Adderall vs. Concerta: Considerations for ADHD Medication

Adderall and Concerta are two commonly used central nervous system (CNS) stimulants that treat attention deficit hyperactivity disorder (ADHD). Though they can both be effective for treating the symptoms of ADHD, such as poor focus and attention, they work differently and carry different risks.

Learn more about the effectiveness, side effects, and risks of Concerta and Adderall with this drug comparison.

What Is Adderall?

Adderall is the brand name for a combination medication that contains amphetamine salts, amphetamine, and dextroamphetamine. Adderall is commonly prescribed to treat ADHD and narcolepsy, with the two prescription stimulants working together to stimulate the central nervous system (CNS) and affect the neurotransmitters that cause impulse control and hyperactivity.

What Is Concerta?

Concerta is a brand for methylphenidate, a stimulant medication that’s used to treat ADHD. It’s available in extended-release tablets that can be effective for up to 12 hours.[1]

Concerta vs. Adderall Dosage

Adderall and Concerta are available in different formulations and dosages. Because stimulant medications have a potential for dependence and abuse, Adderall and Concerta are both intended to be used at the lowest effective dose for the shortest period.

Adderall Dosage

Adderall is available in several formulations and dosages:

Immediate-release (IR) Adderall is prescribed at an initial dose of 5 mg orally once or twice a day for ADHD.[2] The dose is increased by 5 mg each week until it’s effective at treating ADHD symptoms, with a maximum daily dose of 40 mg per day.

For narcolepsy, Adderall IR may be prescribed at an initial dose of 10 mg orally in divided doses, which may be increased by 10 mg each week.

Adderall IR has an initial dose of 2.5 mg per day and is increased in 2.5 mg increments weekly for children aged 3-5 years.[3] Adderall IR has an initial dose of 5 mg orally once or twice per day, then increased in 5 mg increments at weekly intervals for children aged 6-7 years.[4]

Extended-release (XR) Adderall is prescribed at an initial dose of 20 mg once daily for ADHD.[5] Adderall XR isn’t used to treat narcolepsy.

Adderall XR has an initial dose of 5 to 10 mg once per day and is increased in 5 or 10 mg increments at weekly intervals in children aged 6-12 years.[6] Adderall XR has an initial dose of 10 mg orally once a day, then increased to 20 mg per day after one week for children aged 13 to 17 years.[7]

Concerta Dosage

Concerta is prescribed at 18 mg once daily for adolescents and children as an initial dose, though it may be increased until it has the desired results. The maximum daily dose of Concerta is 54 mg per day for children 6-12 years old and 72 mg per day for adolescents and adults. Concerta is not recommended for children under 6 or adults over 65.

Adults are usually prescribed 18 mg or 36 mg per day.[8] The dosage is increased by 18 mg weekly until the maximum daily dose of 72 mg is reached.

Adderall and Concerta Side Effects and Risks

Adderall and Concerta have possible side effects, many of which are mild and subside once your body adjusts to the drug. However, there are some serious side effects. The common side effects of these drugs may include:[9,10]

• Headache
• Stomach pain
• Nausea
• Vomiting
• Dry mouth
• Sweating
• Irritability

The serious side effects may include:

• Chest pain
• Shortness of breath
• Fainting
• Violent thoughts or actions
• Hallucinations
• Numbness in the fingers or toes
• Slowed growth (children)

Though rare, Adderall and Concerta can cause psychosis. Adderall is more likely to cause psychosis than Concerta. Painful erections in men are a potential risk of Concerta.

Adderall and Concerta have potentially serious risks, including heart and blood pressure changes that can cause sudden death if you have heart problems. If you’re pregnant or planning to become pregnant, Adderall and Concerta may have risks.

Adderall vs. Concerta: Which is More Effective?

Studies comparing Adderall and Concerta for treating ADHD have not shown statistically significant differences in their overall effectiveness, but individuals may respond better to one drug than the other.[11] However, the studies did show that participants who responded better to one drug saw little to no results with the other.

Addiction to Adderall and Concerta

Adderall and Concerta may work differently, but they’re both Schedule II controlled substances, according to the Drug Enforcement Administration (DEA), and stimulant medications that have a risk of misuse, abuse, and addiction. Some people misuse prescription stimulants to treat self-diagnosed ADHD, as a weight loss aid, or as a study aid, though stimulants can negatively affect academic performance.

While research shows that Adderall and Concerta can be addictive, no research compares them side by side to see which one has a higher risk. Always take your medication exactly as prescribed. Don’t take more frequent doses or higher doses than prescribed. Do not alter your ADHD medication in any way.

Use of Adderall and Concerta can lead to tolerance, meaning you’ll need higher and higher doses to get the same effects. Increasing your dose or frequency increases the risk of serious side effects or overdose.

Physical dependence is a risk of Adderall and Concerta, even when you take the drugs as prescribed. Your body adjusts to the drug over time and needs it to function. Stopping its use or reducing your dose suddenly can cause withdrawal symptoms like fatigue, depression, and sleep disturbances. You may experience rebound ADHD symptoms, which are symptoms of ADHD that return, often worse than before you started taking the drug.

If you want to stop taking Adderall or Concerta, talk to your doctor about how to do so safely. Both Adderall and Concerta may need the dose tapered to reduce the severity of withdrawal, but this should always be done under the supervision and recommendation of a healthcare provider.

Treatment for Stimulant Addiction

An addiction to Adderall or Concerta is officially known as a stimulant use disorder. The treatment is the same, regardless of which drug you use.

The withdrawal symptoms with stimulant ADHD medications can be difficult to manage on your own, so medical detox is often the first step in seeking treatment. A medical team can supervise your dose taper schedule, withdrawal symptoms, and general health to keep you as safe and comfortable as possible.

Detox can build a strong foundation for treatment, but it’s not an addiction treatment on its own. It’s best to enter a comprehensive treatment program for stimulant use disorder to understand and overcome the social, emotional, and psychological aspects of addiction. Though treatment programs are individualized, they often include a combination of individual therapy, group counseling, family therapy, cognitive-behavioral therapy (CBT), and support groups.

Deciding Between Adderall and Concerta

Adderall and Concerta are two widely used prescription stimulant medications for ADHD. There are differences in how effective these drugs are and their risks and side effects. If you’re considering Adderall or Concerta for ADHD, discuss your options with your doctor.