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Concerta Addiction, Withdrawal | Methylphenidate Side Effects, Alternatives, Tapering

This entry was posted in ADHD Medication on by .
Medically Reviewed

Last Updated on July 21, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Concerta (methylphenidate) is a stimulant used in treating ADHD for children age 6 and over and for adults to age 65. FDA warns sudden death and stroke have occurred in children and adults at usual doses. Safety has not been tested under age 6 or over age 65 or in pregnant or nursing mothers.

Before starting or stopping Concerta it is recommended to research the subject thoroughly to help understand more about how the drug works, as well as learning about possible side effects, withdrawal symptoms and management, and other important topics.

Concerta is licensed by the FDA and can be legally prescribed from the age of 6 through 65. FDA warnings are required to be listed on the label, and include interactions with other drugs, contraindications, cautions for use during pregnancy, and health risks such as sudden death, suicidality, age restrictions, and others.1

Of importance, a prescription for Concerta and others in its class is typically meant to continue over many years, often beginning in childhood and continuing even into adulthood. Currently, about 1 in 10 children have been diagnosed, in the US alone, as needing to take Concerta or other ADHD medications. Some countries around the world have experienced even higher percentages, initiating extremely high drugging of children, for example, in South Africa.8

Below is some additional information that is frequently searched for to help anyone considering stopping or starting a prescription of Concerta.

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What is Concerta used for?

Concerta contains methylphenidate, a drug with similar structure and stimulant properties to cocaine and methamphetamines. Methylphenidate is prescribed to treat ADHD in children and adults between the ages of 6 and 65. The term ADHD is an acronym for attention-deficit-hyperactivity-disorder.

Some believe that ADHD is a bonafide diagnosis that may even be related to autism, and that it should be treated as a psychiatric illness.

The DSM 5 edition revised the official diagnostic criteria for ADHD in 2013.2

Diagnostic Categories

Symptoms of ADHD have recently been separated into two kinds of ADHD. One is “inattentive ADHD” according to the most current psychiatric literature on diagnosis. This disorder is diagnosed against a set of 9 symptoms. A diagnosis for children under the age of 17 years must include evidence of at least 6 of these nine symptoms for at least 6 months; however, for age 17 and up, a patient only needs evidence of 5 of these 9 symptoms to completely satisfy the criteria for diagnosis:

  • Overlooks details in assigned tasks, makes mistakes, careless about details
  • Lack of sustained attention during lengthy activities, such as reading, listening to a lecture or playing
  • Distracted or non-attentive when being spoken to
  • Fails to finish assigned homework or chores, gets easily sidetracked
  • Lacks organization skills such as time management, possessions not organized, etc.
  • Reluctant to begin lengthy tasks such as preparing a long report that requires sustained focus and effort
  • Often loses possessions related to school or work, like pens and pencils, cell phones, etc.
  • Gets distracted by outside sounds or other environmental stimuli
  • Tends to be forgetful about chores, errands, keeping appointments, etc.

The second diagnostic category for this disorder is called “hyperactive-impulsive ADHD,” and the 9 symptoms to satisfy diagnostic criteria for this psychiatric disorder, (required minimum of 6 of the 9 symptoms under 17 years of age, and a minimum of 5 out of 9 for age 17 and older) are:

  • Frequently fidgets, taps with hands, squirms while seated
  • When expected to remain seated, often gets up or leaves the area
  • Runs about, climbs, restless
  • Inability to play quietly or participate in leisure activities quietly
  • Often active, as if driven by a motor, can’t sit still, is difficult to keep up with
  • Talks excessively
  • Blurts out answers before a question has been completed or speaks out of turn
  • Difficulty waiting in a line, waiting for his/her turn, tends to intrude without permission
  • Hyperfocused, becoming overly absorbed in tasks to the detriment of social responsibilities, agreements, appointments, etc.

