Concerta (methylphenidate) is a central nervous stimulant which is being used for attention deficit hyperactivity disorder (ADHD) and narcolepsy. It was approved in the 1960s but became more popular in 1990s when the diagnoses started to grow. In 1996, Adderall started to flow the market where it became more popular for ADHD treatment. In the 2000s, the Concerta got a new form besides immediate-release. The Janssen Pharmaceuticals produced the new form that provided long-lasting effect up to 12 hours.
Vyvanse (lisdexamfetamine) was produced by Shire Pharmaceuticals and it had long-lasting effects up to 14 hours, which was even longer than Adderall. They are both central nervous system stimulants and have similar effects, but also some differences. Let’s take a look.
Concerta vs Vyvanse Comparison Chart
Both drugs are used for ADHD and have similar psychostimulant effects on the body, but they have different active ingredients and can differ in duration of the function. Their off-label use can be different as well, which we will see down below.
|Approved uses||ADHD. Narcolepsy.||ADHD. Binge eating disorder.|
|Formats||ER (Extended-release)||Capsules (Extended release)|
|Dosages||ER: 18 mg/27 mg/36 mg/54 mg||30 mg/50 mg/70 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.||As an inactive prodrug, it is broken down in the body by enzymes to dextroamphetamine and l-lysine. It then acts as a TAAR1 agonist and VMAT2 inhibitor to release dopamine along with norepinephrine from storage sites and inhibits reuptake of these neurotransmitters.|
|Half life||3.5 hours||10 to 13 hours|
|Common side effects||Appetite loss. Dizziness. Headache. Insomnia. Nausea. Nervousness. Vomiting. Weight loss.||Abdominal pain. Appetite loss. Dizziness. Dry mouth. Headache. Insomnia. Irritability. Nausea. Nervousness. Sweating. Weight loss.|
|Date approved||August (2000)||February 23 (2007)|
|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.||Excessive daytime sleepiness.Cognitive symptoms of schizophrenia. Treatment-resistant depression.|
Difference: Concerta vs Vyvanse
They have similar effects, but they function differently. Vyvanse is a prodrug, which basically means it is inactive until it’s digested in the intestines. It breaks down in the presence of enzymes into amino acid l-lysine and dextroamphetamine active ingredient. The dextroamphetamine has an effect which can then last up to 14 hours.
Concerta has a different effect, where some of the active ingredients are released immediately (22%) and the rest of 78% is tapered to slowly release for the next 12 hours. Concerta has an active ingredient methylphenidate, in compared to Vyvanse which has dextroamphetamine. Concerta has also shorter elimination time with it’s shorter half-life period. It is also approved for treating narcolepsy, whereas the Vyvanse isn’t. But, the Vyvanse has its place in binge eating disorder, where Concerta is not involved. Concerta was more used in some researches and trials than Vyvanse.
Abuse Potential: Concerta vs Vyvanse
Both drugs are labeled as a “Schedule II” controlled substance, which means they have a high potential for abuse and they can make dependence quickly. Concerta has the possibility of snorting, where it makes it more appealing for abuse actions. The Vyvanse becomes active later on, after the intake, so it’s not that popular for using it to get a “rush” effect. Another thing which can be a reason why Vyvanse is not that popular for abuse is the time which is needed for the drug to start its effects. It can take up to 2 hours before any euphoria effects start to occur. It can lead to physical and psychological dependence where people can feel they can’t function normally without taking the medicine. This can be due to high dopamine levels.
Those who want to lose weight may abuse Vyvanse as it provides a fast solution but it creates physical dependence. They are both highly controlled substances which make them non-refillable. In order to get a new refill, you need to have a hard copy of a doctor’s prescription.
Dosage & Formats: Concerta vs Vyvanse
Concerta is being produced in four dosing: 18 mg, 27 mg, 36 mg and 54 mg. It is labeled as an OROS (osmotically controlled release oral delivery system). This is the system which releases the 22% immediately and the rest of 78% has an extended release.
