From a historical perspective, one of the most popular ADHD medications of all time is Ritalin. It was first approved by the FDA in 1955 for treating a condition referred to as “hyperactivity.” While there weren’t many diagnoses for hyperactivity in the 1950s, the number of diagnoses skyrocketed in the 1990s, making Ritalin the single most popular pharmaceutical for the treatment of the condition now known as attention-deficit hyperactivity disorder (ADHD).
Ritalin has been around for well over half a century (nearly 60 years) and has been subject to extensive research. Although Ritalin is still heavily prescribed throughout the world, it no longer is the dominant drug of choice for treating ADHD. Nearly 40 years after the inception of Ritalin, a psychostimulant medication known as “Adderall” was engineered by Shire Pharmaceuticals.
Adderall gained steady momentum for its efficacy in treating attentional deficits. It also gained widespread acclaim as a stimulant that could be used as a party drug or to achieve a state of psychological euphoria. Despite the fact that Adderall and Ritalin are both psychostimulant drugs, there are subtle differences in the ingredient composition as well as mechanisms of action.
Ritalin vs. Adderall Comparison Chart
Below is a general comparison chart to help you assess basic differences between Ritalin (methylphenidate) and Adderall (mixed amphetamine salts). Understand that Ritalin was the first medication approved for the treatment of ADHD in 1955, whereas Adderall didn’t hit the market until 1996.
|Approved uses||ADHD / narcolepsy||ADHD / narcolepsy|
|Ingredients||Methylphenidate||Mixed Amphetamine Salts: 75% Dextroamphetamine + 25% Levoamphetamine|
|Formats||IR (Immediate release) or SR (Sustained Release) or LA (Long acting)||IR (Immediate release) or XR (Extended release)|
|Dosages||IR: 5 mg/10 mg/20 mg or SR: 10 mg/20 mg or LA: 10 mg/20 mg/30 mg/40 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||Novartis 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.|
|Half life||1 to 7 hours||11 to 13 hours|
|Common side effects||Abdominal pain. 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||(1955)||February 13 (1996)|
|Effect duration||IR: 3 to 4 hours/SR: 6 to 8 hours/LA: 8 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 (Read: Adderall for depression).|
Ritalin vs. Adderall: What’s the difference?
As you can see by the chart above, these drugs have some obvious similarities and some subtle differences. Adderall is a newer drug comprised of mixed amphetamine salts, whereas Ritalin contains methylphenidate. Both are considered effective agents for the treatment of ADHD and each is classified as a “Schedule II” controlled-substance in the United States.
The formatting and effect duration of each drug is slightly different. Ritalin is manufactured in three formats: an instant release (IR) lasting 3-4 hours, sustained release (SR) lasting 6 to 8 hours, and long-acting (LA) lasting 8 hours. Adderall is limited to two formats: an instant release (IR) lasting 4 to 6 hours and extended release (XR) lasting 12 hours.
Both Adderall and Ritalin are thought to have a high potential for abuse and dependence, therefore they are classified as “Schedule II” controlled-substances. This means that those taking Adderall or Ritalin may end up taking more than the prescribed amounts to achieve a psychological “high” characterized as a stimulatory euphoria. This psychological high is a result of high concentrations of dopamine being released.
Many partygoers take Adderall and/or Ritalin as means of inducing a psychological euphoria as well as to mitigate some of the psychological impairment associated with alcohol consumption. Those who abuse these drugs may resort to administering the substances with non-medically approved modalities such as insufflation or injection. It is common for individuals to resort to snorting Adderall as a quicker way to get high compared to oral ingestion.
The abuse potential is not limited to partygoers – many college students take Adderall and Ritalin to improve their academic performance. Many end up becoming dependent on these substances in order to perform well on tests or get passing grades. Tolerance is quickly built-up to each of these substances, making them both popular drugs of abuse. Adderall may have slightly more abuse potential due to the fact that it is thought to elicit a greater “rush” than Ritalin.
Cost: Which is more expensive?
If you want to purchase the respective generic versions of Ritalin (methylphenidate) and Adderall (mixed amphetamine salts) you can save yourself quite a big chunk of change compared to the “brand names.” The cost of generic versions of Ritalin and Adderall tend to be relatively similar – approximately $50 for a 30 day supply. You may be able to attain Ritalin for less than Adderall depending on your pharmacy.
