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Adderall vs Concerta

Comparing Adderall and Concerta – which is better?
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Adderall and Concerta are both stimulant medications used for the treatment of ADHD. Though they act in similar ways, the medicines have some significant differences. 

Though Adderall and Concerta contain different active ingredients, both of them are approved by the U.S. Food and Drug Administration for treating ADHD in children and adults. 

Determining which is better of the two - Concerta and Adderall, is not an easy task. It is important to first be aware of the contents of each. 

Concerta is available in the market in tablet form. It contains methylphenidate, a potent stimulant. Adderall also comes in tablet form; but it contains a mixture of amphetamine salts. 

Both these ADHD medications are long acting or long term processing that serve to calm the sensors or biological sensory messages which may trigger ADHD to worsen it. 

Adderall

Adderall is an amphetamine-based drug approved for the treatment of ADHD. It is also used to treat narcolepsy. Off-label use of the drug include in the treatment of obesity and depression when other medications fail.

Adderall contains four amphetamine salts: amphetamine aspartate monohydrate, amphetamine sulfate, dextroamphetamine sulfate and dextroamphetamine saccharate.

It is sold in two formulations: instant release (IR) and extended release (XR) formulations. Only the instant release formulation is recommended for treating narcolepsy.

Extended release Adderall contains the four salts in equal proportions. This formulation of the drug is prepared with the drug molecules formed into two kinds of microbeads.

The first kind releases the active agents immediately which make up half of the content in each pill of Adderall. The second type of beads releases the rest of the active ingredients over four hours. The advantage of the extended release formulation is that people living with ADHD can take it once daily.

Both levoamphetamine and dextroamphetamine are contained in Adderall, although there is more of the dextro form.

Dextroamphetamine is the more potent molecule especially in the central nervous system. However, levoamphetamine produce longer therapeutic effect and has a faster onset of action.

Strangely, studies have shown that in some ADHD children, the levoamphetamine form produce better clinical results that the dextro form.

The overall effect of the amphetamines is to increase the levels of such brain chemicals as dopamine, norepinephrine and serotonin. While dextroamphetamine has more affinity for pathways promoting the release of dopamine, levoamphetamine is tied closer to norepinephrine pathways.

These amphetamines increase the levels and effects of dopamine and norepinephrine by:

  • Substituting for the neurotransmitters and acting as substrate for the dopamine and norepinephrine transporters at the synapses between neurons. By doing this, the transporters remove the amphetamines rather than the neurotransmitters from the spaces between the neurons. Therefore, dopamine and norepinephrine act longer at those sites.
  • Entering into neuronal cells and pushing out dopamine into the synapses.

The net effect of these two mechanisms is to increase the amount of dopamine and norepinephrine at the synapses and also lengthen the time these neurotransmitters spend there. This leads to increased concentration, alertness and sociability in people with ADHD.

Concerta

The active ingredient of Concerta is methylphenidate. Like the amphetamines, it is a centrally active stimulant used in the treatment of ADHD and narcolepsy.

Methylphenidate is a derivative of amphetamine and has a similar activity to the amphetamines contained in Adderall.  However, its profile of activity is slightly different from the amphetamines.

Methylphenidate inhibits the reuptake of dopamine and norepinephrine at the synapses of neurons. It does this by binding to both the dopamine and norepinephrine transporters to disrupt the clearance of the two neurotransmitters from the spaces between the neurons.

However, methylphenidate is more active at binding with the dopamine transporter than with the norepinephrine transporter.

Yet another way in which methylphenidate has a slightly different activity when compared to the amphetamine is in its second mechanism of action.

Methylphenidate contained in Concerta also stimulates the release of more dopamine and norepinephrine into the synaptic spaces. However, it does this to a lesser extent than the amphetamines. Moreover, the exact mechanism of releasing these neurotransmitters is still unclear but is definitely not the same as with the amphetamines.

In addition, while the amphetamines substitute for dopamine and norepinephrine at the transporters in the synapses, methylphenidate binds with the transporters.

This means that the transporters are still working in the case of Adderall but they are removing amphetamines instead. With Concerta, the transporters are blocked from functioning at all.

The overall effect of methylphenidate is to improve the symptoms of ADHD by reducing fatigue, improving alertness and attention while maintaining mental focus.

Studies and Researches

The efficacy of both these stimulants has been demonstrated in classroom settings. Both the medicines have the effect of calming the user and allowing him to improve his mental concentration. However, the long-term affects of both medications are controversial. 

According to Terrance Woodworth of the U.S. Drug Enforcement Administration (DEA), both Concerta and Adderall are considered to be addictive and therefore are Schedule II controlled substances in the United States. 

It has been shown that amphetamines are more potent than Concerta. Both medications stimulate the central nervous system. Adderall tends to have harsher side effects than Concerta. 

Concerta Side Effects

Children younger than 6 years should not take Concerta, and anybody having anxiety disorder, a tic disorder or glaucoma should also not take it. 

Patients taking antidepressant medications such as monoamine oxidase inhibitors, or MAOIs should stop taking it at least 2 weeks before starting to take Concerta. 

Some of the common side effects among children taking this stimulant are stomach ache, vomiting, fever, sore throat, nasal irritation, loss of sleep, and dizziness. 

Adults taking Concerta might experience some side effects such as insomnia, headache, increased anxiety and irritability, loss of appetite, dry mouth, weight loss, and excessive sweating. 

Adderall Side Effects

Just like Concerta, Adderall should not be taken at the same time as antidepressant medications such as monoamine oxidase inhibitors, or MAOIs. However, Adderall can be prescribed to kids as young as 3 years. 

Adderall must not be used by patients with high blood pressure, cardiovascular disease, a tic disorder, hardened arteries, or an anxiety disorder. 

Some of the common side effects of taking Adderall include insomnia, dizziness, rapid heartbeat, loss of appetite, dry mouth, and high blood pressure. 

Which is the best?

According to a study, it has been proved that 33% of patients respond better to Concerta, 33% respond better to Adderall, while the remaining 33% respond better to both medications. 

Hence, it is difficult determine which is better among the two – Concerta or Adderall. You must consult with your health care practitioner to find out which one works best for you. 

Comparative studies of methylphenidate and amphetamine show that the latter is slightly more potent and acts for longer than the former. However, such differences are only small and individual differences are more important.

Some users respond well to Concerta while they perform poorly on Adderall and vice versa.

It is important to note that pyschostimulants are known to decrease appetite and, therefore, contribute to weight loss. This effect is, however, more pronounced with the mixed amphetamine salts of Adderall than with the methylphenidate of Concerta.

For more information, read our articles 4 Ritalin Alternatives, 3 Adderall Alternatives, Adderall vs Vyvanse, and Adderall vs Strattera.

Next Article: Adderall vs Strattera
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