Comparing Concerta vs. Ritalin
Medically reviewed by Alex Yampolsky, PharmD
A diagnosis of attention-deficit hyperactivity disorder (ADHD) can be life-altering news that can significantly affect the day-to-day life of yourself or a loved one.
To best manage the symptoms associated with this neurodevelopmental condition, you may pursue a holistic approach to treatment that includes rethinking diet, beginning mental health counseling, or seeking a prescription drug regimen—a common approach to treating ADHD.
As such, healthcare providers may prescribe Concerta or Ritalin: two brand-name medications that contain methylphenidate, a stimulant drug used to treat ADHD.
Concerta and Ritalin work similarly and are taken orally (by mouth).
While both drugs are commonly prescribed and are considered effective, this article will highlight the similarities and differences between Concerta and Ritalin, examining specific indications, dosing regimens, storage requirements, potential side effects, and more.
What Is Concerta?
Concerta is one brand-name version of methylphenidate, a stimulant medication. The drug is administered as an extended-release (ER) tablet, so it must only be taken once daily.
Notably, Concerta is designated as a controlled substance by the Food and Drug Administration (FDA), which means some special rules apply when healthcare providers prescribe them.
For context, a stimulant is defined as a drug that increases the activity of the central nervous system (CNS), or, conversely, contains sympathomimetic- (increased heart rate or blood pressure) type effects.
Concerta is also available as a generic product called methylphenidate ER, administered as an orally consumed capsule.
How Does Concerta Work?
Concerta works by raising the levels of certain chemicals in your brain, including norepinephrine and dopamine. These chemicals improve the body’s ability to pay attention and focus on a given task.
The ER administration system releases the medication into your body over the day slowly. Concerta, therefore, typically only needs to be taken once daily in the morning.
What Is Ritalin?
Ritalin is another version of the stimulant drug methylphenidate. It is an immediate-release (IR) tablet and is typically taken twice a day or three times daily in some cases.
There is another version of methylphenidate available called Ritalin LA. This is similar to Concerta in that it’s taken once daily and lasts longer than the IR version of Ritalin.
Both Ritalin and Ritalin LA are available as generic products.
Finally, like Concerta, Ritalin is designated as a controlled substance by the FDA.
How Does Ritalin Work?
Ritalin works to increase chemicals in your brain called neurotransmitters, in turn increasing your attention and focus.
Through IR administration, IR drugs work quickly once consumed.
However, users must take multiple doses throughout the day, as their effects typically last only a few hours.
Which Is More Effective?
Concerta and Ritalin are both effective drugs for treating ADHD. Since they contain the same active ingredient, their comparative efficacy is similar.
In general, stimulants like Concerta and Ritalin are the most effective treatment for managing ADHD in children, teens, and adults.
However, the differences in how each is administered throughout the day may make one option more suitable for some than others.
As stated above, brand-name Ritalin is a short-acting stimulant that increases focus quickly.
Conversely, Ritalin wears off faster than Concerta, a long-acting drug with steadier symptom control that lasts about 12 hours. In comparison, Ritalin LA lasts around eight hours.
Potential users should work with their healthcare provider to determine which form of methylphenidate would work best for them, as a drug's efficacy is linked to the users' ability to carry out the prescription as prescribed.
Overall, methylphenidate is a relatively well-tolerated stimulant option, but caution and diligence are necessary for using this medication to avoid potentially serious side effects and abuse or dependence.
Administration: Concerta vs. Ritalin
The table below summarizes the differences and similarities regarding how Concerta and Ritalin are traditionally taken:
| Concerta: | Ritalin: | Ritalin LA: |
Available Pill Strengths: | •18 mg •27 mg •36 mg •54 mg | •5 mg •10 mg •20 mg | •10 mg •20 mg •30 mg •40 mg |
Recommended Dose: | • Starting at 18 mg, may increase up to 54-72 mg | •Starting at 5-10 mg, may increase up to 20 mg | •Starting at 10 mg, may increase up to 40 mg |
How Often and When to Take: | • Once daily first thing in the morning | • Two or three times daily, 30 to 45 minutes before main three meals of the day | • Once daily, 30 to 45 minutes before your first meal |
Available Generically: | • Yes | • Yes | • Yes |
Approved Ages: | • Ages 6 to 65 | • Ages 6 and older | • Ages 6 to 12 |
What Are Other Ways to Help Manage ADHD?
ADHD can affect children, teenagers, and adults.
Symptoms include difficulty paying attention, hyperactivity, and impulsivity severe enough to impact everyday life.
Around 5% of school-aged children are affected by ADHD, and over 60% of these children with ADHD may continue to struggle with ADHD as adults.
We don’t know what causes ADHD, but possibilities include genetics, exposure during fetal development or childhood to certain environmental factors, and brain injury.
Behavior interventions, counseling, and therapy are often tried before medication, particularly in children under 6 years old.
Medication is undoubtedly another standard treatment for ADHD, and non-stimulant drugs exist in addition to stimulants like Concerta and Ritalin, such as Intuniv (guanfacine), Strattera (atomoxetine), and Qelbree (viloxazine).
Depending on your or your child’s condition and medical history, your healthcare provider may recommend one or more of these options instead of or in addition to stimulant medications.
Finally, multiple studies have shown that certain lifestyle habits are more likely to occur in children and adults with ADHD.
Comparatively, certain habits that happen more often in people without ADHD include:
An increased amount of physical activity such as participating in sports, physical education class, or minutes spent working out (one hour or more per day in children)
Decreased screen time (less than two hours per day)
More and better sleep (nine or more hours in children and seven or more hours in adults)
While this does not suggest that certain lifestyle habits cause or prevent ADHD, practicing and avoiding certain ones may help to improve symptoms.
