Methylphenidate is considered the first medication approved for the treatment of the condition known as “hyperactivity” in the 1960s. As attention-deficit/hyperactivity disorder gained more mainstream attention in the 1990s, the number of diagnoses continued to skyrocket, increasing the demand for new treatments. By the year 1996, mixed amphetamine salts (i.e. Adderall) were approved for the treatment of ADHD; this further expanded the treatment market.
Mixed amphetamine salts attained mainstream popularity, and eventually surpassed methylphenidate as the most popular treatment. In 2000, the company Janssen Pharmaceuticals had engineered an improvement over standard “immediate-release” forms of methylphenidate. Their newly engineered drug Concerta was known to provide long-lasting relief for up to 12 hours, nearly tripling the duration of effect compared to immediate-release formats.
Nearly 8 years after Concerta had established itself as an effective ADHD medication, Shire Pharmaceuticals released the drug Vyvanse. Vyvanse was created as an improvement over mixed amphetamine salts (Adderall) in that it was a prodrug and provided a longer-lasting effect for nearly 14 hours. Although both Concerta and Vyvanse are similar in that they are psychostimulants, there are subtle differences between the two worth knowing.
Concerta vs. Vyvanse Comparison Chart
Below is a chart comparing Concerta with Vyvanse. While both have commonalities in that they are psychostimulants used to treat ADHD, their secondary approved uses differ, they have different active ingredients, and slight variations in their duration of effect.
|Approved uses||ADHD. Narcolepsy.||ADHD. Narcolepsy. Binge Eating Disorder.|
|Formats||ER (Extended-release)||Capsules (Extended release)|
|Dosages||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).|
Blocks dopamine and norepinephrine transporters - increasing their extracellular concentrations.
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.
The dextroamphetamine component functions as a TAAR1 agonist and VMAT2 inhibitor to release dopamine along with norepinephrine from storage sites.
It also inhibits the reuptake of dopamine and norepinephrine to increase extracellular concentrations and signaling.
|Generic version (?)||Yes.||No.|
|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.|
|Duration of effect||12 hours||10 to 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.|
|Date approved||2000 (August)||2007 (February)|
Concerta vs. Vyvanse: What’s the difference?
The most prominent difference between Concerta and Vyvanse is that Vyvanse is a prodrug, meaning it is inactive until metabolized by the body. Upon ingestion of Vyvanse, it is broken down by enzymes into the amino acid l-lysine and the drug dextroamphetamine. The dextroamphetamine then provides symptomatic relief from ADHD for up to 14 hours.
Concerta is unique in that it delivers an effect for up to 12 hours and the drug is distributed differently than most other long-acting drugs. Approximately 22% of the methylphenidate is delivered immediately, whereas the remaining 78% is released gradually for sustained symptomatic relief for up to 12 hours. Concerta is a methylphenidate-based drug, whereas Vyvanse is effective as a result of dextroamphetamine.
The methylphenidate within Concerta has been involved in more investigational uses than the lisdexamfetamine within Vyvanse. Concerta has a significantly shorter elimination half-life by comparison and a different manufacturer. Concerta is approved to treat narcolepsy – Vyvanse isn’t, but Vyvanse is approved for binge eating disorder – Concerta isn’t.
Both Concerta and Vyvanse are regarded as “Schedule II” controlled-substances, meaning they have a high potential for abuse and may be habit-forming. It is common for users to become psychologically dependent on these substances in order to function. Some people may use them as a means to perform well at school or work, and without them they cannot function.
Upon comparison, Concerta may have slightly more abuse potential due to the fact that it can be crushed and insufflated (i.e. snorted), whereas Vyvanse cannot. While it is considered difficult to crush Concerta, many users still do this to attain the more potent and faster-acting dopaminergic “high.” Vyvanse must be taken orally and metabolized to get any effect, making it less appealing to those attempting to abuse it.
Furthermore, the effects of Vyvanse are not usually immediate, sometimes taking up to 2 hours before the drug “kicks in.” That said, taking high doses of either of these drugs can result in a temporary psychological euphoria as a result of high concentrations of dopamine release. Frequent abuse may result in a condition known as “stimulant psychosis,” which stems from abnormally high dopamine levels.
Others may become physically dependent on these drugs, using them with the intent of losing weight. Many people use Vyvanse for weight loss, and it is approved for the related condition of binge eating disorder. Both Concerta and Vyvanse tend to reduce appetite, speed metabolism, and increase energy for working out.
Those who are overweight may be drawn to these medications as a fast-track weight loss solution and may become physically dependent upon the drug to maintain a certain physique. The fact that both these substances have a high abuse potential, they are non-refillable, and to attain a prescription, a patient must have a physical copy of a doctor’s signature.
Cost: Which is more expensive?
Those that don’t have top-notch insurance or are paying for their prescriptions out-of-pocket often want to know the cheapest medication to treat ADHD. If your doctor wants you to try either Concerta or Vyvanse, one may be preferable over the other if your budget is limited. Due to the fact that Vyvanse is a newer drug, it is not yet sold as a generic (lisdexamfetamine) – making the cost relatively expensive.
