Adderall and Ritalin are two commonly prescribed stimulant medications used to manage the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). While they share similarities in their effects on the brain, they also have distinct differences that can influence their suitability for individual patients. This article provides a detailed comparison of Adderall and Ritalin, focusing on their mechanisms of action, efficacy, side effects, dosage, and potential for weight loss, to help you make informed decisions about ADHD treatment.
Understanding ADHD and Stimulant Medications
Approximately one in ten children in the United States are diagnosed with ADHD. Characterized by hyperactive and impulsive behavior, ADHD can lead to fidgeting, absent-mindedness, and difficulty focusing. Stimulant medications are often prescribed to treat ADHD, and while this may sound counterintuitive, these medications improve concentration and reduce impulsive behavior, allowing individuals to focus more easily on tasks. Stimulants such as Ritalin and Adderall help manage ADHD symptoms and improve your ability to pay attention, think, and engage in tasks.
What are Ritalin and Adderall?
Ritalin, with the generic name methylphenidate, and Adderall are both prescription medications used to treat ADHD. Ritalin is also used to treat narcolepsy and, in some instances, obesity and depression. Ritalin is a brand name for methylphenidate, while Adderall contains mixed amphetamine salts.
Ritalin
Ritalin contains methylphenidate, a psychostimulant that acts directly on the central nervous system. It primarily boosts the activity of neurotransmitters at the prefrontal cortex, which is the part of the brain responsible for maintaining focus, attention, and impulse control. Since it targets the part of the brain specifically, it does not affect the parts of the brain that control arousal and addiction. Ritalin is available in a few different forms, which are instant release, sustained release, or long-acting.
Adderall
Adderall contains a mixture of amphetamine salts (MAS). The mixed amphetamine salts contained in Adderall are dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. Adderall is known to be just as effective as Ritalin in treating symptoms of ADHD. Adderall acts as a psychostimulant on the central nervous system. Adderall is available in both an instant and extended-release formulas.
Read also: Weight Loss on ADHD Meds
How Ritalin and Adderall Work in the Brain
Both Ritalin and Adderall are central nervous system (CNS) stimulants that increase the brain activity of norepinephrine and dopamine, speeding up the transmission of electrical and chemical signals throughout the body. They help control levels of two chemicals in your brain, dopamine and norepinephrine, that affect how well you focus.
- Dopamine: Dopamine is responsible for mood regulation, concentration, and memory recall.
- Norepinephrine: Norepinephrine can increase alertness and reaction times while lowering aggression.
Ritalin and Adderall are thought to work in a similar way - by increasing the concentrations of norepinephrine and dopamine in the brain. These two neurotransmitters transmit impulses between nerves, which helps improve ADHD symptoms such as hyperactivity, impulsiveness, and inattention. Ritalin typically kicks in faster - however, the effects of Adderall are long-acting.
Similarities and Differences Between Ritalin and Adderall
While Ritalin and Adderall have many similarities, there are also key differences that can influence which medication is best for an individual.
Similarities
- Both are approved to treat symptoms of ADHD like focus, hyperactivity, and impulsivity.
- Both are central nervous system stimulants, influencing the levels of norepinephrine and dopamine in the brain.
- They can both cause difficulty sleeping and decreases in appetite.
- Both have the potential for abuse, addiction, and physical dependence.
- Both medications work in similar ways in the brain and have similar side effects.
- Both are regulated in a few important ways, including being only available by prescription, often prescribed in limited quantities, and tracked through state prescription monitoring programs.
Differences
- They have different active ingredients, which can be processed differently by the body. This leads to individual differences in how likely side effects will be and how well the medication may work.
- Ritalin can work quickly but can also wear off quickly, depending on the formulation.
- Adderall can offer support for longer periods throughout the day, depending on the formulation.
- Ritalin appears more likely to cause upset stomach, and Adderall may be more likely to cause appetite loss and sleep disruption.
- Adderall tends to be favored more in long-term treatment of ADHD symptoms due to its ability to alleviate symptoms at lower doses, as well as its longer duration.
Dosage and Forms
Both Ritalin and Adderall are available in short-acting and long-acting formulations.
Ritalin Dosage and Forms
Ritalin can be dosed in a few different forms including:
Read also: Weight Loss with Adderall: What You Need to Know
- Instant release: Effective for around 3 to 4 hours. Tablets are available in dosages of 5, 10, or 20 milligrams.
- Sustained release: Duration of 8 hours. Available dosages: 20 mg
- Long-acting (Ritalin LA): Duration: 6 to 8 hours. Available in extended-release capsules in dosages of 10, 20, 30, and 40 milligrams. The long-acting form of Ritalin lasts 6-12 hours.
Ritalin begins working 20-60 minutes after you take it. The standard duration for Ritalin is three to five hours of immediate-release medication and seven to eight hours for extended-release.
Adderall Dosage and Forms
Adderall is only available in:
- Instant release: Duration: 4 to 6 hours. Adderall doses are available starting at 5 mg and going up to 30 mg, with several incremental options in between. Tablets are available in dosages of 1.25, 2.5, 3.75, 5, 6.25, 7, or 7.5 milligrams.