That said, the sustained-release and long-acting versions of Ritalin are still fairly costly – even for generics. The generic sustained-release version is usually a minimum of $50 and the generic long-acting is a minimum of $70 for a 30 day supply. The generic Adderall XR costs a minimum of $75 most places for a 30 day supply – making Adderall slightly more expensive for generics than Ritalin.
The brand name versions of Ritalin and Adderall are both relatively expensive. Brand name immediate-release Ritalin costs approximately $95 whereas brand name immediate-release Adderall costs nearly $300. Upon cost comparison, it becomes obvious that immediate-release Ritalin can be attained for a fraction of the price of immediate-release Adderall. However the extended release Adderall cost (+$220) is comparable to long-acting Ritalin (+$218).
Dosage & Formats
There are subtle differences in dosage and formats of Ritalin and Adderall. Ritalin can be taken in the format of instant release (IR), sustained release (SR), or long-acting (LA) form. Adderall is limited to two formats of: instant release (IR) and extended release (XR). The instant release version of Adderall is thought to last 4 to 6 hours, whereas the instant release version of Ritalin is shorter acting at only 3 to 4 hours.
A dosage of 5 mg Adderall is thought to be equivalent to approximately 10 mg of Ritalin. Adderall is manufactured in more dosing variations such as 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg for the immediate release. These smaller increments may be preferred by doctors and patients due to the fact that they make it easier to titrate upwards or downwards with the dose.
Ritalin is more limited in their dosing options and is formatted in only 5 mg, 10 mg, and 20 mg tablets for their immediate release (IR). Adderall is thought to have the more versatile dosing options, whereas Ritalin’s formatting in short-acting, moderate-acting, and long-acting options may be preferred by some individuals.
Efficacy: Which drug is more effective?
The biggest component associated with comparing Ritalin and Adderall is determining the efficacy. Both medications are considered clinically effective for the treatment of ADHD and narcolepsy, meaning they both stood the test of randomized, double-blind, placebo-controlled studies. That said, studies have made attempts to compare the medications on a head-to-head basis in order to determine whether one may be more effective than the other for reducing attentional deficits.
An 8-week study with 25 children diagnosed with ADHD compared the efficacy of Ritalin, Adderall, and a placebo. They received either Ritalin 10 mg or 17.5 mg, Adderall 12.5 mg, or a placebo. These were administered twice per day (once in the morning and once in the afternoon). Results demonstrated that both drugs were significantly better than a placebo for behavioral improvements, academic productivity, and staff/parent ratings of behavior.
Researchers noted that Adderall produced a greater improvement than Ritalin on most measures. Authors of the 1999 publication note that Adderall was functionally more potent at the given doses than Ritalin. Another study published the same year compared 42 youths treated with Adderall to 42 youths treated with Ritalin.
They analyzed how a single dose of Adderall compared to a 2 doses of Ritalin. The researchers concluded that one dose of Adderall was equal in efficacy to the 2 doses of Ritalin. They suggested that Adderall may be preferred over Ritalin due to reduced treatment management (i.e. only administering one dose).
Another comparison publication published in 2000 analyzed how 25 mg of Ritalin compared to 12.5 mg of Adderall among 58 children. Results suggested that Adderall was favorable over Ritalin and the behavioral improvements were longer-lasting after single doses. While both drugs produce improvement in attentional deficits, Adderall may be slightly more effective.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10103335
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10405498
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10802980
Mechanisms of action…
The reported subjective effects of both Ritalin and Adderall are considered similar. Both drugs function as psychostimulants and increase concentrations of dopamine and norepinephrine. Ritalin is comprised of methylphenidate, which is thought to act as a “pure uptake inhibitor” without other presynaptic activity. The mixed amphetamine salts within Adderall are thought to elicit additional presynaptic activity releasing dopamine and norepinephrine from presynaptic neurons.
Ritalin is known to have a shorter half-life than Adderall, meaning it is more rapidly excreted. There are thought to be some differences in the way each drug is excreted from the body. Ritalin is thought to metabolize into 80% inactive molecules and 20% to an active metabolite. The mixed amphetamine salts in Adderall are believed to be excreted via urine.
