How does Concerta work?

Concerta works by stimulating the central nervous system. Concerta specifically enhances the effects of norepinephrine and dopamine in the brain. More on Concerta’s uses, side effects, and dangers here.

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Concerta (methylphenidate) is a stimulant medication which is used to treat ADHD (attention deficit hyperactivity disorder). But what are Concerta’s effects on the body and brain? Will everyone react the same way to Concerta use? What are the dangers and side effects of Concerta? Can you get high on Concerta and is Concerta addictive? We’ll explore these questions and more in this article, and invite your questions about Concerta at the end.

How does Concerta affect the brain and nervous system?

Concerta is a brain stimulant which is a controlled release version of methylphenidate. Concerta works by enhancing the effects of norepinephrine and dopamine in the brain. These neurotransmitters have stimulant effects, increasing blood pressure and heart rate, constricting blood vessels, increasing blood pressure, and causing a euphoric high when abused. But at a basic level, Concerta works as a treatment for ADHD by slow and steady increases of dopamine, which are similar to the natural production of the chemical by the brain. The doses prescribed by physicians start low and increase gradually until a therapeutic effect is reached.

How does Concerta work in the body?

Concerta (methylphenidate) can also have a stimulant effect on the body. Concerta can potentially cause:

  • anxiety
  • decreased appetite
  • dizziness
  • nausea
  • sudden, repetitive movements (tics)
  • trouble sleeping
  • weight loss

Note here that Concerta also has some more potentially dangerous side effects, including intensifying mental health issues like bipolar, psychiatric events or suicidal tendencies and has occasionally caused sudden death in people with heart problems.

How fast does Concerta work?

Concerta starts working very quickly, reaching peak blood levels within one hour of oral administration. Crushing or snorting Concerta can result in a quicker onset of action, but taking the medication this way is very dangerous.  How long Concerta in system is usually eliminated from the body in under 48 hours, or 2 days, after ingestion.

How long does Concerta work?

Concerta works throughout the day, with the best effects occuring for 5-9 hours after initial administration. Because of its long-acting effects, Concerta is a very helpful drug for people with ADHD, since they don’t need to take Concerta repeatedly throughout the day.

What makes Concerta work better?

Concerta works best when it’s taken early in the day. Otherwise Concerta can interferes with the ability to sleep. It can be taken with or without food. Since Concerta is an extended-release drug, it shouldn’t be crushed or chewed, because too much of the drug will be taken at once, raising the risk of overdose and serious health complications.

Does Concerta work for everyone?

No, Concerta is a very bad solution for people with heart conditions and other serious health problems. It also has dangerous interactions with some common medications. Concerta should also be avoided by those with a history of mental instability, a history of addiction, or epilepsy.

If you feel a need to take Concerta more frequently or in higher doses (or in other ways different than prescribed) you might be in risk of addiction. For more on Concerta’s addictive potential, how you can seek help, how to find the best rehab options and therapies for you, read in our GUIDE on Concerta addiction treatment programs and get help TODAY.

How Concerta works questions

Still have questions about how Concerta works? Please send us your questions and experience by posting a comment below. We respond to all legitimate concerns with a personal and prompt response.

Reference Sources: NIMH: ADHD Medications
FDA: Concerta Drug Label

NIDA Drug Facts: Stimulant ADHD Medications

NIDA: Stimulants
ToxNet: Methylphenidate
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. A bit about me:
    25 Years old, been Diagnosed with ADHD (Inattentive type) Q2 2017 and since then I’ve been on Concerta XL daily. Started off at low dosage of 16mg and slowly increased the amount which is now 72mg (two 36mg tablets daily). Taking one when I wake up and one around lunchtime (4 hours after first tablet).

    How it works on me:
    From what I’ve noticed, tablet comes in two forms, instant release and long term release. Instant kicks in about 30 mins of ingestion and lasts for about 3.5 hours, long term is around 8 hours. Which is why you wouldn’t take a tablet after 6pm as would cause trouble sleeping.

