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Ritalin vs. Focalin

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If you are searching for an ADHD medication that helps you better manage your ADHD symptoms, chances are you’ve come across two common stimulants—Ritalin and Focalin. These medications are prescribed to treat ADHD symptoms in both adults and children.

Though they are both stimulants, they are not quite the same kind of drug and have different side effects. Because of these differences, one might work better for you than the other. 

It takes time, research, and conversation with an ADHD-experienced medical provider to determine which ADHD medication is best for you. In this article, Klarity provides a detailed breakdown of Ritalin and Focalin to help you fill in the blanks and better understand each medication’s effect on your body and mind.

Klarity has helped 30,000+ people receive high-quality ADHD, depression, anxiety, and insomnia treatment online from the convenience of their own homes. 

Take our brief, 2-minute online mental health assessment to talk to an ADHD-trained medical provider about Ritalin or Focalin.

Are Ritalin and Focalin the Same Thing?

Ritalin (methylphenidate hydrochloride) and Focalin (dexmethylphenidate) are similar medications that stimulate the central nervous system. They treat attention deficit hyperactivity disorder (ADHD) in children and adults. 

These medications work by increasing natural substances (neurotransmitters) in the brain. These chemicals—dopamine and norepinephrine—help improve mental focus, organization, and attention and also help control impulsive behaviors. 

Since these two medications come from the same class of drugs, they have a similar mechanism of action on the brain and tend to share many side effects. However, the chemical differences between the two lead to certain differences you’ll want to be aware of.

The main difference between Ritalin and Focalin is that Focalin has fewer negative side effects than Ritalin. However, Focalin is more expensive than Ritalin. As a result, Ritalin is more commonly prescribed. Medical providers often suggest Focalin when Ritalin’s side effects are too invasive. 

What is Ritalin?

Ritalin is a central nervous system (CNS) stimulant that blocks the reuptake of two neurotransmitters—dopamine and norepinephrine—back into the brain’s neurons (a type of brain cell). 

For brain cells to communicate effectively, these neurotransmitters need to be readily available in the spaces between the neurons, called synapses. CNS stimulants like Ritalin prevent neurons from reabsorbing dopamine and norepinephrine. 

This process leaves an abundance of dopamine and norepinephrine in the synaptic gap, allowing the brain to function normally. 

Forms and Doses

Ritalin (methylphenidate) is used to treat both ADHD and narcolepsy. It is available in two different forms, short-acting and long-acting that vary in the onset and duration of action of the medication. 

Short-acting Ritalin is available as a tablet, chewable tablet, or liquid. Effects can be seen within 30 minutes and last roughly 3-5 hours. Depending on the prescription and the medical provider’s instructions, short-acting Ritalin can be taken as needed throughout the day, 30 to 45 minutes before meals. 

  • Pediatric dosing: the initial dosing starts at 5 mg twice daily and can be increased up to 60 mg per day. The medication should be slowly titrated, increasing 5-10 mg/day at weekly intervals. Some patients require three doses per day. 
  • Adult dosing: the typical dose for adults is between 20-30 mg per day, split between two doses 8-12 hours apart. Some patients may require a 40-60 mg dose per day, which should also be slowly increased weekly. 

Long-acting Ritalin is available in tablets, chewable tablets, oral disintegrating tablets, capsules, oral liquid, and a patch. The various forms have different onset and duration of action, but overall, effects are typically seen within the first hour of consumption and can last up to 12 hours.

  • The extended-release capsules come in 10 mg, 20 mg, 40 mg, and 60 mg doses.

What Ritalin Treats

Ritalin treats the symptoms of ADHD by increasing the supply of dopamine and norepinephrine in the synapses of the brain. 

Norepinephrine helps the brain focus, think more clearly, and operate faster. Dopamine triggers the brain’s reward center and is associated with euphoria or feelings of well-being. 

Because of these effects, Ritalin is effective at treating the following symptoms of ADHD:

  • Absent-mindedness
  • Forgetfulness
  • Problems focusing
  • Problems staying on task
  • Restlessness or difficulty staying still
  • Impulsive thoughts and behaviors

What is the Price of Ritalin?

Generic Ritalin, called methylphenidate, ranges between $8 and $30 for 60 tablets, which is a 30-day supply. This medication is generally less expensive than Focalin. With medical insurance, the copay for generic Ritalin is usually a few dollars.

Ritalin Side Effects

CNS stimulants produce feelings of euphoria and heightened alertness. People often report feeling excited, alert, and energized. However, people also report feeling irritated, agitated, and anxious. 