If we’re comparing “brand name” Concerta to “brand name” Vyvanse, the cost for Concerta is actually a bit more expensive for a 30 day supply. A typical 30 day supply of Concerta costs between $260 and $300 at most pharmacies; the greater the dose, the higher the cost. Those planning on purchasing Vyvanse will end up paying approximately $250 for a 30 day supply.
By comparison, the brand name Concerta is more expensive than Vyvanse. However, if we take into account the fact that Concerta is sold as a generic (methylphenidate ER), the price is cheaper than Vyvanse. Generic Concerta (methylphenidate ER) can be attained at a rate between $100 and $170 for a 30 day supply. This means that generic Concerta (methylphenidate ER) is the cheapest option, followed by Vyvanse, and the most expensive option remains brand name Concerta.
Dosage & Formats
Concerta is engineered as an OROS (osmotically controlled-release oral-delivery system) drug with a composition of 22% immediate-release methylphenidate and 78% gradual-release methylphenidate. This means that the drug starts working within minutes of administration, and should continue to elicit an effect for nearly 12 hours. Concerta is manufactured in four dosing options including: 18 mg, 27 mg, 36 mg, and 54 mg.
By comparison, Vyvanse is manufactured in capsule format as a prodrug, meaning it is biologically inactive until metabolized. The Vyvanse (lisdexamfetamine) powder gets broken down by the body, and metabolized into l-lysine and dextroamphetamine. The fact that the body needs to metabolize the drug before it becomes active means that it takes nearly 2 hours for the drug to “kick in” and the effect can last for up to 14 hours.
Vyvanse is manufactured in doses of 30 mg, 50 mg, and 70 mg – meaning it has one less dosing increment than Concerta. Although Vyvanse may only come in three dosing options, the capsules can be easily opened and powder can be poured onto food (e.g. yogurt) to attain less of the desired dose. Concerta cannot be cut and therefore users may have a more difficult time with titrating upwards or downwards compared to Vyvanse.
Efficacy: Which drug is more effective?
Most people comparing Concerta with Vyvanse are trying to determine whether one drug is superior in efficacy to the other. Both substances were approved for the treatment of ADHD, and are considered significantly more effective than a placebo in randomized, double-blind studies. Concerta elicits an effect for 12 hours, and Vyvanse elicits an effect for nearly 14 hours, meaning it is effective for a longer time-span than Concerta.
Concerta is faster-acting compared to Vyvanse due to the fact that 22% of its methylphenidate is immediately released. Since no head-to-head comparison studies have been conducted, it is impossible to conclude with any type of conviction that one drug is more effective than the other. Dosage equivalency calculations suggest that 36 mg Concerta is equivalent to 25 mg Vyvanse.
This suggests that lower doses of Vyvanse are likely more potent than higher doses of Concerta. In any regard, the efficacy of these drugs is most often based on the individual and subjective interpretations. One person may find that their ADHD responds better to Concerta, another may find that Vyvanse works better, and a third person may not respond well to either drug.
Comparing the active ingredient of each “methylphenidate” with “dextroamphetamine” some would argue that dextroamphetamine is the more potent option. This is based off of studies from the late 1990s/early 2000s suggesting that Adderall (75% dextroamphetamine / 25% levoamphetamine) is twice as potent as Ritalin (methylphenidate). It remains unclear as to whether the dextroamphetamine derived from Vyvanse is superior to the methylphenidate derived from Concerta.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10405498
- Source: http://www.ncbi.nlm.nih.gov/pubmed/10802980
Mechanisms of action
The mechanisms of action of Concerta and Vyvanse are similar in that they both affect the neurotransmitters dopamine and norepinephrine. Furthermore they both elicit a stimulatory effect that improves attention span and reduces hyperactivity. The specific mechanisms of action for each drug are a direct result of their respective formulations and ingredient composition.
Concerta is comprised of methylphenidate, which functions as a catecholamine reuptake inhibitor, specifically inhibiting dopamine and norepinephrine. The inhibition of dopamine and norepinephrine leads to greater extracellular concentrations of these neurotransmitters. Concerta is believed to act as a “pure uptake inhibitor” without additional presynaptic activity.
Concerta capsules are comprised of an osmotically controlled-release oral-delivery system (OROS) which delivers 22% of the methylphenidate immediately (lasting 4 hours), and 78% gradually over the course of the following 8 hours. Due to the fact that Vyvanse is a prodrug, the active ingredient (lisdexamfetamine) remains inactive until metabolized by the body.
Once metabolized, the drug is converted into l-lysine (an amino acid) and dextroamphetamine. The dextroamphetamine inhibits reuptake of dopamine and norepinephrine, but unlike the methylphenidate within Concerta, elicits further presynaptic activity. The dextroamphetamine derived from Vyvanse stimulates presynaptic release of dopamine and norepinephrine from presynaptic neurons.
- Source: http://jad.sagepub.com/content/3/4/200.refs
From a medical perspective, both Concerta and Vyvanse are regarded as first-line treatment options for ADHD. They differ in secondary approvals in that Concerta attained approval for the treatment of narcolepsy, whereas Vyvanse attained approval for the treatment of binge eating disorder. Both drugs are considered effective antidepressant augmentation strategies in cases of refractory depression.
