Short-Acting Stimulants Vs. Long-Acting Stimulants: Comparing ADHD Medications and Durations
The effects of ADHD medications may be felt immediately or hours after taking them — and for as little as 3 hours or as long as 16 hours. In different situations and scenarios, a child or adult with ADHD may benefit most from a short-acting stimulant or a long-acting stimulant. Here, we describe the differences and options.
There are two main types of medication used to treat ADHD: stimulants and non-stimulants. Stimulant medications are typically the first choice to treat ADHD symptoms because they work for 70-80% of people with attention deficit hyperactivity disorder (ADHD or ADD)1.
Within the class of stimulant ADHD medications, there are two main types: methylphenidates (Ritalin, Concerta, Daytrana, etc.) and amphetamines (Adderall, Vyvanse, Evekeo, etc.). There are nearly 30 different stimulant medications used to treat ADHD; almost all of them are different forms of methylphenidate or amphetamine. The characteristics that differentiate them are as follows:
- Form: Pill, orally disintegrating tablet, liquid, or patch
- Delivery system: The chemical makeup of a long-acting medication, e.g., pulse delivery or continuous delivery
- Duration: How long the medication lasts e.g., short-acting stimulants or long-acting stimulants
Short-Acting Stimulants vs. Long-Acting Stimulants
The effects of stimulant medications last for different lengths of time, though they are typically classified as one of the following:
- Short-acting stimulants: These medications start working within 30 to 45 minutes of administration, and typically wear off in 3 to 6 hours.
- Long-acting stimulants: These medications work in phases to treat symptoms throughout the day. Part of the dose is immediate-release, meaning it goes into effect immediately. The rest of the dose is delayed-release, meaning it goes into effect several hours later. These stimulants typically wear off in 8 to 16 hours.
Stimulant medications enter the bloodstream quickly, then are filtered through the kidneys or liver and eliminated from the body fairly quickly2. Stimulants work by gradually increasing dopamine and norepinephrine levels and activity in the brain3. Long-acting stimulants are designed to go into effect and wear off gradually, which may reduce side effects or rebound effects.
How Long Does ADHD Medication Last?
The exact length of time a stimulant lasts depends on the patient’s metabolism. For example, a long-acting stimulant medication may say it lasts for 8 to 12 hours. Some patients may feel its effects for 10 hours. Others may experience just 6 hours of symptom control. Some people require a second, short-acting dose of medication in the afternoon or evening to alleviate symptoms after a daytime dose has worn off. For them, and other ADHD patients, the following options are available.
Short-Acting Methylphenidates and Typical Duration
|Methylphenidate||Methylin Liquid||3-4 Hours|
Short-Acting Amphetamines and Typical Duration
|Mixed Amphetamine Salts||Adderall||4-6 hours|
|Amphetamine Sulfate||Evekeo||4-6 hours|
Long-Acting Methylphenidates and Typical Duration
|Methylphenidate||Aptensio XR||12 hours|
|Cotempla XR-ODT||12-13 hours|
|Daytrana||10 hours with a 9 hour wear time|
|Jornay PM||12-14 hours|
|Metadate CD||8-10 hours|
|Quillichew ER||12-13 hours|
|Quillivant XR||12-13 hours|
|Ritalin LA||8-12 hours|
|Ritalin SR||8 hours|
|Dexmethylphenidate||Focalin XR||8-12 hours|
Long-Acting Amphetamines and Typical Duration
|Amphetamine||Adzenys ER||10-12 hours|
|Adzenys XR-ODT||10-12 hours|
|Dyanavel XR||13 hours|
|Dextroamphetamine||Dexedrine ER||5-10 hours|
|Mixed Amphetamine Salts||Adderall XR||10-12 hours|
1 Advokat, Claire, et al. “Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers.” Frontiers in Neuroscience, 7: 82. 29 May 2013. doi: 10.3389/fnins.2013.00082
2 Understood. “ADHD Medication Rebound: What You Need to Know.” The Understood Team. Web. Accessed 17 June 2019.
3 NIDA. “Prescription Stimulants.” National Institute on Drug Abuse, 6 Jun. 2018, Web. Accessed 17 Jun. 2019.
Updated on September 24, 2020