Here is a more complete list of associated side effects: 

  • Headache
  • Anxiety
  • Nervousness
  • Agitation
  • Sweating
  • Nausea
  • Vomiting
  • Insomnia
  • Appetite loss
  • Stomach pain
  • Skin rash
  • Numbness
  • Cold feeling in extremities (hands and feet
  • “Pins and needles” feeling
  • Dizziness
  • Vision problems
  • Increased heart rate

Warnings

Ritalin is a federally controlled substance (Class II) due to the potential for abuse of the medication or dependence during long-term use. It is important to keep this medication in a safe place to prevent misuse or abuse. 

Selling or giving away Ritalin to someone not prescribed this medication is dangerous and against the law in the United States. 

If you, your child, or anyone in your family have a history of drug dependence or alcoholism, this must be discussed with your healthcare provider before any stimulant is prescribed.

Stimulants also affect your heart and have been known to cause heart attack, stroke, and even sudden death in patients with high blood pressure, underlying heart disease, or a heart defect. 

Discontinue the medication and call a healthcare provider immediately if you begin to experience chest pain, lightheadedness, or difficulty breathing while taking stimulant medications. 

In addition, stimulants may cause new or worsening psychosis, especially in patients with a history of depression, anxiety, bipolar disorder, or schizophrenia.

Call a healthcare provider immediately if you have signs of psychosis, including increased aggression, paranoia, behavioral issues, or hallucinations, such as seeing or hearing things that may not be real. 

You should not start Ritalin if you have the following: 

  • Underlying heart issues or severe high blood pressure
  • Glaucoma 
  • Hyperthyroidism or an overactive thyroid gland 
  • A personal or family history of Tourette’s syndrome or tics (involuntary muscle twitching)

Drug Interactions

Tell your healthcare provider if you are prescribed or use medications for: 

  • Opioid medications 
  • Herbal supplements 
  • Depression or mental illness 
  • Migraine headache 
  • Parkinson’s disease 
  • Antibiotics 
  • Prevention of nausea or vomiting 

Several medications interact with methylphenidate and can cause serotonin syndrome, a serious medical condition. Signs and symptoms include:

  • Altered mental status: agitation, confusion, anxiety, delirium, coma 
  • Autonomic dysfunction: high blood pressure, fast heart rate, sweating, overheating, nausea, vomiting, diarrhea
  • Neuromuscular abnormalities: tremor, exaggerated reflexes, muscle rigidity, involuntary movements
  • Serious complications: breakdown of muscle, metabolic acidosis, kidney or respiratory failure, seizures, and even death 

Do not use Ritalin if you have previously used an MAO inhibitor in the past two weeks, as a dangerous drug interaction may occur. MAO inhibitors include but are not limited to:

  • Isocarboxazid
  • Metaxalone
  • Procarbazine
  • Safinamide
  • Selegiline
  • Phenelzine
  • Linezolid
  • Tranylcypromine
  • Methylene blue injections

What is Focalin?

Focalin (Dexmethylphenidate) is another medication used to treat ADHD in children and adults. Like Ritalin, it is a CNS stimulant and works similarly. It blocks the reuptake of dopamine and norepinephrine in the brain, increasing their availability in the synapses. 

The chemical structures of the two stimulants are very similar, but their slight differences lead to different side effects. Focalin is a stronger CNS stimulant and has fewer side effects than Ritalin.

Like other CNS stimulants, this medication helps to improve attention, focus, and organization and also helps regulate impulsive behavioral problems. 

Forms and Doses

Focalin is available in two different forms, short-acting and long-acting, that vary in the medication’s onset and duration of action. 

Focalin Immediate Release tablets come in 2.5 mg, 5 mg, and 10 mg dosages. This form is taken twice a day, at least 4 hours apart.

  • Pediatric dosing: Initially, start at 2.5 mg twice daily and increase in increments of 2.5-5 mg at weekly intervals with a maximum daily dose of 20 mg/day
  • Adult dosing: Initial dose of 2.5 mg twice daily and may titrate up to a maximum dose of 10 mg twice daily 

Focalin Extended Release capsules come in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg dosages. Medication is taken once daily in the morning.

  • Pediatric dosing: Initial 5 mg once daily and increased in increments of 5 mg/day at weekly intervals with a maximum dose of 30 mg/day
  • Adult dosing: Initial 10 mg once daily and may titrate up to a maximum dose of 40 mg/day

What Focalin Treats

Focalin (dexmethylphenidate) is a central nervous system stimulant used to treat ADHD symptoms in adults and children. Though this medication is not FDA-approved to treat narcolepsy, it can be prescribed for this as an “off-label” use.

Focalin helps treat symptoms of ASHD, including

  • Absent-mindedness
  • Forgetfulness
  • Problems focusing
  • Problems staying on task
  • Restlessness or difficulty staying still
  • Impulsive thoughts and behaviors

What is the Price of Focalin?

Focalin is a more expensive ADHD medication than Ritalin. It is a stronger medication with fewer side effects, making it more expensive. Generic Focalin ranges between $85-100 out of pocket for a 30-day supply, and generic Focalin XR daily dosing is about $200 out of pocket.

