist. Functions by increasing levels and inhibiting reuptake of stimulatory neurotransmitters such as dopamine and norepinephrine. It acts as a TAAR1 agonist and VMAT2 inhibitor.
Generic version? Yes. Yes.
Half life 3.5 hours 11 to 13 hours
Common side effects Appetite loss. Dizziness. Headache. Insomnia. Nausea. Nervousness. Vomiting. Weight loss. Abdominal pain. Appetite loss. Diarrhea. Dizziness. Dry Mouth. Fever. Headache. Insomnia. Irritability. Nausea. Nervousness. Vomiting. Weight loss.
Date approved August (2000) February 13 (1996)
Effect duration ER: 12 hours IR: 4 to 6 hours/XR: 12 hours
Investigational uses Aggression. Bipolar disorder. Criminality. Lethargy. Obesity. Postural Orthostatic Tachycardia Syndrome (POTS). Treatment-resistant depression. Treatment-resistant depression

Difference: Concerta vs. Adderall

Let’s start from the date of production. The Concerta is younger 5 years from Adderall and it was approved for children only, which changed after 8 years later. The Concerta effect duration is like Adderall XR, about 12 hours.

The excretion of Concerta is much faster with a half-life of a drug about 3.5 hours vs Adderall which can last up to 11 to 13 hours, which can be a plus.

Abuse Potential: Concerta vs. Adderall

They are both classified as a “Schedule II” controlled substances which are an indicator that they both have a high potential for abuse. It is easy to develop a dependence and tolerance is rapidly developing, meaning you will need a higher dose to obtain the same effect of a drug which did act before. The drug becomes less effective which means that you will want a higher dose to stay on that level of effects.

Due to a fact that both drugs affect dopamine and norepinephrine, it can create a psychological euphoria which is a state of “being high”. It can be a drug property which is being used for abuse for many people wanting that “kick” effect. This is especially present when snorting Adderall since it gives the “high” effect quicker than using it orally. Another reason for off-label use is for the cognitive function improvement which can be present among students which take Adderall for the sake of concentration, passing tests, being productive and focused. Some even use it for the weight loss.

Dosage And Formats: Concerta vs. Adderall

Concerta is produced only in one format as an “extended-release” (ER). It has several dosing options including 18 mg, 27 mg, 36 mg and 54 mg. These are quite large scale breaks between two doses which can be hard to taper when on withdrawal or in a situation where a patient wants to lower the dosing. It has an active ingredient which is methylphenidate that gives the effect for 12 hours.

Adderall has two formats including XR and IR. Immediate-release lasts from 4 to 6 hours while extended-release lasts up to 12 hours. The IR format has a few dosing options which are 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg and 30 mg. The XR format has 5 mg, 10 mg, 15 mg, 20 mg, 25 mg and 30 mg. It has a smaller distance between doses which is better for tapering the dose. It is estimated that 36 mg of Concerta is equivalent to 10 mg of Adderall XR. This is an indicator that Adderall has a stronger effect.

Efficacy: Concerta vs. Adderall

It is questionable which drug is better. Both drugs are effective when compared to placebo in double-blind, randomized study. It can be subjective and depend on the condition treated and the previous state of the patient as well as their individual characteristics. Some people find Adderall superior to Concerta due to it’s stronger effect, but some like Concerta for its longer effect. Some people reported side effects such as “Adderall crash” when the effect reduces, which isn’t present in Concerta users. Some studies might stand against Adderall for its better effect. It was in the late 1990s/early 2000s. There were no studies which compared these two drugs, so it can’t be stated that one drug has the better effect.

Mechanism Of Action: Concerta vs. Adderall

They are similar in regards to the mechanism of action. They inhibit the reuptake of dopamine and norepinephrine. Concerta does not have the presynaptic activity such as Adderall. The Adderall has 75% dextroamphetamine and 25% levoamphetamine which reacts with presynaptic neuron and releases dopamine. Adderall XR has 50% immediate-release and 50% delayed-release beads which act for 12 hours.

Concerta has the delivery system called OROS ((osmotically controlled release oral delivery system). It is controlled by an osmotic pump which releases the methylphenidate. Since the delivery system for these two medications is different, some might prefer one drug over the other.

Popularity: Concerta vs. Adderall

38% of all psychostimulant prescription belong to Adderall. It is a popular medicine which becomes popular over time. Concerta is prescribed for 23% of prescriptions for ADHD. In 2014, Adderall had over 12.8 prescriptions for generic IR version and 8 million for XR version as opposed to Concerta which had about 8.8 million of prescriptions. If we would compare brand names, Concerta would be more popular one.

Cost: Concerta vs. Adderall

The brand name of Concerta costs about $260 to $300 per monthly supply. If you are on Adderall, you would have to spare about $300 for IR version and $220 for XR for a monthly supply. This makes the XR version of Adderall cheaper drug than Concerta.

A generic version of Concerta (methylphenidate ER) can go around $100 to $170 for a monthly supply. When it comes to Adderall, it goes from $30 to $50 for IR and $75 to $150 for XR version. Considering the lowest price, Adderall is cheaper in the generic version as well.

Side Effects: Concerta vs. Adderall

They have similar side effects which are both due to dopaminergic effect on the brain. It can be appetite loss, weight loss, irritability, insomnia, headaches, etc. They can also stunt growth, which is also another side effect you should know. It is a short-term side effect which isn’t per life. Eventually, the person gets to its adult height.

Withdrawal Symptoms: Concerta vs. Adderall

concertaIf you were taking any of these drugs for several years, you might have a difficult time with its withdrawal. It is especially significant if you were on a higher dosing option and also depends on your individual characteristics such as genetics, sensitivity, lifestyle, etc. Adderall is considered a harder drug to cope with when on withdrawal. Those who were on these drugs for a short-term may not experience strong withdrawal symptoms. You can feel symptoms such as fatigue, slow cognitive functions, ADHD symptoms exacerbation, sleepiness, psychomotor slowing. This can be a shock to your brain which is used to dopaminergic effect which has a certain function. After the brain is left without the drug effect, it leads to cognitive impairment which is usually temporary. It comes back to its natural state after some time.

It is crucial to taper both medicines when on withdrawal. This is the best possible way to withdrawal the medicine without experiencing strong symptoms such as depression, suicidal thoughts, and others. It is a system which gradually tapers the doses with help the body to get adjusted to the new state and to get stabilized.

Methylphenidate has been used for aggression and criminality. Adderall was used for cognitive restoration in stroke patients with investigating effects. Concerta being produced by Janssen Pharmaceuticals and Adderall by Shire Pharmaceuticals.

Which drug is better? Did you have experience with either of these drugs? Comment below to share your experience and tell us your opinion on which drug worked best for you.