This is the question that is most frequently asked by anybody who is faced with these names as treatment options for their children.
Stimulants are mediacations that stimulate the central nervous system. As you are reading this you are already confused…… isn’t it? A kid who is all “hyper” and “wired” is supposed to be treated with a stimulant, as if….This certainly seems counter-intuitive but does have scientific reasons for the same (if you are interested in knowing more about his mechanism of action please feel free to email me.)Stimulants are often used as a first line of treatment for Attention Deficit Hyperactivity Disorder. The above two medications are the different names for the same chemical compound that is most commonly used for the treatment of ADHD. Methylphenidate is available in multiple forms. Ritalin is the methylphenidate and is available as a generic. It is usually given 2 or 3 times a day the starting dose could be 5 mg /day, with a target dose of 1-2 mg/kg/day.
Coming to Concerta. This is the plain old Ritalin in a new packaging J. This medication is the same as Ritalin. This is available as 18 27 36 and 54mg strengths. Only difference is that this is just a different drug delivery mechanism. It was just devised to make it easy for the children who do not have to take 2-3 pills, and in the form of Concerta one pill does the same job as 2-3 pills of ritalin.
So is Concerta one of the long acting forms of medications? In simple terms YES. But it does have a more complicated mechanism. We don’t need to know the detailed mechanism of this OROS (Osmotic-controlled Release Oral delivery System). In simple language the pill is a pill that releases the chemical in a very controlled manner. The outer layer has a coat of medication, which we can say is the 8AM morning dose, thereafter concerta has a water-permeable covering with a laser drilled small hole. As the concerta passes through the gut, the water entering the tablet by virtue of it’s osmotic pressure pushes the active drug through the opening in the tablet thereby mimicking the 2-3 pills your child takes, one in the morning and the second one at noon given at school and the third in the afternoon to control that afternoon hyperactivity. I have attached a diagram from the orange journal (JAACAP) as a reference.
Another question asked frequently by parents is how much concerta is equal to XX mg of ritalin? I would say there are various factors involved in deciding about his conversion, so it is best to leave this decision in hands of your psychiatrist or pediatrician.
