Adhd meds: difference between Methylphenidate & Amphatam

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The two most common stimulants used to treat ADHD are methylphenidate (eg ritalin, equasym, concerta) and amphetamine (eg adderall, vyvanse). I am on the former and it does work for me. However, I'd like to know what are the main differences between the two in terms of effects, side effects? Under what circumstances will someone be prescribed with amphetamine rather than methylphenidate (here in the UK, ritalin/concerta seems to be much more widely used than adderall)? For people with Asperger's as well as ADHD, which drug is more commonly used or preferable?

I think it's all about what works for you.

My eldest had severe side effects with several meds but did well on Focalin. My middle son was put on Adderal first and it was like magic. He had no side effects and his symptoms were controlled from the first day he took it. Often there is an adjustment period, but for him it was instant. He once destroyed some pills and had to switch to Vyanase for a little bit and it helped but not half as well as the Adderal. My youngest and I do very well on Concerta. I've been trying the little guy without meds and he is doing pretty well without them. He's a very unusual child and may be outgrowing his need for ADHD meds, but he's a very unusual person neurologically and I don't think children his age very often do outgrow the need for meds.

Amphetamine and methylphenidate both work primarily on neurons that communicate with dopamine and norepinephrine, but they do it in different ways. Amphetamine is a releasing agent, meaning that it causes transport vesicles to dump their stored up neurotransmitters into the synapse. Methylphenidate works on the same chemicals, but it does not cause them to be released. Instead, it blocks their reuptake into transport vesicles.

Keep in mind that ADD and ADHD are not the same thing. ADD is much more similar to depression, with a lack of attention spam stemming from a general lack of motivation and energy. Amphetamine is used in these cases, and occasionally in depression itself, because it provides a huge boost in a person's desire to get things done. ADHD does not involve a lack of energy, obviously. It involves an inability either to switch or maintain focus, or both, often due to heightened senses leading to distractibility. Methylphenidate and similar drugs (including caffeine and nicotine, which elevate neurotransmitter levels indirectly, though they are not reuptake inhibitors) help these people integrate their senses and control their attention. Giving amphetamine to someone with ADHD could be a terrible idea, as it might make them manic as all hell.

I only recently learned about the differences between ADD and ADHD, and it rings true. I am self-diagnosed AS, and also have all the symptoms of ADHD (overfocussing subtype). I have had some hypomanic and manic periods, and when I tried taking Adderall, it made me feel exactly the same way. Ritalin was great though. I actually went to a job interview on the stuff and got the job, which is rare for me. I often submit a good resume and then totally fail to conduct a decent interview, due to my AS symptoms.

There are some other things to consider when choosing psychostimulants, and I may have time to post about them later.

Thanks for your detailed and helful posts Kiley and cthulukitty. On a busy day, methylphenidate (I've taken both Ritalin and Equasym) does help with my concentration/attention span and I can always get things done. However, on a less busy day like the weekend where I do not have any planned activities, my normal dose actually makes me really sleepy. Is this normal? I thought any stimulant would be more likely to affect my getting to sleep at night and not the other way round?! I have never been on amphetamines. Maybe I should talk to my psychiartrist next time I see him and see if I should switch.

People with ADHD often report that stimulants make them tired. You may also just be strung out and need the sleep. You could try skipping your stimulants on days that you don't need to work or focus. This will help your body maintain itself a little better, conserving energy and neurotransmitters for when they're needed. From what I'm hearing I'd say that you absolutely should not be on Amphetamine. For me, even a tiny dose of the stuff (as in 1/8 of a 20 mg pill) causes me to start talking quickly without stopping, exaggerates my stimming, and makes me feel absolutely compelled to do something without helping me switch my attention to things that are important.

If you feel that you need to switch meds, and I'm not sure why you do, then you should look into the differences between racemic methylphenidate (Ritalin, etc.) and pure dextro-methylphenidate (Focalin, etc.). The dextrorotary isomer penetrates the blood brain barrier and contributes to central nervous system effects, while the levorotary isomer has powerful effects on the autonomic nervous system (these are what you'd call the side effects) and does a poor job of crossing the blood brain barrier. If you are experiencing side effects, switching to the pure dextro isomer might reduce them, while keeping the same level of central activity.

I've been on both types

methylphenidate seems to work better than Amphetamine for me

I used concerta for years

Adderal made me pyschotic so I went back to concerta

I recently out grew concerta and wsa put on vyvanse

It gave me horrid insomnia and halluciations

So I'm back on another methylphenidate called Byphantin(or something)

seems to be better,it just makes me drowsy

i did try not taking any at all on a weekend but then i am back to my very impulsive self - doing things before thinking them through eg buying lots of little things that i don't need from ebay or ordering enough takeaway food for 20 people etc. i've just been reading the guidelines on ADHD medications here in the UK and methyphenidate is the first line treatment and only if it doesn't work or produces severe side effects that dexoamphetamine or stratera will be prescribed. I'l have to maybe try a smaller dose at weekends.

What if the person is combined ADHD, like I think I am? I'm not terribly impulsive, but hyperactive and inattentive, and I'm going to go on Methylphenidate soon.

Oh and I must nitpick. ADD is the old term. ADHD-PI is the correct term. I'm sure you knew that, but err...I'm annoying like that.