However, ADHD is considered by some in the mental health field as a fictitious disease model and do not agree that placing a label on a child, or an adult for that matter, is sound medical practice, or that such labels and treatment models lead to any desirable outcome in helping those so labeled to do better in school, in their work or professional career, or to meet the challenges in general that life may bring.3

Some medical experts question the near tidal-wave rise in reliance on medication to relieve boredom, increase interest and attention span, or as a quick fix to calm down overly-boisterous children or adults.

Other questions have yet to be completely answered as to the wisdom of attempting to alter natural brain chemicals and neural pathways in young people and in adults, and why such practices should have become the most frequently chosen option when such significant questions as to potential long-term health and safety consequences still remain glaringly open.5

adhd young adultsGiving a child a stimulant such as Concerta during the time of transition from puberty into adulthood raises some important concerns. It is during this time that a child begins to sense the rewards of life. The dopamine areas of the brain, called the mesocorticolimbic region, are just getting wired up and interconnected with other parts of the brain at this time. It is likely that stimulants like Concerta could interfere with this very important age-related development. Additionally, it is very common for children and young adults to abuse Concerta, and then stay up one too many nights in a drug-induced mania. Concerned parties, including physicians, may mistake this drug-induced psychosis as an actual mental disorder and prescribe antipsychotic medications. Unfortunately, this is an all too common event and can result in long-term consequences.

Such questions deserve a serious assessment so that informed decisions can be made regarding the use of drug-based treatments, as well as considering other approaches to improving social skills, workplace management skills, improved strategies and skills for learning, and achieving bettered individual mental health without relying on drugs.

Alternative Names and Slang

Concerta has developed a host of slang terms such as:

  • Kibbles & bits
  • Kiddy cocaine
  • Pineapple
  • Kiddie coke
  • Smarties
  • Skittles

These terms would be used in a context of recreational use or diversion.

Side Effects

Concerta is a stimulant, but is probably better known for its paradoxical (non-stimulant) effects particularly in children and teenagers.

Some side effects point to health risks and these should be closely monitored, such as:

  • Serious cardiovascular events
  • Increase in blood pressure
  • Psychiatric-adverse events
  • Seizure
  • Priapism
  • Peripheral vasculopathy
  • Visual disturbance
  • Stunted growth (long-term suppression of growth)
  • Gastrointestinal blockage or narrowing
  • Platelet count changes requiring hematologic monitoring

The above points are from the warnings listed on the FDA label information for Concerta.1

The following is a list of other commonly reported side effects of drugs containing methylphenidate:

  • Nausea, vomiting, upset stomach
  • Loss of interest in eating, decreased appetite, weight loss
  • Headache
  • Dizziness
  • Mood swings, i.e., euphoria to irritability, sadness, anger, hostility, etc.
  • Insomnia, disturbed sleep, unusual dreams
  • Anxiety
  • Tachycardia, racing heart rate even at rest
  • Dry mouth

More serious side effects can include:

  • Suicidality (thoughts or attempts)
  • Increased violence
  • Violent thoughts
  • Thoughts of self-harm
  • Chest pain, difficulty breathing, shortness of breath
  • Poor circulation in fingers and toes causing them to turn blue or white, cold or numb.
  • Fainting
  • Hearing voices in the head, especially directing the person to do certain things, or other auditory hallucinations

Always talk with your prescribing physician if these or other symptoms appear while taking Concerta.

Withdrawal Symptoms

The FDA warns of the following possible withdrawal effects:1

  • Anxiety
  • Insomnia
  • Elevated blood pressure
  • Irritability

While some people report minimal withdrawal symptoms after stopping Concerta, others report a range of withdrawal effects that may include:

  • Psychotic behavior
  • Suicidality
  • Slowed heart rate
  • Headaches, can be severe
  • Anxiety
  • Tiredness, fatigue
  • Nausea, stomach ache, vomiting
  • Panic attacks
  • Depression
  • Increased appetite, ravenous hunger
  • Insomnia
  • Nightmares
  • Cognitive impairment, brain fog
  • Mood swings
  • Drug cravings

Discontinuing/Quitting Methylphenidate

Coming off any medication, especially one that has been taken for years or even decades, may require precise, careful monitoring to ensure the safety of the person during and after the tapering process.