Historically, methylphenidate (within Concerta) was investigated for the treatment of aggression, bipolar disorder, criminality, lethargy, obesity, and postural orthostatic tachycardia syndrome (POTS). Although Concerta specifically may not have been investigated for all of these conditions, its active ingredient was. Vyvanse has been investigated for the treatment of excessive daytime sleepiness and cognitive impairment associated with schizophrenia.
As of 2015, Vyvanse has emerged as the most popular prescription for ADHD. As of 2013, both Concerta and Vyvanse were regarded as being among the top 20 psychiatric drugs. There were an estimated 9.8 million prescriptions for Vyvanse, and an estimated 8.8 million prescriptions for Concerta. This meant that they were in close competition as being the most popular “brand name” ADHD meds on the market.
Only generic Adderall (mixed amphetamine salts) was considered more popular than Concerta or Vyvanse. Data collected for number of most prescribed psychiatric drugs on a monthly basis (June 2013 to July 2014), suggests that Vyvanse was prescribed over 10 million times, yet Concerta didn’t even make the list. Runner-ups to Vyvanse included: Focalin XR (2.8 million prescriptions) and Strattera (2.3 million prescriptions).
This suggests that Vyvanse has continued to gain momentum, in part due to the fact that it is still not available as a generic. Furthermore many doctors prefer Vyvanse due to its longer-lasting effect and the fact that it is a prodrug, which means it must be taken orally (rather than getting snorted). Many people view Vyvanse as an improvement over Adderall, which is why it has attained more popularity than Concerta.
The side effects resulting from Concerta and Vyvanse are thought to be relatively similar due to the fact that they have similar mechanisms of action. Common side effects associated with both drugs include: appetite loss, dizziness, headache, insomnia, nausea, nervousness, and weight loss. Children and adolescents using either drug may experience weight loss, and tend to experience temporary stunting of growth.
This temporarily stunted growth as a result of psychostimulant usage isn’t thought to affect final adult height. A majority of side effects from these drugs are a direct result of dopamine and norepinephrine reuptake inhibition. It could be theorized that additional presynaptic activity of Vyvanse and its increased potency may result in more severe and/or a greater number of side effects than Concerta.
That said, most side effects can be chalked up to individual sensitivities to the active ingredients and dosing. Those taking a higher dose will likely have more side effects than someone taking the minimal effective dose. There is significant variation in regards to side effects based on individual physiology; one person may exhibit fewer side effects with Concerta and another may exhibit fewer with Vyvanse.
Individuals that take either Concerta or Vyvanse for an extended-term (e.g. years) will likely have a difficult time coping with discontinuation symptoms. Discontinuation symptoms are generally severe due to the fact that these substances are highly potent, and artificially increase dopamine. The brain becomes reliant upon these drugs to receive its dopamine fix, which reduces ADHD symptoms and enhances cognition.
Over time, Concerta and Vyvanse use up dopamine stores in the brain and downregulate receptors. This leads a person to experience low dopamine upon withdrawal, and reduced receptor density. Ultimately symptoms emerge including: excessive sleepiness, depression, fatigue, impaired concentration, and psychomotor slowing.
Due to the fact that endogenous production of dopamine is low as a result of substance dependence, these symptoms may last for weeks, months, or even longer. Neither drug should be regarded as more “difficult” than the other to discontinue. Difficulty of withdrawal is usually a result of dosing, term of usage, and whether an individual was abusing the drug.
There are numerous anecdotal accounts of both Concerta withdrawal and Vyvanse withdrawal. Concerta may present more withdrawal difficulties than Vyvanse due to the fact that the doses jump by 9 mg or 18 mg – making downward titrations more difficult. Vyvanse only is manufactured in 3 dosing options, but the powder can be emptied and measured to ensure a gradual downward titration.
Similarities (Recap): Concerta vs. Vyvanse
Listed below are some commonalities shared between Concerta and Vyvanse.
- Abuse potential: Each of these drugs is regarded as having a high potential for abuse.
- Drug type: Both drugs are classified as psychostimulants, increasing concentrations of stimulatory neurotransmitters.
- Duration of effect: Concerta is thought to deliver an effect spanning nearly 12 hours, but Vyvanse is thought to remain effective for up to 14 hours. Concerta is believed to “kick in” quicker and Vyvanse takes nearly 2 hours to produce an effect.
- Efficacy: Neither drug should be regarded as clinically superior than the other for the treatment of ADHD.
- Legal status: These medications are considered legal to possess with a prescription. They are classified as “Schedule II” drugs, meaning they are illegal to possess without a prescription. Prescriptions for both drugs are considered non-refillable.
- Mechanisms of action: The active ingredients of each drug functions by inhibiting reuptake of dopamine and norepinephrine. There may be subtle differences in presynaptic activity, but these differences aren’t regarded as being substantial.
- Medical uses: Each drug was initially approved for the treatment of attention-deficit/hyperactivity disorder (ADHD).