    The effects in a little more detail:
    The effects on me specifically are quite surprising, I feel less lazy, more up to starting and completing many daily tasks/house chores I would normally find difficult to muster energy/enthusiasm. While working on said tasks I still have the same amount of distractability though, I feel now there is an ‘inner voice’ activity in my head which tells me, “yeah this also needs to be done, BUT IS IT.. more important to switch to that task than putting this current one on hold?” In most cases I have an increased ability to save ‘mental notes’ so I can now decide, “no I want to focus completing this one task, keep that other one in mind for when I have completed this task”. Guess what? I actually remember my mental note!! Something I’ve never been able to do in the past, that is amazing to me!!!
    This one considerable improvement I found to be far more effective in conversations I have with people, just the ability to remember how a conversation has progressed to one thing to another, holding mental notes in case it has drifted to another topic so I can bring it back to the topic I was talking about earlier while also taking in the new information about the different topic. I just feel I have more capacity in my brain, like extra kitchen worktop space or like RAM in a computer.

    Ongoing issues:
    Concerta XL doesn’t fix my ADHD, it merely gives my lifestyle a little push in the right direction but I feel if I want to overcome bad habits, lazyness, social skills, organisation then I have to program my brain to get used to this new way of living. All my life I’ve been struggling and I feel the medication has been a massive help, but I realise that it’s not going to be enough as I need to put 80% of the effort to reach my goals into becoming a functionally, reliable human being that is finally confident and in control of my life.

    Note for parents:
    Keep in mind not to take medication if you suffer from heart or serious health problems. Ensure you get a proper diagnosis before taking medication as it will be addictive to someone who doesn’t actually have ADHD. Personally over the last 8 months I have been taking medication almost consistently, sometimes I’ve missed a couple days, even 4 in a row and I feel indifferent, (apart from going back to my lazy ways) I don’t believe I am addicted to this medication like I would be addicted to nicotine (am addicted to nicotine) however that doesn’t mean everyone else would be the same. Which is why I can’t thank enough for my doctor and close friends monitoring my progress. They are very important in order to one day reach my goal.

  2. I take an 18mg dosage every 48hrs, and at times I tend to have pains in my heart because when it beats at times it hurts , then I also get sharp pains in my head , like 2 to 4 seconds of headache but like the type where you just need to seat down , and i have pain from time to time all over my chest this happens frequently.
    At first I used to drink 37mg but it made me crazy , I didn’t want food and I didn’t sleep , but again the pains were frequent just like the 18mg I’m using now
    should i discontinue or should I consult my doctor.

    I use these pills for school

  3. What is the behavioral difference in taking Concerta 36 to switching to Concerta 54? Are the side affects the same or different? I was originally taking Concerta 36 for my ADHD and my autistim but my dosage was just changed from 36mg to 54mg because it was making me very irritable. It also made me feel tired almost everyday. I started taking Concerta 54mg but I have not noticed any change.

  4. Dear addiction blog,

    I’m going to be prescribed by professionals for concerta. My main question is how it is going to be when coming down? I read 5-9hrs for duration of effects. What happens after? The psychiatrist said that the symptoms of my ADD/ADHD would appear stronger than the usual. Would this make cycling ( which is how I get around every day) become dangerous?
    The common side effects listed appear in most cases or only in a few cases?

    Thank you very much in advance!
    Best Regards,

  5. How does Concerta work if you stop taking it on weekends ? I was told it takes a few weeks to notice a change. If I just started my daughter on the meds and stop for the weekend will this effect how long it takes to work and once it does work and I stop on weekends or vacations will this effect her ?

  6. Hi

    A number of people have said that they used concerta whilst studying, writing assignments or in preparation for examination.

    If you do not suffer from ADD is it safe or advisable to use concerta in this way, obviously not everyday of course, but as and when the need arise depending on the amount of work one has to do.

    Jabulani, South Africa.

  7. My husband takes Concerta everyday for a brain injury he suffered years ago. It is probably something he will have to take for the rest of his life. At the moment he has a cold and he has been taking cold and flu medication. I was just wondering if there is anything he should be avoiding with regards to over the counter medication. He also likes those energy drinks. I was wondering if they are also something he should be trying to avoid. Thanks for your time.

  8. Our son has been taking concerta for five year. He is now 17 years old. Initially we agreed to him been put on concerta because we were led to believe it would improve his ability to learn within the context of the classroom. However his ability to learn has as a matter of fact declined although his behaviour continues to be good within the Special Needs Classroom. We want to take him off the concerta and introduce lecithin instead. We would appreciate your comment and advice. Thank you in advance. Mrs and Mr Sails

  9. My partner has got adhd, bipolar and autism as well as aspergers do you know if concerta is the best thing for him as his mum and doctor has put him back on it but i dont know much on it with mental health problems

  10. Hey, I have been diagnosed with Adult ADHD and I recently started a perscription for concerta 18mg. It seemed to work the first two days but By the third day it seemed to not work as well. I’m wondering if it was caused by a placebo effect because i was so relieved to finally have help for my concentration and scatter brainedness, or I have a tolerance to stimulants?? I just want my thoughts to be a little less … All over the place. I’m also on antibiotics for a bad ear infection and the occasional t3, which has little to no effect either. What would be more likely?

