From the Guidelines
Dexedrine XR and Concerta are both effective medications for treating ADHD, but they have different active ingredients and release mechanisms, with Dexedrine XR being more potent and Concerta having a longer duration of action 1. The main difference between the two medications lies in their active ingredients, with Dexedrine XR containing dextroamphetamine and Concerta containing methylphenidate.
- Dexedrine XR is usually taken once daily in doses ranging from 5-40 mg, while Concerta is typically prescribed at 18-72 mg once daily.
- Dexedrine XR's effects last about 8-12 hours, whereas Concerta can provide symptom relief for up to 12-14 hours. The choice between these medications depends on individual patient response, side effect profile, and duration of action needed.
- Dexedrine XR may be preferred for patients who need stronger symptom control or have previously responded well to amphetamine-based medications.
- Concerta might be a better option for those who require longer-lasting effects or have experienced side effects with amphetamines. It's essential to consider the potential side effects of both medications, including decreased appetite, sleep disturbances, and increased heart rate, which should be discussed with a healthcare provider 1. Regular monitoring of pulse and blood pressure is also recommended when prescribing psychostimulant medication, especially for patients with preexisting cardiovascular diseases 1. Additionally, treatment with psychostimulants is associated with a statistically significant reduction in height and weight gain, which requires careful monitoring 1. Overall, the decision between Dexedrine XR and Concerta should be based on individual patient needs and response to treatment, with careful consideration of potential side effects and monitoring requirements 1.
From the Research
Overview of Methylphenidate and Dextroamphetamine
- Methylphenidate, commonly known by the brand name Concerta, is a central nervous system stimulant used to treat attention-deficit/hyperactivity disorder (ADHD) 2, 3, 4, 5, 6.
- Dextroamphetamine, known by the brand name Dexedrine, is also a central nervous system stimulant used for the treatment of ADHD and narcolepsy.
Pharmacokinetics and Duration of Action
- Methylphenidate has a rapid onset of action, with effects lasting about 4 hours for the immediate-release formulation 2.
- Extended-release formulations of methylphenidate, such as Concerta, can provide effects lasting 8-12 hours, with Concerta specifically utilizing an osmotic pump system to deliver the medication over a 12-hour period 2, 6.
- The duration of action for Dextroamphetamine (Dexedrine) Extended Release is not explicitly stated in the provided studies, but it is known to have a longer duration of action compared to its immediate-release counterpart.
Efficacy and Safety
- Methylphenidate has been shown to be effective in improving the core symptoms of ADHD, with a wide margin of safety and relatively mild adverse effects, most commonly appetite suppression and insomnia 2, 3.
- The efficacy and safety of Dextroamphetamine (Dexedrine) are not directly compared to Methylphenidate (Concerta) in the provided studies, but it is known that both medications are effective in treating ADHD symptoms.
Key Differences
- The primary difference between Methylphenidate (Concerta) and Dextroamphetamine (Dexedrine) Extended Release lies in their pharmacokinetics, duration of action, and specific formulations.
- Methylphenidate (Concerta) has a well-established extended-release formulation with a 12-hour duration of action, whereas the specifics of Dextroamphetamine (Dexedrine) Extended Release are not detailed in the provided studies.
- Both medications are central nervous system stimulants, but their exact mechanisms of action and side effect profiles may differ slightly.
Clinical Use and Recommendations
- The choice between Methylphenidate (Concerta) and Dextroamphetamine (Dexedrine) Extended Release should be based on individual patient needs, response to treatment, and tolerability of side effects.
- Clinicians should consider the duration of action, ease of administration, and potential for side effects when selecting a medication for the treatment of ADHD.