- Side effects: Commonly noted side effects from these drugs include: appetite loss, headache, dizziness, nausea, and nervousness.
- Withdrawal: Discontinuing either drug is considered challenging for long-term users or those that have abused either substance. Withdrawal may persist for months until the brain endogenously increases dopamine production.
Differences (Recap): Concerta vs. Vvyanse
Listed below is a recap of some notable differences between Concerta and Vyvanse.
- Cost: Buying brand name Concerta costs between $260 and $300, whereas brand name Vyvanse costs $250 for a 30 day supply. Generic Concerta can be purchased for $100 to $170 for a 30 day supply.
- Format: Concerta is manufactured using OROS (osmotic controlled-release oral-delivery system), delivering 22% immediate-release methylphenidate and 78% delayed-release methylphenidate. Vyvanse is manufactured in prodrug capsules, meaning it must be fully absorbed and metabolized before the drug delivers an effect.
- Generic availability: Concerta is sold under the generic “methylphenidate ER,” but Vyvanse is not yet generic.
- Half-life: The estimated elimination half-life of Concerta is 3.5 hours, whereas the elimination half-life of Vyvanse is an estimated 14 hours.
- Ingredients: The active ingredient in Concerta is methylphenidate, and the active ingredient in Vyvanse is dextroamphetamine (as a result of metabolized lisdexamfetamine).
- Investigational uses: The methylphenidate within Concerta has been investigated for the treatment of aggression and criminality, whereas Vyvanse has not. Vyvanse has been investigated for cognitive impairment associated with schizophrenia, whereas Concerta has not.
- Manufacturers: Concerta is manufactured by Janssen Pharmaceuticals and Vyvanse is manufactured by Shire Pharmaceuticals.
- Popularity: In 2013, there were nearly 1 million more prescriptions for Vyvanse than Concerta. Between 2013 and 2014, there were significantly more prescriptions for Vyvanse by comparison. Concerta seems to have fallen by the wayside in terms of popularity and has been largely replaced by Focalin.
Which drug is better for ADHD? Concerta vs. Vyvanse.
Everyone wants to know whether Concerta is better than Vyvanse or vice-versa. The truth is that neither drug can be objectively considered better than the other. Most people will need to test out each drug for themselves to determine whether they respond better to one drug over the other. Some people will find that these drugs work equally well, while others will report that they experience significant improvement with one substance compared to the other.
Many doctors prefer to prescribe Vyvanse due to the fact that it is a prodrug, making it less subject to abuse. Some people respond better to methylphenidate-based drugs than amphetamine salts and find that they provide a “cleaner” focus; vice-versa also applies. If you respond better to amphetamine salts – Vyvanse may be a better option, whereas if you respond better to methylphenidate – Concerta may be the better option.
As a result of differences in FDA-approved uses, Concerta may be better for treating narcolepsy than Vyvanse, but Vyvanse may be better at treating binge eating disorder than Concerta. It may take some time for you to determine which drug provides you with more superior symptomatic relief compared to the other.
Which drug do you prefer: Concerta or Vyvanse?
If you’ve been through the ringer of ADHD meds and have had the opportunity to try both Concerta and Vyvanse, leave a comment letting everyone know which drug you prefer. Mention whether you found one drug to be: longer-lasting, more potent, effective, or have fewer side effects. Mention any “pros” and “cons” you can think of associated with your usage of Concerta or Vyvanse.
I have a question for anyone out there who has had voice or throat issues on Concerta or Biphentin? Concerta worked well till about 6 months in but I was only on 36 mg. I had problems urinating for the first month, lost a bit of weight, and yes also ground my teeth – but that to stopped.
The worst side effect was the dry mouth which did subside a lot, but I lost my ability to sing? Initially my voice improved, which I’ve read does happen to some people (octave goes up a bit), but then my voice always felt fatigued and I had a lump in throat feeling.
Changed me to Biphentin – great concentration, even tighter throat feeling, and still no voice – have not able to sing for months. I’m off everything to clean my system out in hopes my voice comes back, but withdrawing can take weeks.
Doctor prescribed Vyvanse but have not started taking it as I’m afraid it will cause the same issues. Anyone heard of this?
I found this article and everyone’s comments very helpful, thus I’m hoping to help/reassure others by sharing my experiences. There have been 3 medications I’ve personally tried for my ADHD which have included Concerta, Adderall, and Vyvanse. I have had various doctors for ADHD due to the fact that I travel and have moved a lot related to my career.
With that being said, I was originally prescribed Concerta upon my diagnoses. I don’t recall any negative side effects with that medication. I tried Adderall for a brief period, but I had horrible anxiety on it. I was switched to Vyvanse and initially had no negative side effects on it, but then I started to experience mild mood swings, periods of depression, feeling very out of it to the point where I went from being highly organized and able complete tasks with no issues to the extreme opposite.
At one point I found myself sitting and starting at the same email for 40+ minutes; definite zombie-like feeling. I told all of this to my newest doctor and will be switching back to Concerta. Everyone will have different experiences/side effects to stimulant medications, and other factors such as diet, sleep, stress management, etc. can alter the side effects of such medications as well.
