Vyvanse vs Concerta: How These ADHD Medications Compare

Overview of Vyvanse vs Concerta

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity. Medications like stimulants are often prescribed to help manage ADHD symptoms. Two popular stimulant medications for treating ADHD are Vyvanse (lisdexamfetamine) and Concerta (methylphenidate).

Vyvanse and Concerta are both central nervous system stimulants. They work by increasing the brain chemicals dopamine and norepinephrine, which play essential roles in thinking, attention and behavior control. However, there are some key differences between these two medications.

Vyvanse is a prodrug - it needs to be metabolized by the body's enzymes to become active. This makes the effects come on more gradually and last longer. Concerta uses an advanced release mechanism that delivers a dose immediately and another dose later in the day. Both medications can provide symptom relief for 10-14 hours.

Overall, both Vyvanse and Concerta are effective options for managing ADHD symptoms. Which one is better depends on an individual's specific needs and preferences. Factors like side effects, dosing, onset and duration of action all play a role in determining the right medication for each patient.

Key Differences Between Vyvanse and Concerta

• Vyvanse is a prodrug that needs to be metabolized to become active, Concerta uses an advanced delayed-release mechanism
• Vyvanse may have a smoother onset and offset of effects, Concerta may have more pronounced peak
• Vyvanse duration is around 13 hours, Concerta lasts 10-12 hours
• Vyvanse is taken once a day, Concerta can be taken once or twice per day
• Vyvanse has lower abuse potential, Concerta has higher abuse potential
• Food does not affect Vyvanse absorption, Concerta works best on an empty stomach

How Vyvanse and Concerta Work

Vyvanse and Concerta are both classified as stimulants. However, they work in slightly different ways:

Vyvanse

Vyvanse contains the active ingredient lisdexamfetamine. It is classified as a "prodrug", which means it needs to be metabolized by the body's enzymes to become active. Once ingested, Vyvanse is converted into the active stimulants dextroamphetamine and amphetamine.

Dextroamphetamine and amphetamine work by increasing levels of dopamine and norepinephrine in the brain. This provides symptomatic relief by improving focus and concentration, reducing hyperactivity and impulsivity.

Because Vyvanse needs to be converted to its active form, its effects tend to come on more gradually after taking it. This results in a smoother onset and offset of action, without sharp peaks and valleys in concentration.

Concerta

Concerta contains the active ingredient methylphenidate. Unlike Vyvanse, Concerta does not require conversion and is active as soon as it is ingested.

Concerta uses an advanced release mechanism called OROS (Osmotic-Controlled Release Oral Delivery System). This releases a dose of medication immediately and another dose about 4-5 hours later. The dual delivery system provides symptom relief both in the morning and early afternoon.

Since the medication becomes active right away, Concerta tends to have more pronounced peak effects after taking a dose. Some patients may experience a "kick in" sensation.

Onset and Duration

Understanding how quickly the medication becomes effective and how long it lasts can help guide treatment choices.

Vyvanse Onset and Duration

Because it needs to be metabolized into its active form, Vyvanse takes a bit longer to kick in than Concerta. Vyvanse usually starts working within 1-2 hours. It reaches peak effectiveness around 3-4 hours after taking it.

The effects of Vyvanse generally last for 12-14 hours. This enables once-a-day dosing in the morning to provide coverage throughout the day.

Concerta Onset and Duration

Since Concerta becomes active as soon as it is ingested, effects start within 30-60 minutes. Peak effectiveness is reached around 2 hours after taking a dose.

Concerta provides 10-12 hours of symptom control on average. However, effects may start wearing off more rapidly in the late afternoon or evening as the second dose wears off.

To extend coverage, some patients take Concerta twice a day - usually a larger dose in the morning and a smaller booster dose 4-6 hours later. The dual delivery system was designed to more closely mimic the normal daily rise and fall of dopamine and norepinephrine.

Dosages

Vyvanse and Concerta come in various dosage strengths. The right dosage is determined individually for each patient based on factors like age, symptom severity and sensitivity to side effects.

