While Adderall is considered more addictive, Ritalin has more adverse side effects, particularly during long-term use. This comparison examines the applications, efficacy, dosage, side effects, withdrawal and abuse potential for Adderall and Ritalin, psychostimulant drugs prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.
|About||Adderall is a brand name of amphetamine salts-based medication used for attention deficit hyperactivity disorder and narcolepsy, legal only in the United States and Canada.||Ritalin is the trade name for Methylphenidate which is a psychostimulant drug approved for treatment of ADHD or attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy.|
|Type of drug||Psychostimulant||Psychostimulant|
|Active Ingredient||mixed amphetamine salts - Dextroamphetamine and Levoamphetamine. 25% is the inactive L-enantiomer.||Methylphenidate|
|Used to treat||ADHD, narcolepsy||ADHD, postural orthostatic tachycardia syndrome and narcolepsy.|
|Forms Available||Tablet (5, 7.5, 10, 12.5, 20, 30 mg) or extended-release capsule (5, 10, 15, 20, 25, 30, 36 mg)||Short-acting, immediate-release tablet available in 5, 10, 20mg. Sustained-release (SR) in 20 mg. Long-acting extended-release capsules in 10, 20, 30, 40mg.|
|Dosage||Tablet taken 2-3 times daily, 4-6 hours apart - dosages vary. Extended release ("XR") capsules taken once daily - XR capsules available in 10 mg, 20 mg and 30 mg.||Tablets taken 2-3 times a day before meals. Extended-release tablets taken once or twice a day. The capsules should be taken once a day in the morning|
|Window of effectiveness||Immediate-release: 4-6 hours. Extended-release: 8-11 hours.||Immediate-release: 2-3 hours. Sustained-release: 4-6 hours. Extended-release: 10-12 hours.|
|Legal status||℞ Prescription only; Schedule II (US) and Schedule I (CA)||℞ Prescription only; Controlled (S8) (AU) Schedule III (CA) POM (UK) Schedule II (US)|
|Routes||Oral, Insufflated, Intravenous||Oral and Transdermal|
|Off-label use||Depression, obesity, sleep cycle disorders||Lethargy, depression, obesity|
|Pregnancy cat.||C (US)||C (US)|
|Number of Prescriptions for Ages 10-19 (2011, US)||1.6 million||263,000|
|Addictive?||Yes||Yes – dosage should be slowly reduced before stopping|
|Dependence liability||High||Lower as compared to Adderall|
|Restrictions||Should not be taken during pregnancy or alongside MAOIs||Should not be taken during pregnancy or alongside tricyclic antidepressants or MAOIs. Should not be taken by people who suffer from arrhythmia, hypertension or liver damage.|
|Effect||Increases amount of dopamine and norepinephrine between synapses in the brain.||Increases amount of dopamine and norepinephrine between synapses in the brain|
|Side effects||Weight loss, insomnia, headaches, irritability, increased muscle tension, anxiety, increased heart rate, increased blood pressure, dry mouth, reduced efficacy over time. Slows physical growth in childhood.||Nervousness, drowsiness, insomnia. Can cause psychosis with long-term use. Slows physical growth in childhood.|
|Withdrawal symptoms||Extreme fatigue, insomnia, irritability and mental depression||Psychosis, depression, irritability, temporary worsening of ADHD symptoms|
|Trade names||Adderall, Adderall XR||Concerta, Methylin, Ritalin|
Ritalin and Adderall have broadly similar applications. Both drugs are used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Some doctors also prescribe them for depression and obesity. They have similar mechanisms of action — the drugs increase the amount of dopamine and norepinephrine between synapses in the brain.
Adderall is sometimes prescribed to treat sleep cycle disorders. Ritalin can be used to treat postural orthostatic tachycardia syndrome and treatment-resistant cases of lethargy. Ritalin can also be used to help individuals who are dependent on methamphetamine.
In the following video psychiatrist Dr. Edward Fruitman, M.D. and Medical Director of Trifecta Health Medical Center explains how he decides whether to prescribe Ritalin or Adderall to adults who have ADHD:
A study published in the Official Journal of the American Academy of Pediatrics in 1999 compared the efficacy and time-course of Ritalin and Adderall. Researchers found that Adderall was generally more effective than Ritalin after a few hours, especially for low doses. Generally, lower doses of Adderall produced effects comparable to higher doses of Ritalin, and clinical recommendations favored Adderall for long term treatment.
