Amphetamines (Adderall) vs Methylphenidates (Ritalin) for ADHD Treatment in Adults

Sun, 17 Aug 2025 20:58:56 +0000

Dr. Pagnani of Rittenhouse Psychiatric Associates discusses two categories of controlled stimulant medications used to treat ADHD in adults: amphetamines and methylphenidates. Amphetamines (like adderall, vyvanse and dexedrine) and methylphenidates (like ritalin, concerta and focalin) both increase availability in the extraneuronal space of norepinephrine and dopamine by preventing their reuptake and also increasing their release. These medications have significant abuse potential and patients can develop physiological dependence and tolerance. They can also cause withdrawal, if taken regularly and decreased or stopped abruptly. There are various side effects, some potentially serious, and taking these medications must be under the direct supervision of a medical professional.

Dr. Pagnani discusses that in his clinical experience, he's found that the amphetamine stimulants seem to have a higher likelihood of causing anxiety, irritability, insomnia, restless, tiredness or "crash," between doses or when the medication is wearing off. With that said, these medications may work better for individuals with significant hyperactivity as part of their illness, than the methylphenidates, and there are certainly many patients who tolerate them well. Methylphenidates are often preferred (when medication management with a controlled medication is warranted) for patients who's primary symptom of ADHD is difficulty with focus (mental, as opposed to physical hyperactivity). He discusses that he believes there's a lower abuse potential (although there certainly IS abuse potential) with methylphenidates than amphetamines.

Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.

Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.

These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.

Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.

This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.

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