- Source: http://jad.sagepub.com/content/3/4/200.refs
From a medical perspective, both Ritalin and Adderall are used to treat similar conditions. They are each considered effective first-line treatments for ADHD and narcolepsy. They also are utilized on an off-label basis as an antidepressant augmentation strategy for individuals with treatment-resistant depression. They do differ slightly in terms of other medical investigational uses.
Ritalin has been investigated as a treatment for POTS (postural orthostatic tachycardia syndrome), lethargy, obesity, aggression, and criminality. Due to the fact that both drugs elicit similar stimulatory effects, it could be speculated that both would have similar investigational uses. In some cases they may be tested as counterintuitive interventions for individuals suffering from refractory anxiety. (Read: Adderall for anxiety disorders).
In regards to popularity, Adderall is the single most popular psychostimulant medication on the market. As of 2013 an estimated 38% of all psychostimulant prescriptions were of Adderall. By comparison, an estimated 23% of all psychostimulant prescriptions were for methylphenidate. Ritalin is just one brand name of medication that is comprised of the ingredient methylphenidate.
Based on the sheer number of prescriptions alone, Adderall is more popular. Millions of people are known to be taking Adderall, whereas only hundreds of thousands are thought to be taking Ritalin. Much of the popularity is in regards to the slightly increased efficacy of Adderall over Ritalin as well as the fact that it’s newer.
The side effect profiles of both Ritalin and Adderall are similar. Both are stimulatory medications designed to speed up activity in the central nervous system. Both increase extracellular levels of dopamine and norepinephrine. As a result, there is often significant overlap in side effects such as: anxiety, appetite loss, insomnia, nervousness, and weight loss.
Both stimulants have been documented as stunting the growth of youth. Although short-term stunting of growth is common (i.e. 1 inch), it is believed to be temporary, ultimately not affecting an individual’s final adult height. Each of these drugs also can also provoke “stimulant psychosis” when used at high doses over a long-term.
In addition to reduced height, individuals taking these stimulants tend to also be thinner – weighing less than non-medicated counterparts. For this reason, many people use Adderall for weight loss, despite its lack of FDA approval for obesity. Many people have had success in using Ritalin off-label to lose weight as well.
Ritalin and Adderall are both difficult to discontinue due to the fact that they are habit forming. Those taking either of these drugs may quickly build tolerance and ultimately have a difficult time functioning without the drug, especially after moderate or long-term usage. The difficulty of withdrawal is generally dictated by the dosage taken and duration over which it was taken.
While the medical community may downplay the severity of both Ritalin withdrawal and Adderall withdrawal, those taking the drugs know better. Over a long term, both drugs downregulate dopamine and dopamine receptors. This results in low dopamine levels upon discontinuation, which exacerbates attentional difficulties and hyperactivity.
Furthermore, many anecdotal reports suggest that withdrawal is often protracted, lasting months (or in some cases years) before attentional capacity and full cognitive function is restored. These substances carry risk of dependence. Those that have been taking them for a long term may not be able to face the withdrawal symptoms nor function (at work or school) without the aid of either drug.
Similarities (Recap): Ritalin vs. Adderall
Below is a recap of some general similarities between Ritalin and Adderall.
- Abuse potential: Both drugs are classified as “Schedule II” controlled-substances, meaning they are habit-forming and carry significant abuse potential. Those using either of these substances may feel as if they have become physically or psychologically dependent upon them for functioning.
- ADHD: Ritalin and Adderall are considered first-line treatment options for attention-deficit hyperactivity disorder. Both drugs were found to be significantly better than a placebo in randomized, double-blind studies.
- Generic availability: Each of these drugs is available in generic formats. Generic Ritalin is referenced as “methylphenidate,” while generic Adderall is referenced as “mixed amphetamine salts.”
- Interactions: These drugs each are known to have interactions with MAOIs, antihypertensive medications, tricyclic antidepressants, and more. There is some individual variation regarding pharmaceutical drugs that interact with Adderall compared to those that interact with Ritalin, but there is also some overlap. For more extensive information regarding potential contraindications, talk to a doctor and/or pharmacist.