Another study, also published in 1999 in the Journal of the American Academy of Child & Adolescent Psychiatry found that while both Adderall and Ritalin improved behavior as rated by parents and teachers,
Single-dose treatments of Adderall appear to be as effective as 2 daily doses of MPH and therefore increase the possibility of managing treatment without involving the school in medication administration. In addition, youths who have previously been unsuccessfully treated with MPH because of adverse side effects or poor response may be successfully treated with Adderall.
Yet another study published in the same journal less than a year later, titled A Double-Blind, Placebo-Controlled Study of Adderall and Methylphenidate in the Treatment of Attention-Deficit/Hyperactivity Disorder, concluded that the behavioral effects of Adderall appear to persist longer than those of methylphenidate [Ritalin] after individual doses.
Adderall is available in either tablet or extended-release capsule form. The tablets are usually meant to be taken 2-3 times every day at 4-6 hour intervals. For individuals aged 6 or over, dosage begins with 5mg once or twice daily and can be increased by increments of 5 mg every week. The dose rarely exceeds 30 mg. The capsule is taken once a day in the morning and should be swallowed whole, or opened and the contents sprinkled on apple sauce. Adults taking the capsule usually receive a dosage of 20 mg a day, while children and adolescents usually start with 10 mg a day before the dosage is increased.
Ritalin is available in immediate-release tablets, intermediate-acting extended release tablets, or long-acting extended release capsules. The regular tablets are taken two to three times a day, preferably 35 to 40 minutes before meals. All should be taken before 6pm. The intermediate-acting release tablet should be taken once or twice a day, in the morning and early afternoon, 30 to 45 minutes before food. The long-acting extended release capsule is taken once a day in the morning. All must be swallowed whole or split open and sprinkled onto apple sauce. The average dosage is 20 to 30 mg per day, but some people may receive up to 60 mg.
Adderall may cause a temporary decrease in growth rate but does not affect eventual adult height. It may decrease appetite, leading to weight loss. It can cause insomnia, headaches, increased muscle tension, irritability, and anxiety, as well as an increased risk of cardiac problems.
The most common side effects of Ritalin are nervousness, drowsiness and insomnia. Less common side effects include abdominal pain, loss of hair, chest pain, appetite loss, blood pressure change, dizziness, euphoria, headache, hypersensitivity, nausea, and somnolence. It can slow growth rate in adolescents. Studies suggest that 6% of children who use Ritalin become psychotic after months or years of use; these symptoms fade after they stop taking the drug. Individuals diagnosed with schizophrenia or bipolar disorder typically have earlier onset of the disorder if they took Ritalin in childhood.
Ritalin should also not be taken during pregnancy or within two weeks of taking any MAOI medications. It should also not be combined with tricyclic antidepressants or be taken by patients with severe arrhythmia, hypertension, liver damage, drug-seeking behavior, or pronounced nervousness. Special care should be taken in patients with epilepsy, as it can lower the seizure threshold. When combined with adrenergic drugs, it increases the risk of liver toxicity, and when combined with SSRIs like Zoloft or Lexapro, it can cause hypertension, hypothermia and convulsions.
Adderall is a habit-forming drug. When an individual stops taking Adderall, they may experience extreme fatigue, insomnia, irritability and mental depression.
Ritalin withdrawal can occur if an individual stops taking the drug suddenly. The symptoms include psychosis, depression, irritability and a temporary worsening of the original ADHD symptoms.
Adderall and Ritalin are both often used by college students to increase concentration. Adderall is the more popular of the two.
According to a report by Express Scripts, the largest pharmacy benefits management company in the U.S., the market share of various types of ADHD drugs is as follows:
|Top ADHD Drugs by Market Share|
|Methylphenidate (Ritalin, Concerta, Daytrana, Methylin)||23.4%|
|Dexmethylphenidate (Focalin XR)||4.4%|
- A Comparison of Ritalin and Adderall: Efficacy and Time-course in Children With Attention-deficit/Hyperactivity Disorder - Pediatrics journal
- Dextroamphetamine and Amphetamine - NIH.gov
- Methylphenidate - NIH.gov
- ‘Study Drugs’ Popular Among High School Students - New York Times
- Thousands of Toddlers Are Medicated for A.D.H.D., Report Finds, Raising Worries - New York Times
- How Many Adults Take ADHD Drugs? - Five Thirty Eight