  11. How long does it take of taking Concerta before it reaches it’s therapeutic level to notice a difference in behavior. Like 2 weeks or more or less. Trying to figure out if our child is on the right dose

  12. So im using it for atleast 3-4 months . Im on 54 mg .I am a 24 M that diagnosing with ADD, Anxiety and had a long yime drug problems. Mostly my anxiety has gone with the way that im using it is ; not taking it when goin out cause that way it just makes me nervous about anything . I highly recommend this when you at home or work and need a long time to study/work etc. And when i overdose to 108 it just gets better my focusing on the work i do just my hearth dont thinks the same way :P. So after all im curious about how is this thing affecting ? Like how does it makes me focused on ? Or clearing anxiety ? And also how does others using it and feelin it ? Thanks to all

  13. Hi. I want to find out my son is 8 and repeating gr 2 this year because he doesn’t concentrate,teachers wanted me to put him on ritelin since he was gr o. I took him to dokter last week I thought he had asma but his heart is beating unevenly so i don’t now what he could use biostrach is not working as efectifly as it should. He also got glasses last year…what else please can you help me…i dont want a zombie child. Thank you.

  14. Hello Tracy. When does he take his pills? Maybe in the morning he is more restless as his last dose wears off and the one just taken needs time to start acting. Have you asked his prescribing doctor about this?

  15. My 12 year old is on a high dose of concerta xl but we are still struggling with his behaviour at school but only in the morning. In the afternoon he can concentrate well. Is this normal?

  16. Hi Gemma. Researchers have not yet established the safety of methylphenidate use during human pregnancy. There are no adequate and well-controlled studies in pregnant women, thus doctors and gynecologists advise Concerta should be used during pregnancy only if the potential benefits outweigh the potential risk to the fetus. The potential effects of this medication on labor and delivery lack scientific study, and it’s also unknown whether it’s excreted into the breast milk.

  17. Hi, my husband and I will be starting IVF very soon and I currently take 36mg of concerta, no doctor seems to know the answer but I need to know when to come off the drug? If I’m having a particularly bad day of ADHD can I take one if pregnant? Is there a safe alternative to this drug that you can take whilst pregnant? Any info is gratefully appreciated.

  18. Hi Jennifer. For any strange effects you should always inform your doctor. If the medication is not helping your son, he might need a different dose or should be switched to another medication. So, talk to the prescribing doctor first.

  19. My son that is almost 16 started taking 36mg of Concerta for ADHD appx 3 weeks ago. He also has Conduct Disorder. He takes his medication around 6am every morning and starts his school day at 7:45. Since he has started taking it I have not noticed any positive change in him. I have seen him become more mean and aggressive instead. He has also been suspended in school last week. I am just wondering how long should I wait to give the medication a chance to work before I should be concerned of having no change in his ability to focus at school and contain his need to always talk and be moving?

  20. As I got older and more stressed the worse my depression and ADD/ADHD got. Finally I got tired of dreading just waking up and facing each day. Found out that I had Bipolar depression, PTSD, ADD/ADHD and bad insomnia along with chronic fatigue. Go figure! Was literally addicted to DR Pepper soda (caffeine and sugar). Started seeing a Psych Dr. She started me on Temazepam first to take in addition to 300 to 400 mg of Trazadone at night. Then she added Lamotigrine. Next she added Concerta ER. Am going up from 36 mg to 54 next time I fill my scrip. It was so hard for me to focus and my love of reading was pretty much gone. Couldn’t even sit and concentrate long enough to keep up with my bills…. Math, forget it!…. Now, I sleep between 8 to 9 hours instead of barely at all. Before, my brain just kept circling and I couldn’t hit a good rim sleep. After a few months I am getting better. Will see how the higher dose does. At least now I am gradually getting back to reading novels. It takes me longer because I can’t read but so much at a time. However, my love of reading is returning with my increased concentration. Hoping that the higher dose will get me back to my old self, the one who finishes novels fast and loves reading more than watching movies. It was really hard to admit to anyone that I needed help. Just glad that I got a great doctor who has taken enough time to understand me, my needs and is good at figuring out what meds will work with how my brain is functioning. Concerta gave me my best improvement in years! That being said… everyone’s chemical makeup is different. I hope each of you find what works for you!