Overall, Concerta has worked best for me with no significant changes to mood, sleep, or appetite. Find a good doctor, keep a journal, be honest. Best of luck!
I have been hyper my entire life but just recently officially diagnosed as ADHD. I’m 52 years old. My oldest daughter was ADHD and the 3rd daughter, ADD. I started out with Adderall. I felt calm the first week. After that, I felt hyper again.
I did begin feeling very nervous and anxious in the late afternoon and evening. I only made it up to 30MG dosage. I was on this dosage for about 9 months. I had terrible jaw clenching. The doctor switched me to 36MG dosage of Concerta. I don’t know that I could tell a difference in my overall concentration but I did notice less clenching.
I think clenching made me very anxious. I hate that. I did lose weight, about 20 pounds in 9 months. I had a change in insurance just recently and was able to afford Vyvanse. My doctor wanted me on it to begin with but it was over $300 monthly. I’ve only been on that for a month. Lowest dose. Clenching again.
Can’t tell if it’s working. I had been under a lot of stress at work and I felt like I couldn’t remember anything. I thought I might be in early stages of Alzheimers. That’s one of the reasons doc put me on these meds. I do want to say something…. I’ve been hyper for 52 years! I didn’t start on these as a youngster and grow up being “transformed” by them.
I’m already set in my ways, aren’t I? I’m still hyper. I get accused at work of not taking my pills and then I feel picked on because my concentration isn’t up to par. Don’t really know if I’m better or not. Maybe I just haven’t found the correct dose yet. Doctor is going slow, which I’m pleased about.
My blood pressure has gone up a little but not too much. I don’t know what the “average” dosage for a woman my age should be. I know there are many factors but I’m just a little tired of waiting on what other people consider to be “focused”.
My son is 9. He was put on meds 3 years ago because of ADHD. He has been taking vyvanse and has been doing a lot better in school. But the mood swings and irritability at home in the evenings, keeps the whole family on edge. After his checkup and voices my concerns about his weight gain which has been 1 1/2 pounds in 2.5 years, which put him at 48 pds and he will be 10 in December.
His Dr has decided to switch him to concerta, since it’s short acting and hopefully he will start eating in the evenings. He started sat and honesty he acted as if he had taken nothing. I’m hoping he just has to adjust. Any suggestions? The Dr has put him on pediasure and diagnosed him with failure to thrive.
My son was diagnosed in grade 3 and we tried a variety of drugs. Many of which caused more problems than good. We tried Vyvanse and the because the side effects were too much we finally settled on Adderall. He was on it for a year but he basically fell of the scale when it came to weight gain. He was tiny and never ate.
We did however start him on high calorie diet. Basically if he liked it and it was high calorie it didn’t matter as long as he ate. Ice cream, full fat milk, etc. We also decided to take him off the meds altogether for a few years. Finally, this year (now in grade nine and after working with professionals to learn tools and accommodations plus switching schools to a more structured system) after the workload at school became too much his therapist suggested we consider meds again.
We have him on Concerta and it has worked wonders on him. He’s still not hungry but he eats better. He’s on a 36mg dose after starting at 27mg and going all the way to 54mg, but the 36mg is the best of all worlds. Not perfect but he feels like he can focus. He is moody when he’s coming off but we have learned to cope by speaking calmly and not being reactive to him.
We are simply super understanding of his needs and have created rules and structure for him to live and be guided by. Be patient with the process and take notes if need be to discuss with doctor. Be patient and open to learning new techniques of coping by seeking out professional help and counseling. Family counseling with someone who specializes in this area can increase your chances of success.
Don’t be afraid to try new things. Consider switching schools if need be to one that accommodating of his needs. Helping kids with ADHD is a multi-faceted process. When it comes to diet, young children can eat just about anything. Also, children with ADHD tend to burn a lot more calories than the average person.
Let him eat what ever no matter how unhealthy you think it is and encourage balanced healthy meals as well. My son to this day always has a high calorie snack before bed. Bananas, yogurt or ice cream, a large (12oz) glass of milk, a sandwich(PBJ laced with butter as a base), etc. It will help. Also, please note that protein at every meal is crucial for their brain particularly at breakfast time.
No empty calories at breakfast. Oatmeal, eggs, protein shakes will help his brain, his development and weight. I really hope this helps. I have ADHD as well as my son. He is thin for his age but he is average for a 15yr old. It’s a journey… you will succeed and he will grow. Just keep advocating for him.
My daughter started being ill and missing school at 14. Pediatrician diagnosed inattentive ADHD, Aspergers, severe anxiety and possible depression and put her on Concerta. Her concentration immediately improved but her anxiety continued to get worse and she stopped attending school completely. I asked if the Concerta could be adding to the anxiety and could we try something else but was told no. After 2 years, now under adult services, we’ve changed to Elvanse (Vyvanse). She’s much happier and less anxious! One thing works for some, another for others. Wish we’d been allowed to change 2 years ago!
I too have experienced the challenges of treating ADHD with medication. What I have found helpful for many people is using the symptom record when trailing a medication. It allows both the patient and others an opportunity to identify and document improvement and side effects. This enables us to make an informed decision as to continuing the medication or requesting a change.
