Comparing Ritalin vs. Adderall Effects

Ritalin (methylphenidate) and Adderall (dextroamphetamine and  amphetamine) are two central nervous system (CNS) stimulants. While these drugs contain distinct main ingredients, they treat the same types of problems.

They are alike in how they can trigger a substance use disorder for those at risk. These drugs may also cause harm to pregnant women. Ritalin and Adderall differ in dosage and the length of time they work in the body to relieve symptoms.

This article describes how Ritalin and Adderall are alike and different in their uses, side effects, ways they behave with other drugs, and dosages.

What Do Ritalin and Adderall Treat?

Ritalin and Adderall are two of the most commonly prescribed medications used to treat:

• Attention deficit hyperactivity disorder (ADHD), a common neurodevelopmental disorder causing inattention, hyperactivity, and impulsivity)
• Narcolepsy (disorder affecting the sleep-wake cycle)

Ritalin and Adderall work in similar ways. They improve the way networks that regulate focus, impulsivity, and mood communicate to each other in your brain. This is achieved by directly increasing the levels of the neurotransmitters norepinephrine (a stimulating monoamine) and dopamine, a direct precursor to norepinephrine that is involved in regulating alertness, reward, learning, and mood.

ADHD

ADHD is a medical condition that interferes with a person's ability to pay attention and/or act with the amount of self-control needed to function or develop normally. The condition affects about 8.8% of children aged 4 to 17 and 4.4% of adults aged 18 to 44.

Symptoms of ADHD include the following:

• Inattention: Inattention includes being easily distracted and unable to stay on task. It can cause a person to have difficulty staying focused, organized, and following directions.
• Hyperactivity: Hyperactivity includes an inability to sit still and stop talking when necessary. It can cause a person to move about or fidget and squirm when seated constantly.
• Impulsivity: Impulsivity includes the inability to act without self-control. It can cause a person to act without regard to the consequences of their actions or speech.

While everyone, especially young children, may demonstrate these behaviors occasionally, people with ADHD exhibit these behaviors in an ongoing pattern that lasts longer than six months. About 85% of people with ADHD can control their symptoms with Ritalin or Adderall.

Research indicates that people with ADHD have an imbalance of the neurotransmitter norepinephrine, so they may not receive messages efficiently. These drugs cause increased neurotransmitter activity that promotes alertness, energy, and attention. For people with ADHD, they enable a calming effect.

Narcolepsy

Narcolepsy is a chronic neurological sleep disorder that interferes with the normal sleep-wake cycle. It can cause excessive daytime sleepiness, that lasts from a few seconds to several minutes. Episodes can occur up to several times each day. Those affected are also unable to maintain normal sleep cycles during the night.

Other symptoms of narcolepsy are:

• Cataplexy (sudden extreme loss of voluntary muscle tone while awake)
• Vivid and frightening hallucinations just before falling asleep or awakening
• Brief episodes of paralysis upon awakening or falling asleep
• Fatigue
• Depression
• Memory problems
• Periodic leg movements
• Sleep apnea

For people with narcolepsy, the effect improves alertness and helps people stay awake. Adderall and Ritalin help narcolepsy by increasing brain levels of dopamine. They can also affect the brain levels of serotonin and norepinephrine, neurotransmitters that also support wakefulness.

Ritalin

Ritalin is one of the brand names for the CNS stimulant methylphenidate. This medication is taken orally two to three times daily before eating. The average total dosage for adults is 20–30 milligrams (mg) though 40–60 mg daily can be used if needed.

Ritalin is available in immediate-release tablets of 5 mg, 10 mg, and 20 mg for oral administration. Ritalin-LA is available as 10 mg, 20 mg, 30 mg, and 40 mg capsules.

Side Effects

The most common side effects of Ritalin are nervousness and insomnia. Taking Ritalin also increases your risk of the following physical and psychological side effects, which range from mild to serious conditions:

• Abdominal pain
• Anorexia (loss of appetite)
• Blurry vision
• Dizziness
  
• Headache
• Hypertension
• Hypersensitivity
• Tachycardia (rapid heart rate)
• Insomnia
• Libido change
• Long-term suppression of growth in children aged 7 to 10
• New psychotic or manic symptoms
• Priapism (painful or prolonged penile erection
• Peripheral vasculopathy (numbness, pain, and change in color in fingers or toes)
• Seizures
• Stroke
• Sudden death
• Unexplained wounds

This may not be a complete list of side effects. Side effects can vary based on drug interactions or your reaction to this drug.

Drug Interactions

Ritalin can interact with many types of drugs. Your healthcare provider can review whether you should modify existing drugs when taking this medication.

