Focalin vs Ritalin for ADHD — how to choose

If you’re in search of an attention deficit hyperactivity disorder (ADHD) medication to effectively manage your symptoms, you’ve likely heard of Focalin and Ritalin. Although both are in the stimulant class of drugs, they have different characteristics and potential side effects. In this article, we cover focalin vs ritalin so you have the information you need.

By having a better understanding of these medications, you can have an informed discussion with a healthcare provider.

If you’re ready to take the next step toward finding the right ADHD medication, discover the convenience of online mental healthcare through Klarity Health. Connect virtually with a licensed healthcare provider experienced in ADHD treatment. With providers on Klarity Health, no insurance is needed. Schedule an appointment today.

Focalin vs Ritalin: are they the same?

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

These ADHD medications increase 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 2 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 2 have differences you want to know about.

The main difference between Ritalin and Focalin is that Focalin typically 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 intense. 

What is Ritalin?

Ritalin is a CNS stimulant that blocks the reuptake of 2 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 so they’re more available and the the brain can function better. 

Forms and doses

Ritalin is used to treat both ADHD and narcolepsy. It’s available in 2 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 to 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. 

• Adult dosing: the typical dose for adults is between 20 to 30 milligrams a day, split between 2 doses 8 to 12 hours apart. Some patients may require a 40 to 60 milligrams dose each day, which should be slowly increased weekly. 
• Pediatric dosing: the initial dosing starts at 5 milligrams twice a day and can be increased up to 60 milligrams a day. The medication should be slowly titrated, increasing 5 to 10 milligrams a day at weekly intervals. Some patients require 3 doses a day.

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 taking it and can last up to 12 hours.

• The extended-release capsules come in 10, 20, 40, and 60 millgram 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’s the price of Ritalin?

Generic Ritalin, called methylphenidate, ranges between $31 and $48 for 100 oral tablets. Brand-name Ritalin ranges between $89 and $173 for 100 oral tablets. 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 for Ritalin: 

• 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 (Schedule II stimulant) due to the high 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. 

Taking a higher dosage of Ritalin or taking it more frequently than prescribed can result in physical or psychological dependence. Long-term abuse can cause cardiovascular issues, psychological damage, and a range of other health issues. 

Controlled substances like Ritalin are strictly intended for use under the supervision of a healthcare professional. The best way to avoid dependence is to take Ritalin as prescribed and meet with your healthcare provider regularly.

Additionally, selling or giving away Ritalin to someone not prescribed this medication is dangerous and against the law in the U.S.

Discontinue Ritalin and call a healthcare provider immediately if you begin to experience chest pain, lightheadedness, or difficulty breathing. 

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’re 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 

Don’t use Ritalin if you have previously used a monoamine oxidase inhibitor (MAOI) in the past 2 weeks, as a dangerous drug interaction may occur. MAOIs include but aren’t limited to:

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

What is Focalin?

Focalin is another medication used to treat ADHD in children and adults. Like Ritalin, it’s 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 2 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 2 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, 5, and 10 milligram-dosages. Doses are taken twice a day, at least 4 hours apart.

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

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

• Adult dosing: Initial 10 milligrams once a day and may be increased over time to up to a maximum dose of 40 milligrams a day
• Pediatric dosing: Initial 5 milligrams once a day and increased in increments of 5 milligrams a day at weekly intervals with a maximum dose of 30 milligrams a day

What Focalin treats

Focalin is used to treat ADHD symptoms in adults and children. Though this medication isn’t U.S. Food and Drug Administration (FDA)-approved to treat narcolepsy, it can be prescribed for this as an off-label use (a use it’s not FDA approved for).

Focalin helps treat symptoms of ADHD, 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. Brand-name Focalin costs from $80 to $155 for 100 oral tablets. Generic Focalin (dexmethylphenidate) ranges between $31 and $54 for 100 oral tablets while generic dexmethylphenidate oral capsule, extended-release retails for $258 to $582 for 100 tablets. Prices are per drugs.com without insurance and reflect its discount card.

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 Schedule II stimulant. Since it’s a Schedule II stimulant, Focalin poses a high risk for dependency and should only be taken under the supervision of a medical professional. Prolonged or excessive use of Focalin can result in physical and psychological dependence. 

Potential side effects associated with Focalin abuse include increased blood pressure, elevated heart rate, and the potential for cardiovascular complications, along with psychiatric effects such as heightened anxiety, agitation, or psychosis.

To mitigate the risk of dependency, it is vital to strictly adhere to your healthcare provider’s instructions when taking Focalin. Follow the prescribed dosage and avoid increasing it or altering the frequency without medical supervision. Additionally, you should regularly communicate with your healthcare provider to discuss your progress, any concerns, or changes in symptoms.

Selling or giving away Focalin to someone not prescribed this medication is dangerous and against the law in the U.S.

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 

Don’t use Focalin if you have previously used an MAOI in the past 2 weeks, as a dangerous drug interaction may occur.

Focalin vs Ritalin, which ADHD medication should you choose?

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 you navigate the process and recommend which treatment is right 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 you.

Work with a provider on Klarity Health to find the best ADHD medication

Talk to a licensed ADHD healthcare professional about whether Ritalin, Focalin, or another ADHD medication is right for you. Simply find an ADHD provider on Klarity Health and have an appointment often within 24 hours.

Sources

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

“What is ADHD?,” American Psychiatric Association, https://www.psychiatry.org/patients-families/adhd/what-is-adhd

The information provided in this article is for educational purposes only and should not be construed as medical advice. Always seek the guidance of a qualified healthcare professional with any questions or concerns you have regarding your health. Providers on Klarity Health are independent practitioners with full medical authority. No diagnosis result or treatment option is guaranteed for the services rendered through the Klarity Health platform.

If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.

How we reviewed this article: This article goes through rigorous fact-checking by a team of medical reviewers. Reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the author.