It also provides your prescriber with concrete information about the medications effect on your quality of life. Many practitioners are not well versed in the condition of ADHD and how it impact all facets of our lives. The form can be down loaded from CADDAC website. Treating ADHD includes physical activities, proper nutrition, meditation (mind calmness) and learning about the condition (insight).
So we can learn different strategies to adjust to societal expectations without losing the gifts of ADHD: spontaneity, enthusiasm, creativity, ingenuity, flexibility and ability to be in awe of simple things like a butterfly flying erratically around us.
I have a very complex case, and I am very confused. My 16 year old daughter was diagnosed with ADHD at the age of 3. She has been on various medication throughout her childhood. About 3 years ago she was placed on Vyvanse gradually increasing to the 70mg dose. The reason she was placed on Vyvanse was my child could not swallow tablets and with the Vyvanse you can open them up and mix the with a drink.
It worked for a few years, she was also diagnosed with Focal seizures from the age of 8 and has been on a high dosage of Keppra oral with Tegretol oral solution. Keppra is well known of having side effects of aggressiveness. Last year she was placed on Lovan 20 mg soluble to calm her down. She turned 16years old in February and at this time I felt that the Vyvanse wasn’t working well as she was eating and putting on weight, as she was always a very thin girl and everybody was always concerned of her low weight.
In March this year she finally learnt how to swallow tablet which was great accomplishment. Medication was changed she was placed on Lovan capsules, Tegretol tablets and Keppra tablet and continued to have her Vyvanse. We had an appointment with her Pediatrician in June and it was decided that we would give the Concerta 54 a go. Now she is always tired, goes to bed earlier enough can sleep in until 12 or 1.
Wake up for a while and decide she needs a sleep late afternoon and still goes to bed by 9pm, this is a typical weekend. She is getting more difficult to get to school in the morning as she saids she is tired. If I do get her to school she returns by 11 am and takes herself back to bed until 4-5pm and then back to bed by 9pm.
Now she has put on more weight and has gained 12kg since February and has major stretch marks and she is nearly unrecognizable by family members that haven’t seen her for a while. Her behavior has deteriorated and sometimes she acts like a 10 year old. I am at a lost, can anyone please shed some light on this, what other options do we have. I am so worried about the impact and worried that her weight is going to get out of control. Help Help!
Diagnosed at the age of 3!!??!? Every 3 year old has ADD. She’s been over medicated her whole life. 70 mg of vyvanse is insane for anyone not an adult.
Your daughter is sleeping an abnormal amount, no healthy person sleeps that much. If your daughter was underweight and has grown/been going through puberty, gaining 12 kgs over a 6 month period may not have been unhealthy, and it is incredibly common for people to develop stretch marks while growing. I’m a bit alarmed that you decided Vyvanse, a medication for treating ADHD wasn’t working because your daughter started eating more, that suggests a disordered view of food to me.
I’m also incredibly alarmed that a pediatrician diagnosed your daughter with ADHD at age 3, as it is literally impossible to distinguish between developmentally normal behaviors and ADHD symptoms at that age. It does sound possible that your daughter is depressed, but nobody can diagnose that over the internet. Is your daughter taking Vyvanse and Concerta at this time? It isn’t clear from your post.
I’m not a doctor, so the biggest thing I’d recommend is discussing these issues with your doctor, then getting a second opinion as well and having your daughter see a therapist to work on coping strategies for ADHD that do not involve medication, as well as checking on general mental health stuff. It sounds like your daughter is on many medications right now, and 5 changes have been made to her medications since March if I am reading that right. That is a lot of change in a short amount of time.
I think you should work on establishing a baseline, with only the medications/dosage necessary to prevent seizures for a while (this might take several months as there will be withdrawal symptoms) then work on a treatment plan based on that new baseline. It doesn’t sound like you have a baseline for post-puberty behavior for your daughter. Work on those things, and do your research and be suspicious of anyone who recommends abnormally high dosages or starting/changing multiple medications at once.
I’m mid 30’s and have tried every medication on the market and have spoken with countless people with ADHD regarding medications they have taken. What works best for me is Vyvanse. (Before that Dexedrine) I only take it 5-6 days a week and have do not have any of the side effects associated with long term use.
Concerta and Ritalin are similar in efficacy as Vyvanse for me though not quite as strong in effect and duration. The determining factor for me is that Concerta and Ritalin both make me more socially withdrawn where Vyvance and Dexedrine make me more outgoing with more of a positive mood. Most adults I have spoken to experience the same withdrawn or prefer to keep to themselves when on the Concerta or Ritalin.
This effect may not be the same for everyone but when giving it to kids I think it is important to observe whether they are calm or withdrawn. In the past Ritalin’s effect in this area was written off as it’s just calming them down because it’s effective. As an adult who has experienced the effect I believe more often it is not just a calming affect but a psychological side effect.