- Legal status: Each of these drugs is legal in the United States with a prescription only. Without a prescription, they are considered illegal to possess. Prescriptions for each of these substances are non-refillable without signed permission from a medical professional.
- Psychostimulants: Both of these drugs are classified as “psychostimulants.” The precise mechanisms of action are subject to minor variation based on ingredient composition.
- Medical uses: Ritalin and Adderall are each approved by the FDA for the treatment of ADHD and narcolepsy.
- Neurotransmission: Each of these substances affects neurotransmission similarly by inhibiting the reuptake of stimulatory neurotransmitters like dopamine and norepinephrine.
- Popularity: Although Adderall is the most popular pharmaceutical psychostimulant, Ritalin is still incredibly popular. Decades ago, Ritalin was clearly the most popular psychostimulant drug on the market. Each drugs could be considered the most popular drugs of their respective eras.
- Side effects: The side effect profiles of Ritalin and Adderall are similar in that they both may provoke nervousness, insomnia, anxiety, and result in appetite suppression.
- Withdrawal: Discontinuation from these medications is thought to be difficult due to the fact that a person may have become dependent upon high doses for enhanced cognition. Withdrawal symptoms often include: fatigue, low energy, sleepiness, and psychomotor depression.
Differences (Recap): Ritalin vs. Adderall
Below is a recap of some general differences between Ritalin and Adderall.
- Cost: Although the cost for the extended release (XR) Adderall and long-acting (LA) Ritalin are similar, the cost of the immediate-release (IR) versions of each drug is significantly different. Brand name Ritalin (IR) can be purchased at a fraction of the price of Adderall (IR).
- Duration of effect: The duration of effect differs slightly between the immediate-release versions. Adderall is thought to deliver an effect for 4 to 6 hours, whereas Ritalin is only thought to be active for 3 to 4 hours.
- Efficacy: Results from some studies in the late 1990s/early 2000s suggest that Adderall may be superior in efficacy to Ritalin. While the superiority of efficacy may not be statistically significant, it may be enough for patients to prefer Adderall over Ritalin.
- Formats: Ritalin is available in three different formats (IR, SR, LA) and Adderall is available in two formats (IR and XR). While they both share an immediate-release format, the duration of effect for each format is different.
- Half-life: The half-life of Adderall (11 to 13 hours) is notably longer than that of Ritalin (1 to 7 hours).
- Ingredients: Ritalin is comprised of methylphenidate and Adderall is comprised of 75% dextroamphetamine / 25% levoamphetamine (mixed amphetamine salts).
- Investigational uses: Ritalin has been investigated for the treatment of aggression and criminality. Adderall has been tested as an aid in the rehabilitation of stroke patients.
- Manufacturer: The original patent for Ritalin was held by CIBA, which is now considered Novartis. Adderall is manufactured by Shire Pharmaceuticals.
Which drug is better for ADHD? Ritalin vs. Adderall.
Everyone considering a psychostimulant (or currently taking one) wants to know if the drug they’re taking is the “best.” Both of these substances are considered clinically effective for the treatment of ADHD and narcolepsy symptoms. That said, several studies suggest that Adderall is more effective and longer-lasting at an estimated equivalent dose to Ritalin.
Furthermore, many people prefer Adderall due to the fact that it doesn’t need to be taken as frequently as Ritalin – potentially reducing the number of pills ingested per day. There is no definitive evidence suggesting that Adderall works better than Ritalin, but one study from 1999 indicated that Adderall produced longer-lasting behavioral improvements in youth than Ritalin.
It is important to realize that responses to each drug are subject to significant individual variation. Some people may find that Ritalin works better with less side effects for treating their ADHD, while others may find that Adderall packs a comparatively favorable punch. Others may find that neither drug works all that well or that both carry unwanted side effects. It is important to avoid thinking that one drug is significantly “better” than the other until evidence proves it.
Which drug do you prefer: Ritalin or Adderall?
If you’ve tried Ritalin and Adderall, feel free to share which drug was more helpful for treating your symptoms of ADHD or narcolepsy. Did you experience more side effects or unwanted effects from one drug compared to the other? Some people claim to experience a “cleaner focus” on Ritalin compared to Adderall, whereas others prefer to use Adderall because it eradicates their ADHD to a greater extent.