Worldwide statistics collected over many years have shown that a person diagnosed with ADHD would be five times more likely to develop an addiction disorder.6

Tapering from Concerta in a nurturing, well-monitored and health-restorative setting is recommended to avoid the possibility of further health risks.

Concerta FAQs

Are Ritalin and Concerta the Same Thing?

Both Ritalin and Concerta have the same active ingredient, methylphenidate. Ritalin has a more immediate release and is prescribed to be taken 3 or 4 times per day. Concerta lasts about 10–12 hours for a single dose; hence, dosing is needed only once a day.1,4

ritalin concerta addictionBoth drugs have become popular diversion or street drugs, i.e., not prescribed, but used recreationally, usually crushed and snorted for immediate stimulating effects. These drugs cause an artificial surge of dopamine, which is a natural “reward” chemical.

Both drugs have seen a slight decline in numbers of prescriptions written yearly in the US, yet have seen a significant rise in numbers of prescriptions in other countries around the world.

It seems that this would be viewed as financially broadening the reach of pharmaceutical companies who vigorously market Concerta and similar stimulant drugs.

Given such global expansion in drug sales, coordinated with an ever-increasing prevalence of ADHD diagnoses, perhaps it is possible that ADHD could indeed soon become the leading childhood disorder treated with drugs, across the entire globe.7

Treatment for Concerta Abuse and Addiction?

Alternative to Meds Center provides careful tapering for adults who wish to discontinue Concerta or other drugs safely, in a relaxed and compassionate inpatient facility. Over forty highly trained staff members, including medical doctors, nurses, practitioners, and other caregivers are on hand for round-the-clock client care.

Prior to tapering, lab testing is employed to investigate neurotoxin accumulations. Poisonous toxins and heavy metals are often linked to unwanted symptoms such as anxiety, depressed mood, insomnia, and other ailments.

holistic treatments for concerta addictionWhen these neurotoxic accumulations are removed from the body, using deep cleansing techniques, infrared sauna, nebulized glutathione, and other natural neurotransmitter repair protocols, clients often report near immediate improvements such as more energy and focus, deeper and more restful sleep, better appetite, less cravings, lift in emotions, improved sense of calmness, and many other benefits.

These are improvements to mental health, acquired naturally, that may be available especially where no real investigation of symptoms ever occurred, and stimulants were simply used to achieve an effect that is generally not sustainable.

A person who has become dependent on ADHD or other medication may have made a decision to quit, but may have some reservations. One might be the desire to quit Concerta in a way that does not create further health risks. Another concern may be the desire to correct symptoms that existed prior to medication, and not suffer the return of “rebound” symptoms after quitting Concerta. With gradual and gentle cessation methods, and with exhaustive investigation and holistic corrective techniques, Alternative to Meds Center specializes in both areas.

Contact us at Alternative to Meds Center for more information on the programs we offer, or for other information that may be helpful to you or your loved one.

1. FDA drug label [accessed 2020 Nov 9]

2. Rabiner D PhD “Attention Research Update”, 2013 Jun [cited 2020 Nov 9]

3. Pagan CN “Is ADHD Real?” [cited 2020 Nov 9]

4. “Concerta vs. Ritalin: Dosage Differences & More” [cited 2020 Nov 9]

5. Sroufe LA “Ritalin Gone Wrong” NYTimes, 2012 Jan 28 [cited 2020 Nov 9]

6. Richie H, Roser M “Drug Use”, 2019 Dec [cited 2020 Nov 9]

7. Scheffler RM, Hinshaw SP, Modrek S, Levine P “The Global Market For ADHD Medications” HealthAffairs, 2007 Mar/Apr [cited 2020 Nov 9]

8. “SA has one of the highest prescription rates for ADHD medication” Health24, 2017 Jul 18 [cited 2020 Nov 9]

Originally Published Sep 13, 2018 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Concerta Addiction, Withdrawal | Methylphenidate Side Effects, Alternatives, Tapering
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