Treatment of Narcolepsy
While not their primary use, stimulants like Ritalin and Concerta have a place in treating narcolepsy because they promote wakefulness and focus.
Of note, both are FDA-approved for the treatment of narcolepsy.
More than being overtired, narcolepsy is a sleep condition in which a person experiences excessive sleepiness during the day and cannot stay awake, no matter the situation.
The condition may be accompanied by cataplexy, or muscle weakness that can lead to the person collapsing on the floor. This is called type 1 narcolepsy, which may be more severe than type 2 narcolepsy (narcolepsy without cataplexy).
They may be used in addition to behavioral modification and other non-stimulant medicines.
Side Effects & Precautions
Like other stimulants, Concerta and Ritalin both possess the potential to cause side effects.
Fortunately, most existing side effects will typically disappear after taking the medication over several weeks to months.
If not, your healthcare provider may try to lower your dosage or switch to a different medication.
Above all, it's crucial to know that Concerta and Ritalin carry a black box warning (the strictest warning designated by the FDA) for abuse and dependence.
Common Side Effects
Some commonly experienced side effects of stimulant ADHD medications, such as Concerta and Ritalin, include the following:
Decreased appetite
Nervousness, anxiety, or irritability
Mood swings
Headaches
Upper abdominal pain and stomach aches
Monitor your symptoms if you experience any side effects while taking other medication.
If you notice you grow continuously worse, contact your healthcare provider immediately.
Severe Side Effects
Side effects of Concerta and Ritalin that are less common but may potentially be more severe include the following:
Increased blood pressure or pulse, which should be monitored especially closely in those with pre-existing heart disease
Tics, or repetitive muscle movements such as eye blinking
Minor delay in regular growth pattern in children
Prolonged and painful erections, often after some time on the drug or after a dose increase
In the case of a medical emergency resulting from using Concerta or Ritalin, call 911 immediately.
Who Should Avoid Concerta & Ritalin?
Stimulant drugs like Concerta and Ritalin are not for everyone.
Certain pre-existing conditions may necessitate other treatment options for ADHD, such as:
Known heart abnormalities: Stimulants should be avoided in people with severe heart arrhythmias (irregular heartbeat), cardiomyopathy (general term for heart disease), or other heart problems in which the effects of Concerta or Ritalin may worsen.
Psychotic disorders: Conditions like bipolar disorder, major depressive disorder (MDD), schizoaffective disorder, or other psychotic disorders, may be worsened by taking stimulant medications.
Seizure disorders: Stimulants may lower the seizure threshold in patients with a history of seizure disorders, prior EEG abnormalities, and, very rarely, people without a history of seizures.
Potential for Interaction: Concerta vs. Ritalin
Concerta and Ritalin have very similar drug interactions.
Some of these include the following:
Monoamine oxidase inhibitors (MAOIs), including Emsam (selegiline), Parnate (tranylcypromine), Marplan (isocarboxazid), and Nardil (phenelzine), need to be stopped at least two weeks before starting to take stimulants like Concerta or Ritalin. Handling these types of drugs together can result in a hypertensive crisis (dangerous spike in blood pressure).
Antihypertensive drugs, or drugs used to treat high blood pressure, such as diuretics, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and beta-blockers, may not work as well if taken along with Concerta or Ritalin.
Risperidone, an antipsychotic medication, if taken along with Concerta or Ritalin, may come with an increased risk of extrapyramidal symptoms (EPS; side effects that can develop after taking certain antipsychotic medications).
Lastly, Ritalin and Concerta may decrease the metabolism of some other groups of drugs, meaning they may stay in your system longer, and it may be necessary to compensate for this by lowering their dose.
Examples of these drugs include the following:
Anticoagulants, such as Jantoven (warfarin).
Anticonvulsants, such as phenobarbital, Dilantin (phenytoin), and Tegretol (carbamazepine).
Some antidepressants, including tricyclic antidepressants (TCAs), such as Pamelor (nortriptyline).
Selective serotonin reuptake inhibitors (SSRIs), such as Lexapro (escitalopram), Zoloft (sertraline), and Prozac (fluoxetine).
Before starting any medication, ensure that your healthcare provider and pharmacist know all your medications and supplements, as some adjustments may need to be made.
Summary
Ritalin and Concerta are two versions of the same stimulant medication, methylphenidate, used to treat ADHD.
They are thought to increase focus and attention by increasing the amount of certain chemicals in the brain, such as norepinephrine and dopamine.
Concerta is an orally administered ER tablet taken just once a day. In comparison, Ritalin may be taken two or three times daily as an IR tablet or just once daily as a DR capsule called Ritalin LA.
While stimulants generally work well to control symptoms of ADHD, they can cause side effects such as appetite changes, trouble sleeping, nervousness or anxiety, and more potentially severe effects like worsening mental health conditions, heart problems, or abuse and dependence.
Frequently Asked Questions
Does Concerta or Ritalin carry the potential for abuse?
Per the black box warning that applies to both drugs, there exists a considerable risk for those with a history of addictive or unstable substance use to become addicted to or to begin consuming Concerta or Ritalin in an unhealthy manner.
Therefore, if you have a medical history that reflects the potential for addiction, speak to your healthcare provider before starting either drug.
How should I store Concerta or Ritalin?
Store Concerta and Ritalin at room temperature (68 to 77 degrees F) in a dry place, away from too much humidity.
It’s best to dispose of unused stimulant medications by taking them to a medicine take-back program offered by your local pharmacy or sponsored by the Drug Enforcement Agency (DEA).
If this is unavailable, you can mix the medicine with a substance like dirt or kitty litter, place the mixture in a sealed plastic bag and discard it in the household trash.