Vyvanse Dosage

Vyvanse comes in 6 capsule strengths:

• 10 mg
• 20 mg
• 30 mg
• 40 mg
• 50 mg
• 60 mg

In clinical trials, the most common effective dosage range for adults was 30 to 50 mg per day. Maximum daily dosage is 70 mg.

For children ages 6-12, starting dosage is typically 20 to 30 mg once daily in the morning. Maximum dosage for children 6-12 years old is 70 mg per day.

Concerta Dosage

Concerta comes in 4 tablet strengths:

• 18 mg
• 27 mg
• 36 mg
• 54 mg

In clinical studies of adults, average effective dosages ranged from 36 to 76 mg per day. Maximum recommended dose is 108 mg daily.

For children starting Concerta, recommended dosage is 18 or 27 mg once daily. Children may be titrated up to maximum daily dose of 54 mg.

Side Effects

Vyvanse and Concerta are both stimulants and have similar potential side effects. However, some may be more likely with one medication versus the other.

Common Side Effects

Common side effects of Vyvanse and Concerta can include:

• Decreased appetite
• Trouble sleeping
• Headache
• Stomach ache
• Dry mouth
• Anxiety
• Irritability or mood swings

These side effects are usually mild. Taking the medication with food, staying well hydrated, adjusting dosage and other lifestyle modifications can often minimize adverse effects.

Less Common Effects

Some less common side effects may be more likely with one medication or the other. For example:

• Vyvanse - Dizziness, weight loss, slowed growth in children
• Concerta - Skin rash, high blood pressure, tics

Vyvanse tends to have lower risk of cardiovascular effects like increased heart rate and blood pressure changes. Concerta is more associated with sudden changes in mood or behavior.

Serious Side Effects

In very rare cases, serious side effects may occur with stimulant ADHD medications like psychosis, seizure, cardiomyopathy or pulmonary hypertension. Concerta may have slightly higher risk of seizures due to its more rapid onset of action.

If concerning side effects develop, the prescribing doctor should be notified immediately to determine if medication should be changed or discontinued.

Effectiveness

Many studies have found both Vyvanse and Concerta to be highly effective at reducing symptoms of ADHD.

Vyvanse Effectiveness

In clinical trials of adults with ADHD, Vyvanse significantly improved attention and concentration. Symptoms like forgetfulness, distractibility, disorganization, hyperactivity and impulsivity were reduced.

Vyvanse has also been shown effective in ADHD trials involving adolescents and children. Improvements were seen in academic performance, classroom behavior and socialization.

Concerta Effectiveness

Concerta has been extensively studied in adults, adolescents and children with ADHD. It consistently shows benefit for inattention, distractibility, hyperactivity, impulsivity, work/school performance.

The effects of Concerta on ADHD symptoms have been shown to last 10 to 12 hours. This allows many patients to get through the school or workday with just a single morning dose.

Overall, research indicates Vyvanse and Concerta are similarly effective options for managing ADHD symptoms.

Abuse Potential

Stimulant medications like Vyvanse and Concerta do carry some risk of abuse and dependence. However, Vyvanse likely has lower abuse potential than Concerta.

Vyvanse Abuse Potential

The prodrug mechanism of Vyvanse provides protection against abuse. Because Vyvanse needs to be metabolized to become active, it can not be used in ways to create a rapid high. In clinical studies, Vyvanse had lower likeability scores compared to other stimulants.

The controlled release of active drug also minimizes ups and downs, reducing cravings and addictive potential. Vyvanse is classified federally as a Schedule II controlled substance, indicating it does still have abuse risk that needs monitoring.

Concerta Abuse Potential

Concerta is more easily abused than Vyvanse. Since Concerta becomes active as soon as it is ingested, it can be misused in ways that lead to dangerous spikes of stimulant effects. Tablets can also potentially be crushed and then snorted or injected for a rapid high.