  21. Hello Nicole. It’s impossible to be still tolerant to the medication after so many years. I think it’s best to see what your doctor will say.

  22. I was on Concerta when I was 20-22 along with celexa for my anxiety. I only got off my meds because I was dropped off my parents insurance and had to start paying full price. Well 12 years later after having 2 kids it was time for me to get back on meds for my anxiety and my ADHD. It was out of control. My new dr sent me for an eval and started me on Vyvance 30 mg and 3 weeks in I made an appt because it wasn’t working like my concerta did. I asked her if I could take concerta and she agreed. She put me on the dose amount I was on in my 20’s. Well that was 3 weeks ago and I don’t notice a difference. As a matter of fact no one, not even my bosses and coworkers notice a difference. I have made an appt my my dr but was wondering if this just means that I’m older and have more on my plate so therefore I need a higher dose. I’m on 36 mg ER.

  23. we have just upped my son’s concerta dose from 36mg been that for 6 yrs to 45mg just wondering when he should see a difference? Thanks

  24. Hello Annemarie. I’d suggest that you record hour son’s symptoms on a calendar and bring the data to a pharmacist or your prescribing doctor. You need a professional medical opinion to sort out what’s going on.

  25. My son is 5 years six months. He used 15 mg of methylphenidate for ADHD combined with a diagnosis of somewhere on the autism spectrum. We have changed it to concerta 27 mg six days ago. One day he will be emotional and little bit aggresive, next day he is the sweetest most obedient little boy. Is this normal when starting the concerta and will it improve after a few more days? The reason we changed was because on the methylphenidate he reacted like a robot the first hour and as it weans off he is back to being hyper and at times uncontrolable. Half a pil did nothing for him and a full pill had that robotic effect. At school they said he was not roboticn, but i could not believe he could act differently at home then at school on the medication and it was really sad to see him like that, but now on the new medication they say he cries for nothing and gets angry and and aggresive. I really don’t know what to do now. Any advice?

  26. Hi again, Jacques. I’d suggest that you schedule an appointment to review the efficacy of the medication. You may need a dose change and/or medication change.

  27. my doctor prescribed me concerta 54mg once a day.. for me to focus and concentrate better. But it seems to dull my thinking instead, is this normal? or is my dosage to high?

  28. Hello Marina. Thanks for your question. The mechanism of Concerta and other ADD/ADHD medications is not quite understood at the moment. The effects are dose-dependent, however, and usually do not last after dosing. Check out the FDA’s Concerta Medication Guide for reference, or speak with your local pharmacist for a better understanding of Concerta.

  29. My 7 year old just started concerta for ADD and has been on it for 10 days and her focus and attention has improved. Does concerta actually change the way the neurotransmitters “talk to each other” and if they improve these pathways between these transmitters, are these improved pathways now permanent? Or do they still need the concerta? How will I know when my daughter does not need it anymore? Thanks for your help?

  30. Hello Victoria. It’s possible that your body has become physically dependent on Concerta (methylphenidate) and that you are experiencing withdrawal when you miss a dose. I’d suggest that you consult with your prescribing doctor and your pharmacist to talk about these side effects and see if there may be a medication which may have the same effect on focus without the unwanted side effects. Good luck!

  31. HI. I have startede taking Concerta for helping me with the inability to focus and keep my thoughts together. It has helped me dramatically. My concern and question is this: If I don’t take it, I am WIPED out the day I don’t take it. I have NO motivation or ability to function. Almost like I am sick ( but don’t feel ill). Just completely exhausted and want to lay down and sleep. Is it wearing out my adrenals? I can’t figure out why when I don’t take it I am not able to function. The doctor said, take it only when you need it….um, daily is when I need to use it to work. Any thoughts?
    Thank you for your time.

  32. Hello Concerned MOM. I was just reading about another mother who tried alternatives to amphetamines for her child, using a nutritional plan. She found that fish oils, in particular, helped her child gain focus and attention. Have you spoken with a nutritionist or your doctor about this option?

  33. What other medication besides Ritalin is use as a stimulate to help boost with concerta??? also my son is on 27 mg and it seems not to be working as well as it use too..What are some options..he takes the pill at 5 am because hes on the school bus at 545 am and school starts as 8 am..What are some other options because the meds seems not to be working anymore?????

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