Concerta and Vyvanse are the brand names of long-acting stimulant medications prescribed for the treatment of attention deficit hyperactivity disorder (ADHD). Vyvanse can also be used to treat binge eating disorders.
Here we explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.
What is Concerta?
Concerta is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Janssen. It is a prescription drug used for the treatment of ADHD (attention deficit hyperactivity disorder) in children aged 6 to 18, and sometimes in adults too. The medication is taken orally as a tablet. Your physician will decide how often you take it and at what dose.
ADHD is a condition that causes differences in brain development and activity. The most common effects of this are problems paying attention, impulsive behavior, excess energy, and difficulties with controlling your emotions. It usually emerges and is diagnosed in childhood, often between the ages of 6 and 12. It can be diagnosed later in life though. ADHD can be very disruptive to your life, affecting performance at school and in the workplace, as well as interfering in your home and social life.
Concerta helps with ADHD by affecting your brain activity. The medication increases activity in certain regions of your brain, improving your attention, helping you focus, making you less impulsive, and easing other symptoms of ADHD. Concerta is often used alongside other treatments, like counseling and behavioral therapy.
The active ingredient in Concerta is called methylphenidate. This helps with brain activity by increasing the amount of norepinephrine and dopamine in your brain. These two substances are naturally produced in your brain and they help to send signals between your neurons.
Usually, excess norepinephrine and dopamine are reabsorbed by the neurons that make it. Methylphenidate blocks this from happening though, allowing levels of these substances to increase. Higher levels of norepinephrine and dopamine enhance communication between your neurons, increasing brain activity. This is associated with improvements in thinking and behavior, like increased attention and reduced impulsivity.
Concerta is available in extended-release tablet form, in the following doses: 18, 27, 36, and 54 mg.
Concerta should be taken in the morning once daily, with or without food. It should be swallowed whole with water. It should not be chewed or crushed. The recommended starting dose is 18 mg once daily for children and adolescents new to methylphenidate, and 18 to 36 mg/day in adults. The dose may be increased at weekly intervals to a maximum of 54 mg/day in children and 72 mg/day in adolescents and adults.
For additional safety information, read the full prescribing information and medication guide. Always speak with a healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.
What is Vyvanse?
Vyvanse is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Shire PLC. Vyvanse is a central nervous system stimulant medication used to treat ADHD symptoms in children (Attention Deficit Hyperactivity Disorder) and moderate to severe binge eating disorder (BED) in adults.
Vyvanse belongs to a class of drugs known as amphetamines. These work by blocking the reuptake of norepinephrine and dopamine into the presynaptic neuron and increasing the release of these monoamines into the extraneuronal space.
Vyvanse is not recommended for weight loss. The use of other sympathomimetic drugs for weight loss has been associated with serious cardiovascular adverse events. The safety and effectiveness of Vyvanse for the treatment of obesity have also not been established.
Vyvanse is similar to Adderall. The main difference is that Adderall is a mixture of four different kinds of amphetamine salts (one of which is dextroamphetamine) while Vyvanse only contains one type of amphetamine salt, called lisdexamfetamine.
Vyvanse is a prodrug, meaning lisdexamfetamine is converted into dexamphetamine once it is in the body. An advantage of Vyvanse is that it may be less likely to be abused. Vyvanse is a federally controlled substance because it has a high potential for drug abuse and can lead to dependence. You should store Vyvanse at room temperature, but away from light and moisture. Do not store them in the bathroom, and keep all medications away from children and pets.
Vyvanse is available in capsule and tablet form, in the following doses:
- Capsules: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, and 70 mg
- Chewable tablets: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg
To make swallowing easier you may open the capsule and sprinkle the medicine into a glass of water or orange juice, or mix it with yogurt. Once the medicine has dissolved, drink or eat the mixture right away.
For additional safety information, read the full prescribing information and medication guide. Always speak with a healthcare professional for medical advice or about any changes to your dose so they can monitor and evaluate your condition.