Ritalin may interact with the following drugs:

• Anticonvulsants: Anticonvulsants, or anti-seizure medications, include Dilantin (phenytoin) and Luminal (phenobarbital).
• Anticoagulants: Anticoagulants like Jantoven (warfarin) inhibit the function of vitamin K, which is essential to the formation of blood clots.
• Monoamine oxidase inhibitor (MAOI) use: Avoid Ritalin if you've taken an MAOI for Parkinson's disease or depression in the last 14 days. You can increase your risk of excessively high blood pressure if you combine these medications.
• Blood pressure medications: Ritalin may impact high blood pressure medications like Zestoretic (lisinopril and hydrochlorothiazide).
• Halogenated anesthetics: Anesthesia helps you fall asleep or limits how much pain you feel during a medical procedure. If halogenated anesthetics are used, you'll likely need to skip your Ritalin doses on the day of your procedure.
• Vasopressors: Vasopressors tighten blood vessels and raise blood pressure in emergency medical situations. These drugs include epinephrine and dopamine administered as injections.
• Risperdal (risperidone): Risperdal (risperidone) is an antipsychotic. When combined with Ritalin, you may have extrapyramidal symptoms (EPS), which are uncontrollable muscle movements.
• Tricyclic antidepressant drugs: Tricyclic antidepressant drugs, which include Anafranil (clomipramine) and Tofranil (imipramine), work by blocking the reuptake of monoamine neurotransmitters in the brain.
  
  

Potential for Abuse

Ritalin is safe and effective when used as prescribed under the direction of a healthcare provider. However, it has a high potential for overdose, abuse, and dependence when misused at higher doses.

Some teenagers and young adults misuse it to discover what Ritalin feels like. They try to take advantage of its perceived ability to cause increased alertness, improved energy, and heightened focus and attentiveness. It is a growing problem on college campuses as up to 38% of college students seek this so-called "study enhancer."

Ritalin is also used for its euphoric effect, or "higdea

h," that can be achieved when misused at high doses. When Ritalin is abused, it is usually diverted from peers, family, or friends who have legitimate prescriptions for this drug. People who abuse this drug swallow the tablet, snort the powder from crushed tablets, or dissolve the tablets in water to make an injectable mixture.

Adderall

Adderall is one of the brand names for the CNS stimulant that contains a combination of the neutral sulfate salts of dextroamphetamine and amphetamine. This medication is taken orally two to three times daily at intervals of four to six hours. The average total dosage for adults is 40 mg or less.

Adderall is available in immediate-release tablets of 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg for oral administration. Adderall-XR is available as once-daily, sustained-release oral capsules of 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg. This drug can be taken with or without food.

Side Effects

The primary side effects of Adderall can include an irregular or fast heartbeat and increased blood pressure. Other side effects range from mild to severe and include the following conditions:

• Abdominal pain
• Alopecia (baldness)
• Anger/aggression
• Anorexia
• Bowel ischemia (abdominal pain, blood in stool, urgent bowel movements)
• Blurry vision
  
• Dry mouth
• Gastrointestinal problems
  
• Headache
• Hypertension
• Tachycardia
• Insomnia
• Libido change
• Long-term suppression of growth in children aged 7 to 10
• New psychotic or manic symptoms
• Overstimulation
• Palpitations (fast-beating, fluttering, or pounding heart)
• Priapism (painful or prolonged penile erection
• Rhabdomyolysis (extreme muscle pain, dehydration, and confusion)
• Seizures
• Serotonin syndrome (a life-threatening reaction when amphetamines are used with other drugs that affect the serotonergic neurotransmitter system, such as MAOIs)
• Severe allergic reaction
• Stroke
• Sudden death

This may not be a complete list of side effects. Side effects can vary based on drug interactions or your individual reaction to this drug.

Drug Interactions

Adderall can interact with many types of drugs. Your healthcare provider can review whether you should modify existing drugs when taking this medication.

Adderall may interact with many of the same types of drugs that can cause problems with Ritalin. When taking Adderall, talk to your healthcare provider about potential interactions with the following drugs:

• Anticoagulants/blood thinners: Anticoagulants like Jantoven (warfarin) inhibit the function of vitamin K, which is essential to the formation of blood clots.
• Anticonvulsants/anti-seizure medications: These include Dilantin (phenytoin) and Luminal (phenobarbital).
• Blood pressure medications
• Cold or allergy medicines that contain decongestants: Over-the-counter old or allergy medicines that can contain decongestants usually include pseudoephedrine or phenylephrine.
• MAOI use: Avoid Adderall if you've taken an AMOI for Parkinson's disease or depression in the last 14 days.
• Stomach acid medications: Stomach acid medications include all proton pump inhibitors (PPIs) that work to reduce stomach acidity. These medications include Prilosec (omeprazole) and Nexium (esomeprazole).

