Concerta for ADHD: Everything You Need To Know

Concerta is one of the most popular Attention Deficit Hyperactivity Disorder (ADHD) medications for kids. It works the same way as other stimulant medications (like Ritalin or Adderall), but it’s popular because it stays in the system for a long time and kids usually only need to take it once daily.

It can be confusing as a parent to decide among the seemingly endless options for ADHD treatment. Here’s everything you need to know about Concerta, including its uses and benefits, common side effects, and associated risks.

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What is Concerta?

Concerta is a stimulant medication that contains methylphenidate. It is used to treat symptoms of ADHD, including:

• Inattention 
• Hyperactivity
• Impulsivity

Concerta is approved to treat ADHD for kids over the age of 6, teens, and adults up to the age of 65. It’s one of the most popular most popular ADHD medications for kids.

Concerta was the first approved extended-release form of methylphenidate. The effects of one Concerta dose last for around 12 hours. Ritalin (another brand name for methylphenidate) was approved first but didn’t provide relief for as long.

Concerta is also sometimes used to treat narcolepsy.

Side effects 

Concerta, along with other stimulant medications for ADHD, has been found to be safe and well-tolerated for most kids over 6 years old. Most people taking Concerta don’t experience adverse effects. But all medications, including stimulants, come with a chance of some side effects. 

Some common and mild side effects of Concerta (and other stimulants) include:

• Decreased appetite
• Weight loss
• Trouble sleeping
• Stomachache
• Dry mouth
• Anxiety
• Fatigue after Concerta
• Irritability
• Nausea and vomiting
• Dizziness
• Increased blood pressure
• Increased heart rate

In clinical trials, less than 1% of kids found that the side effects of Concerta were so intense that they had to stop taking the medication.

If your child is having very uncomfortable side effects on Concerta, or if you notice them getting more anxious or irritable than usual, then it could be possible that their dose is too high. Side effects are often resolved simply by lowering or adjusting the dosage of Concerta. Talk to your child’s prescribing doctor to figure out a plan for how to move forward.

How does Concerta work for ADHD?

Concerta is a type of stimulant medication and contains methylphenidate, one of two compounds that have been approved to treat ADHD (the other is amphetamine). 

Stimulants like methylphenidate are the most effective type of ADHD medication treatment.

Stimulant medications work by increasing the levels of certain brain chemicals, like dopamine and norepinephrine. ADHD affects levels of dopamine, which causes core symptoms like inattention and impulsivity. Stimulants make more dopamine available to use, which makes it easier for different parts and pathways in your brain to communicate with each other.

Stimulants don’t “cure” ADHD; they only work to decrease symptoms while they’re in your system. But that can be a very powerful effect; without the symptoms of ADHD getting in their way, your child may be more likely to be able to succeed at school and in relationships.

Concerta is unique in that it’s only available in an extended-release capsule. This means that a little bit of the medication is released throughout the span of 10 hours or so. The amount that gets released steadily increases the medication dosage in the blood each time, which is called a “backloaded” delivery system. 

Concerta was the first ADHD medication that uses this type of “backloaded” system. Other extended-release stimulants maintain a steady level of medication in the blood throughout the day. One delivery system isn’t necessarily better than the other.

Dosage

The right dosage of Concerta will depend on your child and their unique needs.

For kids and teens who are new to Concerta, the FDA recommends that the starting dose be 18mg once a day. The maximum recommended dose for kids and teens is 54mg a day.

Because of Concerta’s extended-release, backloading delivery system, these capsules should never be crushed or chewed. Breaking the capsule into pieces will cause the entire dose to be released all at once, instead of slowly throughout the day.

This could make it difficult for young kids to take Concerta if they aren’t used to swallowing whole capsules.

Concerta is typically taken once a day in the morning, with or without food. Always follow your prescribing doctor’s exact instructions on how, and when, to take any medication.

Risks

In general, Concerta is safe for kids over the age of 6. 

The FDA says that people should not take Concerta if they:

• Have severe anxiety or agitation
• Have glaucoma
• Are diagnosed with or have a family history of tics or Tourette's syndrome
• Have recently (in the past 2 weeks) taken a type of antidepressant called monoamine oxidase inhibitors (MAOIs)
• Have a known allergy or bad reaction to stimulant medications or methylphenidate

On top of these, there are some considerations and risks that apply to all stimulant ADHD medications, not just Concerta.

First, all stimulants can increase blood pressure. Tell your doctor if your child has a history of high blood pressure, heart disease, or any other heart problems like an irregular heartbeat. This doesn’t mean that your child can’t take Concerta, but their doctor may want to monitor them.

Stimulants can also cause manic or psychotic episodes, especially in children who are already vulnerable to these types of symptoms. If your family has a history of bipolar disorder, psychosis, or other psychiatric disorders, your child may need to go through an evaluation.

Parents often worry about whether stimulant medications like Concerta are addictive. Stimulants are a classified substance under the Drug Enforcement Administration (DEA). All stimulants, including ADHD medication, have the potential for abuse.

But most experts say that parents of kids with ADHD have nothing to worry about. There is no evidence that kids who take stimulant medication are more likely to develop substance use disorder (SUD, or the official diagnosis for drug and alcohol addiction) as adults. Kids with untreated ADHD, on the other hand, may be at higher risk for SUD. 

It may be something to keep in mind if you know that your child or teen already misuses stimulant drugs like cocaine or meth.

Lastly, some reports state that stimulants like Concerta can delay children’s growth. This is understandably a worry for parents. However, newer research has found that although there might be a slight delay in growth when kids take stimulants, this effect is temporary. There is no long-term effect on growth or height from taking stimulants, so there’s no need to worry.

In general, if you notice any new ADHD symptoms in your child, especially heart or mental health symptoms after they start to take Concerta, tell their doctor immediately. 

Drug interactions

This isn’t an exhaustive list of all of the medications that could have a negative interaction with Concerta. Always be completely honest with your child’s doctor about any medications they’re taking, including natural supplements.

Some medications that could have a dangerous interaction with Concerta include:

• Monoamine oxidase inhibitors (MAOIs); potentially fatal interaction
• Blood pressure medication (vasopressors)
• Anticoagulants
• Anticonvulsives
• Tricyclic antidepressants
• Selective serotonin reuptake inhibitors

Other considerations

Concerta is available in generic form, which is good news for parents as generics have a lower cost. Read more about the cost of Concerta.

But be careful, because the generic name of Concerta -- methylphenidate HCl ER -- is currently used to describe many different kinds of ADHD medication. Only one of them is an exact generic replica of Concerta, and this one is higher in quality than the others.

Ask your pharmacist to tell you exactly what version of methylphenidate HCI ER they’re giving you. 

Takeaway

Concerta is a safe and effective medication for kids with ADHD. There are so many different types of ADHD meds, and what works for other children might not work for yours. In general, all stimulant medications (including Concerta) are about equally effective. Deciding on what treatment method is best for your child and their ADHD symptoms is a personal choice that is between your family and your child’s doctor. 

Be honest with your child’s doctor about the symptoms you’re seeing and any other concerns you might have. And make sure your child also understands how important it is to be transparent about how they’re feeling after starting any new medication.

ADHD is treatable. No matter if your child takes Concerta or manages their ADHD another way, they can live a long, happy, and successful life.

This article is for informational purposes and is not a substitute for individual medical or mental health advice. Please consult with your or your child's prescribing doctor before changing, starting, or stopping a medication routine.