ADHD is a common condition found in children, adolescents, and adults. It is characterized by an inability to sustain concentration, being easily distracted, and tending towards impulsivity.[1]
Estimates of rates of ADHD in the adult population range from 2.5% to 4.4%.[2][3] ADHD is divided into three types, depending on which symptoms appear. These are inattentive, hyperactive, and combined.[4]
Medication, including Concerta and Vyvanse, is highly effective at treating ADHD, with 75-92% of patients finding that their symptoms have improved.[5]
Understanding the medication on offer for ADHD can help you decide on the right treatment for you. Here’s what you need to know.
- ADHD is a common condition that causes difficulty in many areas of life, especially education and work
- ADHD can be effectively treated with stimulant medications, including Concerta and Vyvanse
- Some people will respond better to one of these medications than the other. If one isn’t effective, it can be helpful to try the other
Understanding Concerta and Vyvanse in ADHD treatment
Concerta and Vyvanse are both CNS stimulants that increase norepinephrine and dopamine in the brain.
Concerta contains methylphenidate which is a reuptake inhibitor. This means that it prevents the body from absorbing and breaking down norepinephrine and dopamine.[6]
Vyvanse contains lisdexamfetamine, which is a pro-drug. Pro-drugs are substances that only turn into the active ingredient as they are processed within the body. Lisdexamfetamine becomes d-amphetamine which stimulates the release of norepinephrine and dopamine.[7]
Key differences: Concerta vs. Vyvanse
Both Concerta and Vyvanse are slow-release medications. Concerta relies on the pH in the stomach to control how quickly the drug is released, which means that it can be affected by foods or other medications that can alter the pH in the body (and especially the digestive system).[3]
As a prodrug, Vyvanse does not rely on pH to control the slow release, instead using the rate at which the body is able to metabolize lisdextamphetamine. It is unaffected by anything that impacts the pH of the digestive system.
The effects of Concerta typically last for 8-12 hours. This is slightly shorter than Vyvanse, which can have an effect over 13-14 hours.[8] Concerta typically reaches peak concentration within 4.7 hours.[6] For Vyvanse, this may be closer to 3.5 hours.[3]
Comparing effectiveness
Both Concerta and Vyvanse are highly effective in treating ADHD.[2] There is limited evidence that Vyvanse may be more effective for some patients, but this effect is very small.[2][9][10]
Side effects and safety profiles
The side effects of both Concerta and Vyvanse are very similar. They include:[3][6]
- Decreased appetite
- Dizziness
- Dry mouth
- Irritability
- Insomnia
- Nausea
- Upper abdominal pain
- Diarrhea
- Fatigue
- Headaches
- Anxiety
- Tachycardia and palpitations
Concerta and Vyvanse may cause additional strain on the cardiac system, so caution is recommended for patients with existing heart problems.[6]
There is also little information about how these drugs might affect pregnant women.[6] Again, caution is recommended.
Addiction potential: Concerta vs. Vyvanse
Both Concerta and Vyvanse are listed as Schedule II drugs, meaning that they pose a risk for addiction and abuse.[11]
The risk of abuse is closely linked to how quickly a drug takes effect. Drugs that work more quickly are more likely to be abused.[3] As extended-release drugs, Vyvanse and Concerta may be less prone to abuse than other stimulants. As a prodrug, Vyvanse may be significantly less susceptible.[3]
How to choose which one is right for you
Choosing between Concerta and Vyvanse is difficult, as they have very similar effects and side effects. Switching between the two medications is straightforward without the need to taper discontinuation, so patients should be encouraged to change medication if it does not appear to have the desired effect.[3]
The cost of these drugs may also be a factor, although this can fluctuate over time. Discuss with your doctor whether there are any indications that one of these medications might be a better choice for your personal circumstances.
Alternative ADHD treatments
Stimulants such as Concerta and Vyvanse are the most common forms of treatment for ADHD, but there are alternatives.
Non-stimulant medications
The FDA has licensed some non-stimulant medications for the treatment of ADHD. These include:[2][8][12]
- Vasodilators, including clonidine and guanfacine
- Antidepressants, such as bupropion
- Noradrenaline reuptake inhibitors such as atomoxetine
Behavioral interventions
Behavioral interventions, including CBT or metacognitive therapy, can support a patient to develop their self-management skills which can ameliorate some of the effects of their condition.[3]
Behavioral interventions aimed at children should typically involve the parents, child, and school to achieve the best results.
Combination therapy
The best outcomes for ADHD patients are usually seen when pharmacological therapies are combined with behavioral therapies. This reduces the symptoms of ADHD and teaches the skills to cope effectively with any symptoms that remain.
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