Everything you need to know about Concerta
Many other versions of methylphenidate work faster than Concerta but do not work as long, so a person may need to take several pills per day.
In this article, learn more about how Concerta works, possible side effects, and dosages.
What is Concerta?
A doctor may prescribe Concerta to help a person manage the symptoms of ADHD.
Concerta is one brand of a drug called methylphenidate. Other brands of the drug include Ritalin, Equasym, and Daytrana.
Although all versions of methylphenidate are central nervous system stimulants, each brand is available in slightly different dosages and formulations.
Concerta is an extended-release formula, which means that a person typically takes fewer doses than would be necessary with an immediate-release formula.
Concerta works by increasing dopamine and norepinephrine levels in the brain. Dopamine plays a vital role in producing feelings of motivation and reward, while norepinephrine affects the brain's ability to pay attention. Concerta helps boost the activity of these chemicals in the brain.
What does extended-release mean?
Methylphenidate has a short half-life, which means that the body metabolizes it quickly. When using a medication with a short half-life, people may need to take several daily doses to get consistent results.
People with ADHD — children in particular — may have trouble remembering to take several pills throughout the day, and inconsistency can limit the effectiveness of the treatment.
Extended-release formulations, such as Concerta, offer a solution. Immediately after a person swallows this type of pill, the outer shell dissolves, allowing for rapid delivery of the medication.
Throughout the day, the inner shell of the drug dissolves gradually, delivering more of the drug at a slow, consistent rate.
The Food and Drug Administration (FDA) approved Concerta for the treatment of ADHD in 2000.
Doctors sometimes prescribe stimulants such as Concerta on an off-label basis to treat other conditions. People with certain sleep disorders, such as narcolepsy, may use Concerta when other drugs fail.
Common side effects of Concerta include headaches, trouble sleeping, and decreased appetite.
Possible side effects of Concerta include:
- trouble sleeping
- decreased appetite
- congestion and throat pain
- anxiety or nervousness
- stomachaches or diarrhea
- twitching and tics, especially with long-term use
Concerta can also change a person's judgment or behavior, causing other side effects. In a 2-week placebo-controlled trial involving adolescents who took Concerta, 6% of the participants reported accidental injuries, compared with 3% of the placebo group.
Concerta tends to increase blood pressure and pulse modestly. In some people, however, it can cause dangerous hypertension or an uncomfortably rapid heart rate. A doctor will regularly monitor the heart rate and blood pressure of a person taking Concerta.
Rarely, people report severe side effects of Concerta. These include:
- blurred vision and other eyesight changes
- aggression or hostility
- slow growth in children
- blockages of the intestines or esophagus
People with structural or other abnormalities of the heart and people with a history of heart disease are more vulnerable to these complications.
The right dose of Concerta depends on a person's age, as well as their symptoms, existing conditions, and other medications.
Some people take Concerta along with other forms of methylphenidate.
For adults and children under 65 years old who are not taking methylphenidate, the guidelines are as follows:
- Adults begin with a morning dosage of 18–36 milligrams (mg). A doctor may raise this in 18-mg increments every week, but the total dosage should be less than 72 mg per day.
- Children ages 6 and older and adolescents should begin with a morning dosage of 18 mg. A doctor may raise this by 18 mg each week, to a maximum daily dosage of 54 mg for children and 72 mg for adolescents.
People should take the drug in the morning with water. Do not crush or chew Concerta tablets.
It is not necessary to take Concerta with a meal, but a person who experiences decreased appetite may want to eat breakfast before taking it.
To ensure that a person experiences the most benefits, a doctor may recommend taking Concerta 30–45 minutes before work, school, or other daily activities that require concentration.
It is crucial to avoid taking Concerta alongside monoamine oxidase inhibitors (MAOIs) or within 2 weeks of taking an MAOI.
Since Concerta can raise blood pressure, it is best to talk to a doctor before taking it with any other stimulant or drug that can raise blood pressure.
Clonidine, a high blood pressure medication, and other alpha-2 agonists may cause serious side effects when a person takes them with Concerta.
Concerta may change or decrease the effectiveness of:
- anticonvulsant drugs
- blood thinners
- tricyclic antidepressants
Is it safe during pregnancy or for children?
The FDA classify Concerta and other forms of methylphenidate as pregnancy class C drugs. This means that some animal studies have shown that they present a danger to the fetus, but that there are not enough studies in humans to determine the effect.
In studies of rats, high doses of methylphenidate have caused birth defects and other negative outcomes.
In some cases, the benefits of methylphenidate may outweigh the risks, but a person must consult with their doctor before determining the best course of action.
Researchers do not know whether infants can come into contact with Concerta through breast milk.
The FDA have approved Concerta for use in children ages 6 and older, but not in younger children.
One alternative to medication is trying behavioral therapy.
Concerta is not the only option for treating ADHD. People who do not have good results from Concerta may see improvements after taking a different stimulant or a different combination of medications.
Some people with ADHD choose nonstimulant drugs, such as atomoxetine (Strattera), guanfacine (Intuniv), or clonidine (Kapvay). Other drugs, such as antidepressants, may also help.
Beyond medication, people with ADHD may benefit from treatments such as family and behavioral therapy, as well as accommodations at work or school and lifestyle changes, such as sticking to a regular routine.
The American Academy of Pediatrics recommend that parents and caregivers of children with ADHD pursue a treatment that involves both therapy and stimulants, rather than medication alone.
Because Concerta is an extended-release medication, it does not require a person to take multiple pills throughout the day. This may make it a better option for people — including children — who find it easier to take a single pill per day.
Treatment for ADHD begins with an accurate diagnosis from a doctor. Anyone who suspects that they or a child in their care has ADHD should ask for a referral to a pediatrician or physician who specializes in the condition.