- Extended release (Adderall XR): Lasts for up to 12 hours because this brand of Adderall is designed for slow and sustained release. Capsules are available in dosages of 1.25, 1.875, 2.5, 3.125, 3.75, 5, 7.5 milligrams. The long-acting version of Adderall may last up to 24 hours.
Adderall begins working 30-60 minutes after you take it. The standard duration for Adderall is four to eight hours for immediate-release and 8-12 hours for extended-release.
Ritalin vs. Adderall Dosage Conversion
It goes without saying that the higher the dosage amount, the stronger a drug is. However, doses of Ritalin are not equal to Adderall. If you plan to switch from Ritalin to Adderall (or vice versa), you must consider the following factors.
- Potency: The efficacy of Adderall is approximately twice as strong as Ritalin - 5 mg of Ritalin is about equivalent to around 2.5 mg of Adderall. Thus, if you plan to switch from Ritalin to Adderall, you’ll likely need to decrease your dosage. Similarly, if you want to switch from Adderall to Ritalin, your dosage will increase. But, always keep in mind the dosage duration forms when it comes to equivalency.
- Duration: It’s always important to consider how long a drug takes to kick in. If you’re transitioning from a short-acting, fast drug to a slow-acting, long-lasting drug, the dosage amount should be increased to compensate for the new decrease in speed.
Finding the Right Dosage
Ultimately, determining the right dosage amount isn’t an exact science - doses vary for each individual. To help determine the right medication and dosage for your needs, consider trying pharmacogenetic testing.
Read also: Does Adderall Help You Lose Weight?
Side Effects of Ritalin and Adderall
When comparing the side effects, you see that they’re very similar to one another, since both are central nervous stimulants that increase the availability of certain neurotransmitters in the brain. Like any drug, both Ritalin and Adderall come with the risk of significant side effects. Since they affect the brain in similar ways, many of these effects overlap.
Common side effects of Adderall and Ritalin can include:
- Sleep problems
- Appetite problems/Loss of appetite
- Anxiety
- Increased heart rate
- Headache
- Dizziness
- Irritability
- Weight loss
- Restlessness
- Tremors
- Tics
- Diarrhea
- Constipation
- Mood swings
- Hives
- Insomnia
- Nervousness
- Belly pain or nausea
- Raised blood pressure
- Stomach upset
- Skin rash
They also come with warnings about the chance of heart problems, mental health problems, seizures, blurred vision, and circulation problems in your fingers and toes.
Adderall-specific serious side effects include: Increased blood pressure, Irregular heart rate, and Sudden cardiac arrest. Ritalin-specific side effects include: Psychosis and Numbness or tingling.
Ritalin vs. Adderall Side Effects
Head-to-head studies are limited, but some differences in side effects across a broad population can be estimated.
- Methylphenidate (Ritalin) tends to cause higher rates of stomach upset and may increase depression symptoms.
- Amphetamine salts (Adderall) tend to cause higher rates of insomnia and loss of appetite.
The adverse effects you experience (as well as their extent) varies depending on your metabolism. For example, if you tend to break down drugs quickly, you might metabolize them before they even get a chance to work - in this case, you’ll need medication that can last for a long time like Adderall. Conversely, if you break down drugs too slowly, they’ll remain in your system for longer than usual (which increases the chance of experiencing side effects). In this situation, you’ll want a medication that acts quicker like Ritalin.
Ritalin and Adderall for Weight Loss
Both Adderall and Ritalin are frequently abused by recreational users as a means to lose weight due to the common side effect of decreased appetite. Stimulants can lower hunger and make your body burn calories faster. However, long-term abuse of stimulants like Ritalin and Adderall are not only a sustainable form of weight loss, but can quickly turn into an addiction and result in physical damage to the body.
Abuse and Addiction Potential
While Adderall and Ritalin do have therapeutic benefits for people with ADHD, there is also a potential for abuse and addiction with both of these drugs. The FDA classifies both medications as Schedule II controlled substances. That means while Ritalin and Adderall aren’t as chemically addictive as certain drugs, people can develop a dependence or psychological addiction to their benefits.
When they’re taken, particularly at high doses, they create a high which can include feeling euphoric, self-confident, and energetic. When these drugs are taken in significant doses, particularly by people who don’t have ADHD, it can make them feel high, energetic, or able to stay awake for long periods of time.
Long-Term Symptoms of Abuse
When an individual abuses stimulants for a long period of time by taking more than they are prescribed, they can experience detrimental physical side effects including:
- Slurred speech
- Dizziness or vision changes
- Weakness and numbness of extremities
- Rashes such as hives, peeling or blistering skin
- Mood swings including paranoia, mania or aggression
- Seizures
While Adderall has a higher potential for addiction, both medications are popularly misused by those looking to improve concentration and are often abused by college students who use them as “study drugs”.
Important Precautions and Warnings
When dosed properly along with open, consistent communication with your doctor, these medications are generally safe and effective but it’s important to take precautions. Giving your doctor an accurate medical history is also vital because certain conditions can be affected by stimulants.
