Attention deficit hyperactivity disorder (ADHD) affects approximately 5 percent of children and 2.5 percent of adults in the United States, according to the American Psychiatric Association. The Centers for Disease Control and Prevention (CDC) estimates that the numbers are higher. In a survey, they found that 11 percent of children have been diagnosed with ADHD as of 2011. The CDC has named ADHD as one of the most common neurodevelopmental disorders among children. ADHD often lasts into adulthood.
A combination of medication and behavioral therapy is often used to treat ADHD. Both stimulant and nonstimulant medications may be used to treat ADHD. While nonstimulants seem to have fewer side effects, stimulants are the most widely used medication.
Lisdexamfetamine dimesylate (brand name: Vyvanse) and methylphenidate (brand name: Ritalin) are two types of stimulant drugs used to treat ADHD symptoms like poor focus, impulse control, and hyperactivity. They help treat these symptoms by increasing levels of chemical messengers such as dopamine and norepinephrine in the brain. Each medication works in a slightly different way and remains in the body for different amounts of time. These two drugs can also have unique side effects.
Methylphenidate enters the body in its active form. Lisdexamfetamine dimesylate is known as a prodrug. A prodrug enters the body in an inactive form. The body then removes a substance called lysine to make lisdexamfetamine dimesylate active. Because of this extra step, the effects of lisdexamfetamine dimesylate can last up to 14 hours.
Lisdexamfetamine dimesylate (Vyvanse) should only be taken once a day because its effects are long lasting. It should be taken in the morning. You can take it with or without food. The typical dose is 30 mg. You can either swallow the capsule whole or open the capsule and mix the contents with food like yogurt, water, or orange juice.
Methylphenidate (Ritalin) is available in short-acting, intermediate-acting, and long-acting (extended-release) forms. Short-acting tablets are taken two or three times a day. Sustained-release (Ritalin SR) tablets and extended-release (Ritalin LA) capsules are taken once a day.
Short-acting methylphenidate (Ritalin) may only last in the body for four hours, while the longer-acting forms can last for up to eight hours. Some types of the medication need to be taken without food. Others can be taken with or without food. Doses range from 5 to 40 mg.
Both drugs are controlled substances. This means they have the potential to be abused or used improperly. Because of the way the body breaks down and uses lisdexamfetamine dimesylate (Vyvanse), it may be slightly less likely to be abused than methylphenidate (Ritalin). People who have a history of alcohol or drug dependence should talk to their doctor before taking either of these drugs.
The two drugs can have similar side effects. The common side effects for both drugs include:
- appetite loss
- digestive issues, including diarrhea, nausea, or stomachache
- dry mouth
- mood disorders, such as anxiety, irritability, or nervousness
- trouble sleeping
- weight loss
Methylphenidate (Ritalin) has also been known to cause headache and is more likely to cause increased heart rate and high blood pressure. The effects of lisdexamfetamine dimesylate (Vyvanse) last longer than immediate-release methylphenidate (Ritalin) and may be more stimulating.
Both drugs can also have more serious adverse effects, including:
- heart problems
- psychotic or manic symptoms
- reduced growth in children
These medications are not right for everyone. You may not be able to take either of these drugs if you have:
- recently taken or are taking a monoamine oxidase inhibitor antidepressant medicine
- heart or circulation problems
- an allergy to the drug, or you’ve had a reaction to it in the past
- a history of drug abuse
In addition, you should not take methylphenidate (Ritalin) if you have the following conditions:
- Tourette syndrome
Both drugs treat ADHD symptoms like inattention, hyperactivity, and impulsive behavior. Very little research has been done comparing the two drugs directly. Studies that have compared lisdexamfetamine dimesylate (Vyvanse) with other stimulant drugs have found that it is about equally effective.
One advantage of lisdexamfetamine dimesylate (Vyvanse) is that its effects last longer in the body than Ritalin. It may also be less likely to be abused.
Your doctor can help you decide which of these drugs is better for you. Once you do get a prescription, it’s important to take the medicine exactly as prescribed.