Ritalin Vs. Adderall: An ADHD Medication Comparison

Ritalin vs. Adderall

Adderall and Ritalin are both stimulant medications approved for the treatment of attention deficit hyperactivity disorder (ADHD or ADD) symptoms. Though they achieve similar symptom control, these ADHD medications have different main ingredients. Adderall delivers amphetamine/dextroamphetamine and Ritalin delivers methylphenidate.

Adderall and Ritalin  have properties in common. They are both central nervous system stimulants approved for the treatment of ADHD and narcolepsy. When taken for ADHD, these stimulants help many people improve focus and attention, and they can also reduce hyperactivity and impulsivity. It is believed that they achieve symptom control by increasing the activity of norepinephrine and dopamine in the brain.

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Roughly 85% of patients will achieve symptom control using amphetamine or methylphenidate. Both medications work in similar ways in the brain and have similar side effects. The primary difference is that Ritalin works quickly and reaches peak performance earlier than does Adderall, which stays in the system longer.

“One molecule is not intrinsically better or to be preferred over the other,” says Dr. William Dodson, a specialist in adult ADHD. “In large groups, they have the same response rate, efficacy, side effects, and cost.”

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Ritalin Vs Adderall: ADHD Medication Summary

Ritalin’s main ingredient is methylphenidate hydrochloride (MPH), the same ingredient in Concerta, Contempla, Metadate, Methylin, and Quillivant. It was first approved by the FDA in 1955 for treating hyperactivity and, since the 1990s, it has become the most widely known drug for treating ADHD.

The response rate to MPH is identical to that of amphetamine — roughly 70%. That is, 70% of people will get a robust level of benefits from the first molecule they try and 30% will either get no benefits or the side effects will outweigh the benefits. For these people, the logical next step for them is to try the other class of stimulant ADHD medication: amphetamine.

Adderall is a combination of salts from levoamphetamine and dextroamphetamine, more commonly called amphetamine. It is generally well tolerated and effective in treating the symptoms of ADHD. Although the ingredients in Adderall can be misused and abused, it is not considered habit forming when taken at prescribed doses. It is available in immediate-release and extended-release formulations.

According to a 2017 survey of ADDitude readers, 37.54 % of children with ADHD have used Adderall, the second most common medication for children with ADHD, and 32.37% have used Ritalin at some point. Among adults with ADD, 53.67% have used Adderall, the most common medication among adults, and 33.27% have used Ritalin at some point.

[Download: The Ultimate Guide to ADHD Medication]

Those who have used Adderall and Ritalin rated the medications’ efficacy in the chart below, which also tracks the percentage of patients who experienced three common side effects.

Adult Patients: Adderall vs. Ritalin

ADHD Medication Comparison

ADHD Symptom Control

Ritalin is usually a shorter acting medication. Some people prefer this, as it allows them to better control side effects such as loss of appetite or trouble sleeping. They may be able to take the medication during school hours without any noticeable impact on appetite or drowsiness at night. Adderall usually lasts longer, which means it controls symptoms without the need for as many daytime doses.

There are many different medications available to treat ADHD, and the right choice for each patient is highly personal. Each individual responds differently to medications and there isn’t any way to predict how you or your child will react. As such, others’ reactions should not influence your treatment decisions. Some people try several different medications and dosages before finding the one that works best for them.

That said, people who found Adderall helpful told us:

• “I noticed a world of difference within a half hour of taking the first pill. I could focus on a task before jumping to something else.”
• “It helped control ADHD symptoms and allowed me to focus on learning and listening.”

Those who found Ritalin helpful told us:

• “Ritalin was very effective with focus and concentration at school.”
• “Ritalin was very effective. I’m still using it after 16 years.”

“These are some of the safest, most effective, best tolerated medications in medicine,” Dodson says. “The problem has always been the lack of clinicians who are adequately trained in how to use them. These medications should not be blamed for the failures of American medical education.”

That said, those who did not find Adderall helpful told us:

• “It seemed good at first, but then he started exhibiting a lot of anger and moodiness. He had no appetite during the day but would eat tons at night.”
• “It had the opposite effect; I was more hyperactive.”

Survey respondents who did not find Ritalin helpful told us:

• “Ritalin was in no way effective. It caused moodiness, aggression and agitation.”
• “Ritalin was not effective for me. There was a quick onset and sharp decline.”

Is Ritalin or Adderall Stronger? ADHD Medication Dosage Explained

Adderall is available in both immediate release and extended release formulations. The immediate release comes in 5, 7.5, 10, 20, and 30 mg doses. The extended release (XR) is available in 5, 10, 15, 20, 25, 30, and 36 mg doses. Both can be taken with or without food.

Doctors often start with a 5 mg dose and slowly increase it to find the lowest dosage that provides the best symptom relief. When using the immediate-release formulation, you may take a dose in the morning and then another four to six hours later. Many people choose not to take an additional dose so it doesn’t interfere with sleep. Adderall XR is FDA-approved for one dose per day, however some patients require more than 8 to 11 hours of symptom relief so their physicians may prescribe more coverage.

Ritalin is available in three formulations: immediate release (5, 10, 20 mg), sustained release (SR) (20 mg), and extended release (LA) (10, 20, 30, 40, 60 mg.) It is often started at the lowest dose and gradually increased as needed. Patients taking the immediate release formation often take one dose in the morning and another one at lunch. The extended release is expected to last six to eight hours and is often prescribed for once in the morning. The sustained release is in between and may be prescribed for once or twice a day, depending on individual needs.

Ritalin Vs Adderall: ADHD Medication Side Effects

Most people taking Adderall do not experience side effects. That said, the most common side effects when taking Adderall include:

• loss of appetite
• weight loss
• dry mouth
• stomach upset
• dizziness
• headache
• diarrhea
• nervousness
• trouble sleeping

It may also raise your blood pressure. Some parents who took the ADDitude treatment survey indicated that their child’s weight loss was a major concern:

“It controlled behavior, but with significant loss of appetite.”

“We stopped based on lack of appetite and weight loss.”

Ritalin has similar side effects. Some people prefer the immediate release because it allows them to better control loss of appetite and trouble sleeping, for example, because it remains effective for only a few hours. Some patients take one dose at breakfast and eat lunch before taking a second dose. The most common side effects for all three formulations of Ritalin include sleeplessness, nervousness, reduced appetite, headache, abdominal pain, rapid heart rate, and increased blood pressure.

“If stimulant medications are fine-tuned they shouldn’t disturb sleep,” Dodson says. “There is the paradoxical reaction in which people with an ADHD nervous system calm down and focus when taking medication. I ask my patients to try to take a nap on their optimal medication and dose. If they can nap in the afternoon, we know that they will be able to sleep normally at night.”

Ritalin Vs Adderall: ADHD Medication Warnings

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. If these medications are used, a patient must do so only under the close supervision of a doctor with consistent monitoring of the heart condition and blood pressure.

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