From the Research
When switching a patient from Concerta 54mg to Adderall, the recommended starting dose is typically 20mg of Adderall per day, divided into two doses (10mg twice daily). This conversion is based on the approximate stimulant equivalence between methylphenidate (Concerta) and mixed amphetamine salts (Adderall) 1. The transition should be done with a clean switch rather than cross-tapering, meaning the patient should stop Concerta completely before starting Adderall the next day. After initiating Adderall, dose adjustments may be necessary based on the patient's response and tolerability, with careful monitoring for side effects such as increased heart rate, blood pressure changes, appetite suppression, or sleep disturbances. Some key points to consider when making this switch include:
- Monitoring for cardiovascular effects, as amphetamines have been shown to increase blood pressure and heart rate 2
- Being aware of the potential for increased risk of adverse cardiovascular events, particularly in patients with pre-existing cardiovascular conditions 2
- Regular follow-up appointments should be scheduled every 2-4 weeks during the transition period to assess effectiveness and adjust dosing as needed. It's also important to note that individual responses to stimulants vary significantly, and some patients may require higher or lower doses than the conversion suggests 1. The maximum recommended daily dose of Adderall for adults is 40mg, though some patients may require higher doses under close medical supervision.