The last two I don’t recommend their use unless nothing else works:
Adderall: multiple amphetamine salts mixed. Causes significant increase in heart rate and blood pressure unlike the Vyvanse and Concerta. For this reason it has been removed for child use in Canada. It also seems to be mood destabilizing for most. I specifically am highly irritable and reactive on Adderall which I am not with any of the other medications nor when I on no medications. I have seen multiple adults and teenagers fly off the rails on Adderall including severe mood swings, over taking and/or snorting their adderall, suicidal tendencies, violence, hyperfocusing on less important things while neglecting responsibilities, and engaging in high risk behavior.
Adderall was the first patented ADHD medication in nearly 40 years from the original Ritalin and Dexedrine the marketing of this drug (I believe) is responsible for the much wider awareness over the last 15 year of ADD/ADHD. Due to that it was the go-to drug for ADD for way too long and I still meet people who prescribe or get prescribed Adderall for no other reason than previous marketing.
Strattera, a failed antidepressant medication repurposed for ADHD helps a very low percentage and in my opinion should only be prescribed for adults who can not tolerate or have no relief from the stimulant based medications. For me after two weeks it had no positive effect and after 2 months had a very depressing effect. The few people I have met who have had the opportunity to try strattera for themselves have similar reports. However parents and spouses of people who are on Strattera have seen relief for themselves as the patients are less contradictory and much more compliant to their instruction.
When asked about the other ADHD symptoms, they really couldn’t say one way or another. This is just information from my experience and interactions. Everyone may be slightly different. I hope these comments will assist in helping you examine and pay attention to the effects of the medication you try for you or your children to be able to come up with the most effective option.
That being said, nearly every doctor I have spoken with has a favorite that they will primarily prescribe and support and it may be difficult to get them to prescribe other options if what they prefer shows any side of improvement without severe side effects. It is up to you to be thorough and push to find the best solution for your situation. Other things that augment the effectiveness of medication and reduce the side effects for me are regular exercise, good organic diet with attention given to when and how much protein and carbohydrates/sugars I eat, mediation, and day’s off from medication.
I am currently on Vyvanse and I love it but we all react differently to each as the article points out. Vyvanse for me seems to kick in sooner than Concerta did although that’s not how it’s supposed to be. :) It is a smoother release for me, not as much of an initial nervous rush, and lasts longer and all the way through the day. I started noticing the Concerta would lose efficacy for me at the 4-6 hour mark and be useless by the 10 hour mark or sooner.
My Vyvanse lasts me through perfectly. Cons… Took about 2 weeks for me to get used to it upon starting and wow, I have never had such teeth clenching, grinding and anxiety. I had to wear a night guard to sleep as I was injuring the inside of my mouth in particular my inside cheeks / tongue. Eating was painful there for awhile. And once when I was off it for about 4 days due to needing the prescription rewritten, it all started again quickly and I had to endure it all over again.
Little shorter time frame at least however. I get so much more done, motivation, energy, concentration and more. I have tried almost all options over the past 20 years and through today, Vyvanse has been my favorite.
Thank you for taking the time to write an article comparing these two drugs. It is well-thought and well written. Though I did note that you used an incorrect header for your Concerta vs. Vyvanse chart. Instead of the word Vyvanse, you used Adderall at the top of the chart. The rest looks correct and appears to be all the information for Vyvanse not Adderall so I believe you just mistyped. You may want to look it over and correct it to avoid any confusion (it threw me off for a minute).
Again, great article. I hope you write more of this type of article, where you compare one very popular drug to another in its class. That would be very helpful to a lot of people (including pharmacists, like myself).
Thank you for this information. I found it very helpful. One caveat is the use of the term “popularity” in reference to medications: the article does not explicitly define this term, but seems to use it to mean most used. Adderall may well be more frequently scripted than Vyvanse or Concerta, but this may well be governed by health insurance coverage. Using the term “popularity” in way is misleading, if not actually disingenuous.
Would love to switch my son’s medicine from vyvanse to concerta. Your story sounds a lot like what he’s going through and he’s been on Vyvanse for awhile, and I wonder if he’s become immune to it’s effectiveness. His mood this year seems to be a lot worse than it was last year.
Last year he was basically “straight A” where as this year he’s struggled a lot more. And doesn’t have the drive like he did last year (depressed / anxious). So I’m glad I got to read your story. Thanks for sharing. ?
I have taken both. I find Vyvanse to be much more relaxing. I was very tense while on Concerta. I can actually nap while on Vyvanse but my focus is still there, while Concerta, forget about it. Keep in mind that his dosage may not be correct. He very well could need an increase. It could also be other things going on or other things that need to be adjusted.
Bridget, interested to know how it went with the switch for your son. Sounds EXACTLY like my son this year. He’s been on vyvanse almost 6 years (40mg), and this year he has no motivation, says he feels “not like himself”, is frustrated, knows what he needs to do but can’t make himself do it, moody. He, too, has always been an “A” student, but he also never had to study.
I was chalking a lot of this up to stress of honors and AP classes and hormones. But after last night, I feel like we are back to the very beginning of this whole process. We spoke to the doctor this morning and he wants him to switch to the Concerta. I realize not all kids will react the same, but VERY curious to know how your son has done with the switch. Thank you!