Vyvanse comes in three dosing: 30 mg, 50 mg, and 70 mg. It has one less than Concerta, but it comes in the forms of the capsule, as a prodrug. It gets broken down to l-lysine and dextroamphetamine which acts for 14 hours. Although there are less dosing options for Vyvanse, the capsule can be opened and the drug can be dosed to a lesser powder quantity. Concerta on the other hand, can’t be cut into smaller pieces, therefore, it can’t be reduced.
Efficacy: Concerta vs Vyvanse
When comparing two medicines, it is important to look at the specific condition which is being treated. Both drugs are used for ADHD and are considered effective when compared to placebo in double-blind, randomized study. Its effects can be different during the time. Concerta has a fast effect while Vyvanse takes some time to act. Vyvanse, on the other hand, has a longer effect, up to 14 hours, while Concerta lasts for 12 hours. Since Concerta releases one part immediately and the other 78% acts for 12 hours, it is equivalent to compare 36 mg of Concerta versus 25 mg of Vyvanse.
Comparing these two drugs, it is fully subjective and up to every each of individual how they find the drug useful. Some find Concerta to be more effective due to its faster effects while others find Vyvanse better due to its longer action.
Mechanisms Of Action: Concerta vs Vyvanse
Concerta is a drug containing methylphenidate which is a catecholamine reuptake inhibitor. It affects dopamine and norepinephrine levels. It has a stimulative outcome which helps with hyperactivity and reduces the activity of the brain which is proven to help with focus, attention and organization in ADHD.
Vyvanse is a prodrug which is activated in the body. When the lisdexamfetamine gets released from the initial prodrug form, it acts as a reuptake inhibitor of dopamine and norepinephrine. It increases the levels of dopamine and norepinephrine taking it from presynaptic neurons.
Popularity: Concerta vs Vyvanse
There are a lot of users for both drugs, with estimated 8.8 million prescriptions for Concerta and about 9.8 million prescription Vyvanse. They are one of the most prescribed drugs in psychiatry making the top 20. The only drug which is more popular than Concerta and Vyvanse for ADHD therapy is Adderall. Vyvanse was also the most popular drug for ADHD in 2015 and the most popular drug prescribed for a monthly use in June 2013 and July 2014, with a prescription over 10 million. This can be due to a fact that it isn’t available in its generic form, where the Concerta has generic forms other than brand ones. It has less potential for abuse due to its low possibility for snorting and “high” rush. It has also a longer effect which can be convenient for the long-term use.
Side Effects: Concerta vs Vyvanse
They are similar in terms of side effects since they have nearly the same effect on the nervous system increasing the levels of dopamine and norepinephrine. They can cause decreased appetite, weight loss, nausea, anxiety, headache, dizziness. Vyvanse can have greater side effects due to its increased potency and presynaptic activity over Concerta. It can be brought to a minimum with using minimal effective dose which will prevent side effects. Not all side effects will appear among all the users since they require certain individual characteristics and factors.
Withdrawal: Concerta vs Vyvanse
These drugs are labeled as a “Schedule II” controlled substance. This is due to its strong abuse potential and influence on dopamine and norepinephrine levels. When dealing with withdrawal from this drugs, it can be a difficult time when having to bear with all the symptoms. It is all due to low dopamine levels. It exacerbates the ADHD symptoms, causes depression, fatigue, impaired concentration, sleepiness, slow cognitive functions and psychomotor activity. These symptoms can be present for months and can be hard to deal with. The tapering can be easier with Vyvanse since it’s in a form of powder and it can be easily measured to gradually lower the dose, even if it’s only in 3 dosing options. On the other hand, Concerta has a high span between two doses (18 to 9 mg) and it can be harder to taper. It isn’t convenient to break into smaller doses since you can’t cut it into smaller dosings.
Which Drug Is Better? Concerta vs Vyvanse
It is fully optional. Some like Vyvanse better than Concerta and vice-versa. It is subjective and not every drug will work the same with every individual. It has to do with their own characteristics, factors, genetics and other things as well. Depending on what you need, you may want a different option.
Which do you find better? Do you use some of these drugs for ADHD? Comment below to share your experience.