Focalin Side Effects

Like Ritalin, Focalin produces feelings of euphoria and heightened alertness. Patients taking CNS stimulants often report feeling excited, alert, and energized. Likewise, they also report feeling irritated, agitated, and anxious. 

Here is a list of associated side effects: 

  • Headache
  • Anxiety
  • Nervousness
  • Agitation
  • Sweating
  • Nausea
  • Vomiting
  • Insomnia
  • Appetite loss
  • Nasal congestion
  • Sore throat
  • Stomach pain
  • Skin rash
  • Numbness
  • Cold feeling in extremities (hands and feet
  • “Pins and needles” feeling
  • Dizziness
  • Vision problems
  • Increased heart rate

Rarer side effects include:

  • Raynaud’s Syndrome (rare): Call your healthcare provider and do not continue medication if you notice changes in color (white, blue, and red) in your fingers and toes in response to cold or stress. This may be associated with pain or a “pins and needles” sensation in the affected digits. 
  • Priapism, or prolonged or painful erection lasting four or more hours. If this is to occur, seek medical care immediately and do not continue the medication. 

Warnings

Like Ritalin and Concerta, Focalin is a federally controlled substance (Class II). It is important to keep this medication in a safe place to prevent misuse or abuse. 

Selling or giving away Ritalin to someone not prescribed this medication is dangerous and against the law in the United States.

Cardiovascular events have been reported in both pediatric and adult patients. 

  • Heart attack
  • Sudden cardiac death
  • Stroke
  • Increased heart rate 
  • Increased blood pressure

Psychiatric or Behavioral Effects: 

  • New-onset psychosis or mania 
  • Exacerbation of psychotic or manic symptoms (visual or auditory hallucinations, delusional thinking)
  • Aggressive behavior

Drug Interactions

Tell your healthcare provider if you are prescribed or use medications for:

  • Opioid medications 
  • Herbal supplements 
  • Depression or mental illness 
  • Migraine headache 
  • Parkinson’s disease 
  • Antibiotics 
  • Prevention of nausea or vomiting 

Several medications interact with methylphenidate and can cause serotonin syndrome, which is a serious medical condition. Signs and symptoms include:

  • Altered mental status: agitation, confusion, anxiety, delirium, coma 
  • Autonomic dysfunction: high blood pressure, fast heart rate, sweating, overheating, nausea, vomiting, diarrhea
  • Neuromuscular abnormalities: tremor, exaggerated reflexes, muscle rigidity, involuntary movements
  • Serious complications: breakdown of muscle, metabolic acidosis, kidney or respiratory failure, seizures, and even death 

Do not use Focalin if you have previously used an MAO inhibitor in the past two weeks, as a dangerous drug interaction may occur.

Which ADHD Medication is Right For You?

Several medications are FDA approved for treating ADHD in children and adults. While it may be overwhelming to read and compare each individual medication, a healthcare provider can help navigate this process with you to determine where to start and which treatment is best for you. 

Everyone reacts to each medication differently, so it may take some “trial and error” to figure out the best possible treatment plan for your mental health. 

We also help people receive anxiety, depression, and insomnia medication online. 

How Klarity Helps You Find the Best ADHD Medication

Fast, convenient, and affordable ADHD treatment is only 48 hours away! Start by taking our brief online mental health assessment. From there, you can schedule a telemedicine appointment within 48 hours.  

We’ve put 30,000+ Americans in contact with fully licensed and trained mental health clinicians who can diagnose your condition and prescribe online anxiety, depression, insomnia, and ADHD medication. 

Klarity is fast—after taking our brief, 2-minute mental health assessment, you’ll be able to speak with a clinician and receive ADHD medication within 48 hours.

Klarity is convenient—meet with us from anywhere you have cellular data or wi-fi. Klarity puts the doctor’s office in your pocket.
Klarity is affordable—there are no hidden fees, subscription fees, or membership fees. You pay for your medication refills and telehealth appointments. No insurance needed.

Sources

“Attention-Deficit/Hyperactivity Disorder.” National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd

“Compare Focalin vs. Ritalin.” GoodRX Health. https://www.goodrx.com/compare/focalin-vs-ritalin

“Focalin – Uses, Side Effects, and More.” WebMD. https://www.webmd.com/drugs/2/drug-22256/focalin-oral/details

John P. Cunha, DO, FACOEP. “Focalin vs. Ritalin.” RxList. https://www.rxlist.com/focalin_vs_ritalin/drugs-condition.htm

“Ritalin – Uses, Side Effects, and More.” WebMD. https://www.webmd.com/drugs/2/drug-9475/ritalin-oral/details

“What is ADHD?” American Psychiatric Association.

https://www.psychiatry.org/patients-families/adhd/what-is-adhd

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