I started taking vyvanse in 8th grade and it was honestly amazing – I lost weight quickly (I was overweight prior to taking it), was able to focus in school and suddenly my grades shot up, gained motivation, and just more overall confidence/energy/happiness (which could have also been caused by weight loss and improvement in school). However, both my parents and psychiatrist noted that it made me significantly more anxious and emotionally unstable, so they switched me to concerta.
With the concerta, I have been able to focus well and do well in school. There is still a decrease in appetite, but I haven’t lost/gained any weight in the last 2 years (I got down to a healthy weight after taking vyvanse and have maintained it every since). I would say I am overall happier than I was prior to taking any ADD medications, and definitely more “emotionally stable” than I was on vyvanse.
I still get anxious, but that’s probably not due to either medication. So to rap this comment up (which I’m sure no one will ever read), both medications have worked wonders for me. Along with the weight loss/maintenance, they have improved my life so much! They give me MOTIVATION. While other people my age spend hours procrastinating watching Netflix, I feel motivated to do my homework early/on time and actually succeed in life.
I am honestly just so thankful these medications exist. Like I said earlier, no one will ever read this. I just wanted to share my story and so I’m taking this opportunity to do so.
I read your comment and am so glad you’ve found relief!
I read your comment too and it was very helpful! My daughter is nervous about starting meds and your experience will be totally relatable and reassuring – thank you for sharing!
I read your comment and I think your insight is pretty amazing. You have helped many people and parents make important decisions. Listening to patients is really important. Thanking you for sharing is even more important. Thanks for your courage ?.
Thank you for sharing. I am going to try Concerta with my son and he had been taking Vyvanse. I had noticed that he was also more emotional at times w/ the Vyvanse and the effects are not consistent, so we will be trying Concerta to see if it will work better for him to keep his mood more even while still helping him focus and feeling motivated in school.
Having made the difficult decision to start him on meds has made a big difference for him academically and socially. I see that he is feeling better about his abilities. So it has been worth it.
Lisa, we just switched (10 yr old) from Vyvanse to Concerta. Have you found your son’s moods to be more stabilized? My daughter has explosive episodes and anger outbursts. Hoping the switch will level her out!
I read your comment and I’m glad I did. Thank you for sharing, it’s helping me make an informed decision on which med to take.
Hey, I read your comment. Just recently got diagnosed at the age of 45. I’m on concerta for the 5. week, and take 54mg in the morning, and 36 in the afternoon. The end dose for me is 54/54, next week, and if the concerta not does enough for me then, I don’t know what to do. So its a very good read mate. Thanx
Thanks for sharing your experience with both meds. As you can see, somebody did read your post and I am glad I did because it was very informative!
Hey I read your post and Found it informative, and I was able to relate to the same symptoms. I am extremely narcoleptic, and I cant wake up with out the Vyvanse. For me it does not take 2 hours to feel the effects, probably 30-45 minutes at the most, and my mind id fully awake. The expert say it takes 2 hours to metabolize in the system and feel the effects, I gather the experts don’t rely take the medication, and the med. testers are not truly narcoleptic.
I take the highest dose of 70mg around 6:30am, and by 7:30am I am getting for work like the people that take coffee in the morning. However, around 4pm, I start to fall asleep, and cant really concentrate and need to start napping. The one positive thing I like about being awake is that in my position I have to publicly speak, and if I don’t take my medication I will panic, because my brain does not remember anything, I write notes to help me stay on track, but it’s still a challenge for me.
Nobody knows this at work because I don’t feel comfortable people knowing I have this condition, and at times they can notice I go straight into dead air and feeling sleeping. Anyhow, I wanted you to know that people do read these post, and they do help people like me understand we are not alone with these conditions, and it may take medication to act and be normal, heck its better than looking like a fool in public.
Read your comment and so happy for your success with both medications. You have helped many people by taking the time to comment on this post. Many are grateful for your experience and especially in sharing it.
I read it all, my son was just started on vyvanse and is in 8th grade. This was very helpful as I was of course reluctant to start him on medication. So thank you.
Thank you so much. I felt like my son was more anxious and unstable emotionally on Vyvanse so I agree with you 100% percent.
I read your comments! I found what you had to say helpful. My son has ADHD and struggled so hard in school both academically and socially. It was so sad!! He started out on adderall and then switched over to Vyvanse and then switched again to Concerta which we have found works best for him. He is now on the honor roll and has many friends.
He also is less grouchy with our family, after school when the meds were wearing off, was a problem! He would become hostile and frustrated not being able to express himself properly. I would encourage anyone who is struggling with ADHD to try the different medications and find which one works for best for them. I am glad you are doing well keep up the good work!
I appreciate your comment that you took the time to write! Don’t ever feel like it didn’t make a difference as I am a concerned mom working on med changes with my 5th grader right now so I’m thankful to read your view on the differences. Thank you for taking the time!
I read your comment, too. Thanks so much for sharing your story!
I found Concerta better as it did not cause the severe jaw grinding/clenching & the release of Concerta was more even. It also controlled binge eating better than Vyvanse in my opinion.