Taking Concerta And Vyvanse Together

In our latest question and answer, the pharmacist discusses combining use of Concerta and Vyvanse.

Jan 21, 2018

FishyOne asked

Can you think of any downsides to combining Vyvanse and Concerta if the person (diagnosed with ADHD and under a psychiatrist’s care) responds well to both stimulants independently? The issue is that the Vyvanse seems better at improving move and irritability but the Concerta seems better at so-called Executive Functions of the prefrontal cortex. Obviously, the doses would not be the same as if only one of the medications are taken. But overall, are there advantages and disadvantages to this for some people with ADHD? Thank you

Answer

There are currently no studies or guidelines that recommend the combined use of Vyvanse and Concerta together. However, in practice, there are some providers that do prescribe and dose two different stimulant medications to their patients for daily use based on response and efficacy. When this occurs, most commonly an extended release medication (like Concerta) is prescribed for daily coverage and an immediate release product (e.g. Adderall), is prescribed during the day to be used as needed (i.e. as a "booster").

Combining Vyvanse And Concerta

It would be relatively uncommon for two long acting ADHD stimulants, like Vyvanse and Concerta to be prescribed together but there certainly could be individual cases where the combination is safe end effective for use. It's highly individualized and you should speak to your doctor regarding your options. Most often though, a stimulant is combined with a non-stimulant medication to attain complete coverage of symptoms.

While not completely akin to using two long acting stimulants, current research shows that the combination of two ADHD medications (in different medication classes) can be far more effective than a single agent. For example, guanfacine combined with Focalin (dexmethylphenidate) showed more consistent benefit for ADHD symptoms than either agent alone. Another study showed that the combination of Strattera (Atomoxetine) and different amphetamine stimulants were more effective that a single agent for certain individuals.

Summary

Choice of medication(s) for the treatment of ADHD and other co-morbid conditions (i.e. the presence of other diseases such as ADHD with anxiety) is highly individualized. While the use of two stimulant medications isn't unheard of, it is not common. Generally, the combination of a stimulant and non-stimulant medication is more often used to appropriately treat all symptoms and conditions.

Ready for a more personal experience with your meds?