ADD Medications

Concerta vs. Ritalin: An ADHD Medication Comparison

Concerta and Ritalin are both stimulant medication formulations containing methylphenidate hydrochloride, a chemical compound that produces stimulation by increasing dopamine and norepinephrine levels in ADHD brains. The end result for many: improved focus, reduced impulsiveness, and dampened hyperactivity. Compare and contrast these popular ADHD medications here.

Choosing an ADHD medication: Concerta vs. Ritalin

Medical review conducted by Dr. William Dodson, a member of ADDitude’s ADHD Specialist Panel

Concerta and Ritalin are stimulant medications used to reduce symptoms of attention deficit hyperactivity disorder (ADHD or ADD). These medications are different brand-names for the same drug, called methylphenidate hydrochloride (MPH), which a new meta-analysis identified as the most effective first-line treatment for children with ADHD.

Since these popular medications are made from the same chemical compound, they both act similarly — they do not cure ADHD, but they can increase focus and reduce impulsiveness and hyperactivity. The main differences are in the length of effectiveness, the strength, and the dosage.

ADHD Medication Summary

Concerta and Ritalin share the same active ingredient. However, Ritalin is a short-acting stimulant that boosts focus and attention quickly. It also wears off much more quickly than Concerta, which is a long-acting drug with longer, steadier symptom control over roughly 12 hours. Some patients report a more abrupt onset and offset with Ritalin, but other side effects — namely, appetite and sleep trouble — are very similar.

According to a 2017 survey of ADDitude readers, 42.28% of children with ADHD have used Concerta at some point and 32.37% have used Ritalin at some point. That makes these medications among the most popular among children. Among adults with ADD, 27.68% have used Concerta and 33.27% have use Ritalin, the most commonly used after Adderall.

[Medication Reviews: Adderall, Concerta, Evekeo, Mydayis, Ritalin, Vyvanse, and More]

Among those who have used Ritalin and Concerta, the medications’ efficacy is rated in the chart below, which also tracks the percentage of patients who experienced three common side effects.

Pediatric Patients: Concerta vs. Ritalin

Medication Extremely or Very Effective Not Very or Not at All Effective Irritability or Moodiness Sleep Problems Dampened Personality
Concerta 44.65% 22.52% 34.10% 32.69% 22.48%
Ritalin 38.87% 21.77% 36.18% 28.31% 23.79%

Adult Patients: Concerta vs. Ritalin

Medication Extremely or Very Effective Not Very or Not at All Effective Irritability or Moodiness Sleep Problems Dampened Personality
Concerta 36.00% 29.06% 23.91% 26.09% 13.59%
Ritalin 40.77% 21.62% 23.57% 20.14% 16.7%

ADHD Medication Comparison

Concerta Ritalin
Manufacturer Janssen Novartis
Compound Methylphenidate tablet with osmotic pump technology; biphasic release with initial peak at 1 hour (22% of dose) and 78% gradual release over 9 hours Methylphenidate HCI
Approved Ages Over the age of 6 Over the age of 6; Sometimes used for children younger than 6
Dosages Extended release tablet available in 18, 27, 36 and 54 mg. Short acting, immediate release tablet available in 5, 10 and 20 mg.
Ritalin SR (Sustained release), available in 20 mg
Ritalin LA (Long acting) extended release capsule, available in 10, 20,30, and 40 mg.
Considerations Potentially dangerous when used by people with heart problems
Must be swallowed whole
Not-absorbable shell may be passed in stool
Potentially dangerous when used by people with heart problems
Abrupt onset and offset increase the number and severity of side effects
Window of Effectiveness 8-12 hours 3 to 4 hours for short acting
About 6-8 hours for sustained release
8 to 10 hours for extended release
Side Effects Headache
Stomach ache
Trouble sleeping
Nausea
Decreased appetite
Nervousness
Headache
Stomach ache
Trouble sleeping
Nausea
Decreased appetite
Nervousness
Generic available Yes Yes

ADHD Symptom Control

Despite chemical similarities between Concert and Ritalin, different patients will react differently to these medications. For example, when discussing Concerta, one respondent to ADDitude’s 2017 ADHD treatment survey said, “It has always been extremely helpful for me to get stuff done,” while another said, “It didn’t help at all; discontinued after two months.”

The same goes for Ritalin. One person felt it provided “help with focus and initiation of work and task completion,” while another said, “It left me feeling dull and moody.”

While it’s true that individuals react to the same medication in very different ways, it is also true that roughly 30% of all ADHD patients do not get a benefit from or cannot tolerate taking any MPH. These people may report experiencing no benefits or feeling dull and moody. And the logical next step for them is to try the other class of stimulant ADHD medication: amphetamine.

[Free Download: What You Need to Know About Methylphenidate Vs. Amphetamine]

The experiences and feedback of other patients are interesting, but not necessarily helpful as you weigh your own or your child’s medication options. Each individual processes, metabolizes, and reacts to medication differently, and there is currently no reliable way to predict how any given medication will impact one individual.

Medication Dosage

As noted in the chart above, Concerta is available in 18, 27, 36 and 54 mg. doses. Ritalin is available in short-acting, sustained release, and extended release formulations, each with its own dosage options.

Ritalin and Concerta dosages are based on how an individual metabolizes medication — not on height, weight, and/or age. Your doctor may start with the lowest dose and slowly increase it depending on your response. When starting the medication, it is helpful if you keep track of the dosage, how it affected your ADHD symptoms, and how long it lasted. This information will help you and your doctor determine your ideal dosage.

[Free Download: ADHD Medication Monitoring Sheet]

ADHD Medication Side Effects

Side effects from methylphenidate often disappear within a few weeks of starting the medication. However, for some people the side effects are severe enough to merit a cessation of the medication. The most common side effects with both Ritalin and Concerta include headache, stomach ache, loss of appetite, insomnia, and nervousness. Less common side effects include dizziness, drowsiness, and anxiety. As with effectiveness, you should keep track of your side effects and discuss these with your doctor.

Anecdotally, adult patients who took the ADDitude treatment survey reported side effects including the following:

Ritalin

  • “Makes me lethargic and lazy. Just like to watch TV on couch now. Just no ambition.”
  • “Caused headaches and emotions like crying.”
  • “My appetite eventually adjusted.”
  • “Made my heart rate increase and blood pressure go up.”

Concerta

  • “Jitteriness – felt like I was jumping out of my skin.”
  • “Minor loss of appetite.”
  • “Increased irritability and anger and dramatically changed my moods.”
  • “Left me unable to sleep, headaches and constant stomach ache.”

Medication Warnings

Methylphenidate medication labels include warnings for potential serious cardiovascular events. Children and adults with pre-existing cardiac conditions or heart abnormalities should seriously discuss the use of these medications with their doctor and weigh their benefits and risks. If these medications are used, a patient must do so only under the close supervision of a doctor with consistent monitoring of the heart condition and blood pressure.

[ADHD Medication Side Effects That No One Should Tolerate]

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