Potential for Abuse

Like Ritalin, Adderall has a high risk of addiction and the potential for abuse. Misusing this or any other prescription stimulant can lead to a substance abuse disorder. The results can include addiction, health problems, and failure to meet work, home, or school responsibilities.

Adderall has the reputation of being a "smart drug" among high school and college students who use it to help them stay awake to study or complete assignments. However, these students may be putting themselves at risk for little reward.

Research indicates that people who take this drug don't perform better on cognitive function tests than control subjects who took a placebo. Instead, they increase the risk of long-term physical and mental problems among the healthy people who use them.

Ritalin vs. Adderall: The Differences

The key difference between Ritalin and Adderall is in their main ingredients, as follows:

• Ritalin contains methylphenidate hydrochloride.
• Adderall contains a combination of amphetamine and dextroamphetamine.

When comparing amphetamine vs. methylphenidate, research indicates that Ritalin is the best choice for children or adolescents with ADHD, while Adderall is generally better for adults with this condition. However, Adderall is the only one of these drugs approved for children aged 3 to 6 years.

Ritalin starts working faster than Adderall, as follows:

• Ritalin starts to work about 20 to 30 minutes after administration.
• Adderall starts to work in approximately 30 minutes to one hour.

Short-acting Ritalin lasts three to five hours, and long-acting Ritalin (Ritalin LA) lasts about eight hours.

While Adderall takes longer to work, the short-acting version lasts about four to six hours, and the extended-release version (Adderall XR), is only taken once daily. Since Adderall stays in your body longer, it controls symptoms with fewer doses.

How Much Ritalin Is Equal to Adderall?

If you're considering switching from Adderall to Ritalin, it's important to know that the efficacy of Adderall is about twice as strong as Ritalin. A 5 mg dose of Adderall is equivalent to 10 mg of Ritalin.

However, your exact dosage of Ritalin or Adderall depends on how fast your body metabolizes the medication and the type of formulation (short-acting vs. long-acting) you use. These drugs are not prescribed by height and weight, so finding the right dosage is often a matter of starting slow, then increasing the dosage in increments.

Cost Comparison

The prices of Ritalin and Adderall can vary widely by location, pharmacy, and insurance coverage. Most insurance plans—including Medicaid and Medicare—cover a percentage of the price of both drugs when prescribed for approved conditions.

Like other medications, the generic forms of these drugs usually cost less than the brand-name versions. According to the FDA, the cost of generic medications can average around 85% less than brand-name drugs when there are multiple generics for the same drug on the market.

The cost of Ritalin and Adderall are relatively close. Consider the following strategies to help lower costs:

• Ask your healthcare provider to prescribe a 90-day supply.
• Switch to an extended-release formulation.
• Apply for patient assistance programs if you qualify.
• Check the drug manufacturer's website and social media for coupons or rebates.
• Compare prices on a prescription comparison website like SingleCare.
• Use a pharmacy savings card, which may allow you to purchase medications at prices lower than insurance.

What About Vyvanse?

Vyvanse (lisdexamfetamine dimesylate) is a stimulant used to treat ADHD in children age 6 years and older. It is also prescribed to treat moderate to severe binge eating disorder (BED) in adults.

Vyvanse is an amphetamine drug like Adderall. It works by affecting the neurotransmitters dopamine and norepinephrine. It is a Schedule II drug, which can be addictive and lead to substance abuse disorder over time.

Vyvanse is administered as a once-daily, timed-release capsule or chewable tablet in an extended-release only. It lasts 10 to 14 hours. There is no generic drug for Vyvanse, which means it can be more expensive than other ADHD drugs.

Vyvanse is different from other ADHD medications because it is a prodrug. This means it is an inactive substance that must be metabolized in the body to become an active medication called dextroamphetamine. Because it requires an extra step to work, Vyvanse is considered less harsh, so its side effects are not as strong as other ADHD medications.

Summary

Ritalin and Adderall treat ADHD and narcolepsy by changing the balance of certain brain chemicals. The result can safely bring relief to people dealing with symptoms of these life-changing problems.

While these medications use different drugs, they both work as central nervous system stimulants They are also common in their risk for causing substance abuse. They may also pose problems for pregnant women.

When used the right way, these drugs can safely produce results. When choosing the right drug and dosage, a healthcare provider weighs issues like current health problems and your other prescribed drugs and other medications. While it may take some time for you to find what works, you should eventually find a drug that provides relief from symptoms.