Common side effects of Concerta and Vyvanse
The most common side effects of Concerta in clinical trials include:
- Feeling nervous
- Mood changes
- Irregular heartbeat
More serious side effects of Concerta include:
- Allergic reactions
- Muscle spasms
- Psychological issues like paranoia and suicidal thoughts
The most common side effects of Vyvanse in clinical trials include:
- Dizziness, nausea
- Dry mouth
- Upper abdominal pain, stomach pain, vomiting, loss of appetite, decreased weight, diarrhea, constipation
- Increased heart rate
More serious side effects of Vyvanse include
- Serious cardiovascular reactions
- Sudden death has been reported with CNS stimulant treatment at recommended doses in pediatric patients with structural cardiac abnormalities or other serious heart problems
- Sudden death, stroke, and heart attacks in adults
- Increased blood pressure and increase in heart rate Increases
- Suppression of growth – monitor height and weight in pediatric patients
- Peripheral vasculopathy, including Raynaud’s phenomenon
- Serotonin syndrome
- New or worsening psychosis
- Withdrawal symptoms if you suddenly stop using this medication – severe tiredness, sleep problems, mental/mood changes such as depression
These aren’t all the side effects Concerta or Vyvanse can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or a pharmacist.
Concerta and Vyvanse interactions
Concerta can interact with other medications. These include:
- Monoamine oxidase inhibitors (MAOIs) taken for depression
- Tricyclic antidepressants
- Selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) antidepressants
- Medicines for Parkinson’s disease, like levodopa
- Medicines for epilepsy
- Blood pressure medications
- Blood-thinning medications
- Cough or cold remedies that can affect blood pressure
Vyvanse can interact with other medications. These include:
- Acidifying and alkalinizing agents – acidifying agents decrease amphetamine blood levels, and alkalinizing agents increase amphetamine blood levels
- MAO inhibitors – isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication
- Serotonin syndrome toxicity increases if you are also taking other drugs that increase serotonin, e.g. MDMA, St. John’s wort, certain antidepressants (fluoxetine, paroxetine, duloxetine, venlafaxine)
- Do not use medications containing amphetamine or dextroamphetamine while using lisdexamfetamine
Concerta and Vyvanse can interact with other medications. This can change how Concerta and Vyvanse and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.
Concerta and Vyvanse contraindications
You should not use Concerta if you:
- Are allergic to the active ingredient methylphenidate
- Are allergic to any of the other ingredients in Concerta
- Are under six years of age
- Have thyroid problems
- Have glaucoma
- Have a heart condition
- Have high blood pressure
- Have problems with the blood vessels in your brain
- Have tics or Tourette’s syndrome
- Have mental health conditions like schizophrenia, borderline personality disorder, mania, severe depression, or an eating disorder
Talk to your doctor before using Concerta if you:
- Have a liver or kidney condition
- Have a narrowing or blockage in your food pipe or gut
- Have ever had seizures or an abnormal brain scan (ECG)
- Are female and have started your periods
- Have a mental health problem where you experience mood swings, hallucinations, paranoia, anxiety, or depression
- Are about to have an operation
- Are intolerant to some sugars
- Are pregnant or are planning to become pregnant
- Are breastfeeding or are planning to breastfeed
You should not use Vyvanse if you:
- Are allergic to the active ingredient lisdexamfetamine dimesylate
- Are allergic to any of the other ingredients in Vyvanse
- Are taking monoamine oxidase inhibitors (MAOI)
- Are pregnant or are planning to become pregnant – there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications during pregnancy
Talk to your doctor before using Vyvanse if you:
- Are taking any of the medications that could interact with Vyvanse
- Are breastfeeding or are planning to breastfeed – lisdexamfetamine can pass into breast milk and may cause side effects in the nursing baby
- Have depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions
- Have kidney disease
- Have coronary artery disease
- Have blood circulation problems in your hands or feet
- Have a drug or alcohol addiction
- Have a family history of heart disease, heart problems, or high blood pressure
Other drugs for ADHD
Concerta and Vyvanse are both classed as Schedule II drugs and controlled substances by the U.S. Food and Drug Administration (FDA) because of their potential for abuse and dependence.
If you have any concerns about Concerta or Vyvanse side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.