Concerta's dual release mechanism can also increase abuse potential, as taking more pills leads to escalating stimulant effects. For these reasons, Concerta is classified as a Schedule II controlled substance.

Proper precautions are needed with both medications, like keeping prescriptions secure and safely disposing of unused medication. But Vyvanse appears to have lower addictiveness.

Cost and Availability

Vyvanse and Concerta are both brand-name prescription medications. Key differences in their cost and availability include:

• Vyvanse currently has no generic forms. Concerta has generic versions available (methylphenidate ER).
• Vyvanse may cost more, around $365 for a one month supply without insurance. Concerta is around $315 monthly.
• Vyvanse may have more generous manufacturer discounts and coupon offerings.
• Both medications may require prior authorization from insurance.
• Concerta may have wider insurance coverage and lower co-pays.

Ultimately costs will depend on each patient's insurance plan, deductibles and pharmacy benefits. Those without coverage can explore resources like manufacturer coupons and patient assistance programs to lower out-of-pocket expenses for either medication.

Lifestyle Considerations

Certain factors in a person's daily routine may influence treatment choices between Vyvanse and Concerta.

Taking With or Without Food

Vyvanse can be taken with or without food, without affecting its absorption or effectiveness. Concerta is recommended to be taken first thing in morning on empty stomach for optimal results.

Those who prefer not to take pills before breakfast may find Vyvanse more convenient. Taking Concerta with food can decrease amount absorbed by 20-30% in the morning dose.

Swallowing Pills

Vyvanse is only available as capsules, whereas Concerta comes in tablets. Those who have difficulty swallowing pills may find Vyvanse capsules easier to take.

Concerta tablets can not be crushed or chewed due to the special controlled release mechanism. Vyvanse capsules can be opened and sprinkled into drinks or soft foods if needed.

Timing of Effects

Vyvanse may be preferred when a very gradual onset of effects is desired. Concerta may work better for those wanting the medication to kick in for the most coverage in mornings.

Concerta can be taken twice a day to extend duration of action. This fits better with some lifestyles versus once-daily Vyvanse.

FAQs

Is Vyvanse or Concerta more effective?

Research indicates Vyvanse and Concerta are similarly effective for treating ADHD. Both significantly improve symptoms of inattention, hyperactivity and impulsivity. Which medication works better will depend on individual factors.

Does Vyvanse last longer than Concerta?

On average, Vyvanse appears to have a longer duration of action than Concerta. Vyvanse typically lasts around 13 hours, while Concerta is effective for 10-12 hours in most patients.

Can Vyvanse and Concerta be taken together?

It is generally not recommended or necessary to take Vyvanse and Concerta together. They are both stimulant medications with similar mechanisms of action. Combining the two would increase the risk of side effects without providing much added benefit.

Is Concerta stronger than Vyvanse?

It is difficult to classify one as stronger than the other. At equivalent therapeutic dosages, Vyvanse and Concerta are likely to have similar effects on ADHD symptoms. Concerta may have more potential for abuse at very high doses.

Can I take Vyvanse one day and Concerta the next?

It is best not to switch back and forth between Vyvanse and Concerta on different days. These medications have different durations of action and onset/offset profiles. Inconsistent dosing could lead to side effects or fluctuations in effectiveness.

The Bottom Line

Vyvanse and Concerta are both effective, FDA-approved medications for treating ADHD. They have similar mechanisms of action targeting dopamine and norepinephrine. However, there are some key differences between these stimulants:

• Vyvanse is a prodrug, Concerta uses an advanced release mechanism
• Vyvanse may have a smoother onset/offset, Concerta may kick in faster
• Vyvanse lasts around 13 hours, Concerta 10-12 hours
• Vyvanse is taken once daily, Concerta can be taken once or twice a day
• Vyvanse has lower abuse potential, Concerta has higher abuse risk

Choosing between Vyvanse vs Concerta depends on an individual's needs and lifestyle. Working closely with a doctor can help weigh the benefits and drawbacks of each option to identify the right treatment plan.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.