Concerta is a medication containing methylphenidate that is used to treat ADHD. It is a central nervous system stimulant that can cause several side effects, including headaches, reduced appetite, weight loss, and insomnia. It can also cause severe side effects in some cases, which may require professional treatment or medication changes. [1]
What is Concerta?
Concerta is a central nervous system (CNS) stimulant containing methylphenidate. It is widely prescribed and often abused for its euphoric and stimulant effects. Concerta is a Schedule II controlled substance due to its risk for abuse and addiction. [2]
Unlike other ADHD medications such as Adderall, Concerta is not classed as an amphetamine, although it shares similar properties with other medications in this class, which contribute to its medicinal uses and abuse potential. [2]
How is Concerta used?
Concerta is approved for use in the treatment of attention deficit/hyperactivity disorder (ADHD) in people over the age of 6. [1]
Concerta is available as an extended-release tablet in 18 mg, 27 mg, 36 mg, and 54 mg strengths. It is an extended-release tablet, to be taken only once per day, as the medication is released gradually into the body. [1][3]
A typical daily dosage of Concerta is between 18 and 72 mg. Often, individuals will be gradually tapered onto the medication, slowly increasing the amount to find the most effective therapeutic dose. [1][3]
Why do people abuse Concerta?
People abuse Concerta because of its euphoric and stimulant effects. ADHD medications, such as Concerta, can increase concentration, energy, and alertness, so they may be abused to enhance academic or athletic performance. Additionally, they can cause reduced appetite and weight, so they are sometimes abused for weight loss. [4]
Concerta affects a person's dopamine levels and activity, which is the primary neurotransmitter involved in the brain’s reward system and causes a feeling of pleasure. Concerta causes a large release of dopamine in the brain, which contributes to a feeling of euphoria or ‘high’. This then reinforces its misuse and abuse and contributes to the development of tolerance, dependence, and addiction. [2]
Prolonged and heavy use or abuse of Concerta can result in the development of tolerance. This causes the effects of the substance to be reduced and can lead to increased amounts or frequency of use to achieve the desired effects. Similarly, physical dependence can lead to increased use or misuse of the medication to prevent the onset of Concerta withdrawal symptoms. [1]
Medications such as Concerta that are regularly prescribed can be easily accessible to those wishing to illicitly sell or misuse the medication. Some people attempt to obtain several prescriptions to misuse or share tablets, which is referred to as ‘doctor shopping’. Concerta is sometimes abused by unintended administration methods, such as intranasal or intravenous use. [2][4]
Common side effects of Concerta
When starting a new medication, it is common to experience side effects. These side effects can also occur when the medication is misused or abused. Typically, side effects last a short period and are alleviated within several weeks. If any of the following side effects occur and are persistent or concerning, it is advised to consult a doctor. [1]
Common side effects of Concerta include: [1][3]
- Stomach pain
- Nausea
- Vomiting
- Constipation
- Diarrhea
- Reduced appetite
- Weight loss
- Headache
- Insomnia
- Heartburn
- Drowsiness
- Sweating
- Increased blood pressure
- Increased heart rate
- Dizziness
- Coughing
- Palpitations
- Dry mouth
- Agitation
- Restlessness
- Anxiety
- Irritability
- Low mood
- Tightness in muscles
- Confusion
- Shaking
- Decreased libido
Severe side effects of Concerta
In some cases, particularly if used in large doses or abused, Concerta can cause severe side effects. These side effects may require professional treatment and monitoring. Severe side effects of Concerta can include: [1][2][3]
- Blurred or impaired vision
- Rapid or irregular heart rate
- Pain or tightness in the chest
- New physical or verbal tics
- Trouble breathing
- Trouble with speech
- Weak or numb limbs
- Rash, hives, or blisters
- Fever
- Swelling of the mouth or throat
- Prolonged or painful erections
- Suppressed growth in height or weight in children
- Seizures
- Extreme changes in mood or behavior, such as severe depression, suicidal ideation, or aggression
- New or worsening psychotic symptoms, such as hallucinations, delusions, or paranoiaÂ
- New or worsening manic symptoms, particularly in those with a history of bipolar disorder or manic episodes
- Increased risk of cardiac issues, particularly in those with a history of heart problems
- Tolerance
- Dependence
- Addiction
Prolonged use or abuse of Concerta can result in an increased risk of tolerance, dependence, and addiction. When tolerance develops, the effects of the medication become reduced, resulting in the individual requiring increased doses to achieve the same effects. [1]
When physical dependence has developed, the body requires continued use of the medication. If Concerta is reduced or stopped, it can cause the onset of withdrawal symptoms. Abruptly stopping Concerta can result in symptoms including severe depression and sleep disturbances. [3][5]
Addiction is a distinct condition although it may be more likely to occur alongside the development of tolerance and dependence. It can result in harmful drug-seeking behaviors, reduced quality of life, and impaired functioning. [6]
Concerta overdose
Using Concerta as prescribed is unlikely to result in an overdose. However, taking larger doses than prescribed or in unintended ways, such as intravenous administration, can increase the risk of dangerously high amounts of methylphenidate. As a stimulant, overdose effects occur as a result of overstimulation of the central nervous system. Signs of a Concerta overdose include: [1][3]
- Agitation
- Vomiting
- Confusion
- Headache
- Increased heart rate
- Aggressiveness
- HallucinationsÂ
- Palpitations
- Twitching
- SeizuresÂ
Overdose may be more likely if Concerta is used in combination with other substances. In the event of an overdose, call 911 immediately.
Getting treatment for Concerta dependence
Individuals taking Concerta as prescribed will likely receive regular treatment reviews from the prescribing clinician and may be advised to spend trial periods without their medication, to determine whether it is still required. If it is not, the doctor will taper the individual off their medication, which may take several days or weeks. [3]
Someone taking Concerta in high doses, for a prolonged period, or misusing or abusing the substance, may require specialist services to provide treatment to manage the detox and withdrawal process and ongoing recovery. [2]
This may involve outpatient services, such as attending appointments with a doctor to receive medicinal or therapeutic treatment during withdrawal. Alternatively, if addiction or additional substance use is present, it may be necessary to utilize inpatient services, such as a rehab facility. In a rehab facility, professionals can provide continuous monitoring and treatment of withdrawal symptoms, along with therapeutic and medicinal support. [5][6]
Treatment for Concerta dependence may include: [2][5][6]
- Medication: Stimulant withdrawal symptoms may include changes in mood and sleep patterns. Medications such as antidepressants and benzodiazepines may be prescribed short-term to help manage this.
- Therapy: Individuals may benefit from therapies such as cognitive behavioral therapy (CBT) to change addictive behavioral patterns, manage cravings, treat underlying mental health issues, and reduce or prevent substance use. Group therapies and 12-step programs may also be beneficial throughout the recovery process.
- Holistic therapies: Holistic therapies, including nutrition counseling, mindfulness, yoga, and exercise, can help improve mental and physical well-being and assist in the recovery process.
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