It’s vital to work with your healthcare team to ensure both of these ADHD medications do not worsen existing conditions or place you at risk of more adverse effects. Make sure your doctor is aware if you have a history of:
- Hypertension
- Cardiac disease
- Liver disease
- Glaucoma
- Alcohol abuse
- Psychiatric or neurological disorders
Stimulant medication labels include warnings for potential serious but very rare cardiovascular events. Children and adults with pre-existing cardiac conditions or heart abnormalities should discuss the use of these medications with their doctor and weigh their benefits and risks.
People may wonder if it’s safe to take Adderall and Ritalin together, and while there are no specific interactions known between the two drugs, what can end up happening could be like an overdose. For example, both are stimulants of the central nervous system, so if you took them together, you might be at a higher risk of experiencing a cardiovascular problem or dangerously high blood pressure.
Ritalin and Adderall: Which is More Effective?
Direct comparison studies and placebo trials indicate that Ritalin and Adderall are effective in ADHD. Despite their differences, many studies conclude that neither Adderall nor Ritalin necessarily work better than the other and the effectiveness of treatment is dependent on the individual.
Studies show that stimulants work well on ADHD symptoms for about 80% of people who take them. About half of those people get the same results from either Adderall or Ritalin. But for the other half, one drug works better than the other. This is because they work in different ways and can cause different side effects.
Not everybody responds equally to either Ritalin or Adderall so if one treatment is ineffective or intolerable it is appropriate to try another. Some people respond better to Ritalin, while others do better with Adderall.
Cost and Availability
Adderall is available in both brand and generic forms. Ritalin is also available in brand and generic. Prices can vary widely, so check with your insurance plan to see what’s covered and compare prices at your local pharmacies. In general, the longer-acting forms of both Ritalin and Adderall are costlier than the shorter-acting forms. And the generic versions can cost much less than brand names.
Cash prices for different forms of Ritalin and Adderall can be estimated as:
- $10.41 per tablet for brand name Adderall instant release tablets.
- $0.30 per tablet for generic amphetamine salts instant release tablets.
- $0.69 per capsule for generic amphetamine salts extended release capsules (generic for Adderall XR).
- $1.00 per tablet for brand name Ritalin instant release tablets.
- $0.66 per tablet for generic methylphenidate instant release tablets.
- $3.53 per capsule for generic methylphenidate extended release capsules (generic for Ritalin LA)
Long-Term Safety and Monitoring
“Stimulant medications like Ritalin and Adderall are generally safe when used as prescribed, but long-term use requires monitoring,” Spence says. Recent studies have shown long-term stimulant use can lead to a higher risk of cardiovascular issues, including increased blood pressure and heart rate, says Beckmann.
If you’re taking Ritalin or Adderall, you should also expect to track their long-term safety through:
- Regular follow-ups. Plan on checking in with your doctor every three to six months to chat about symptoms, side effects, growth (for children), blood pressure, and heart rate.
- Occasional drug holidays. Some people might need to take breaks to reexamine the need for medication or lessen side effects. It can also help the medication work better by lowering the brain’s tolerance.
- Mental health monitoring. Watch for mood changes, increased anxiety, or dependency on the medication.
Alternatives to Stimulant Medications
Behavioral therapy is still recommended as a first-line treatment for ADHD in young children. If this doesn't work and your doctor advises medication, it is important to monitor your child for sympto improvement or development of side effects. Some people manage ADHD with prescription nonstimulant medications, such as atomoxetine or viloxazine. Others use antidepressants or behavioral therapy.
Making an Informed Decision
Choosing the right medication is a personal decision guided by a doctor. There is no formula for figuring out which medication will be best for you. Some people respond better to Ritalin, while others do better with Adderall. Doctors often try one medication first, monitor the effects, and may switch or adjust the dose as needed.
Before discussing any specific medications, you and your doctor should discuss your specific symptoms and concerns, and what treatment is most appropriate for you. A confident diagnosis of ADHD requires a lot of information, and in many cases the risks and benefits favor starting with a non-stimulant medication, or behavioral changes without medication, rather than a stimulant like Adderall or Ritalin.
The Role of Genetic Testing
Choosing The Best Medication Selecting the right ADHD medication isn’t easy. How do you know which dosage and duration is right for you? How do you know which medications will (or won’t) cause significant side effects? That’s where ClarityX comes in.
At ClarityX, we use genetic testing for ADHD (or pharmacogenetics) to determine your ability to metabolize prescription medications based on your DNA.ClarityX offers two types of tests:
Mindwell test: This test is designed for mental health medications, which cover conditions including ADHD, depression, and anxiety.Max Rx: This test evaluates your response to over 265 FDA-approved medications and covers an additional 21 therapeutic areas, including psychiatry, cardiology, pain, rheumatology, and many more. After providing a simple, at-home saliva sample, you’ll receive a personalized report detailing your unique medication response. With this information, you and your doctor can make better, safer choices for your health.