Vyvanse vs. Ritalin: Differences, similarities, and which is better for you

In this article:

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost comparison
• Side effects
• Interactions
• Warnings
• FAQs

In this article

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost comparison
• Side effects
• Interactions
• Warnings
• FAQs

Attention-deficit hyperactivity disorder (ADHD) affects an estimated 7 million children in the United States. Diagnosing patients with ADHD has many steps. Patients may exhibit symptoms such as not listening when spoken to directly, failing to get organized to complete tasks, or forgetfulness in daily activities. Patients with ADHD may need special accommodations in settings such as the classroom to complete their work successfully. Only a healthcare provider can diagnose ADHD, but once a diagnosis is made, there are treatment options to help these patients realize a higher quality of functioning in daily activities. 

One of the most common types of treatments for ADHD is a class of medications known as central nervous system (CNS) stimulants. Vyvanse (lisdexamfetamine) and Ritalin (methylphenidate) are two medications within this class. Other well-known stimulants include Adderall/Adderall XR (amphetamine salts), Concerta (methylphenidate extended-release), Daytrana (methylphenidate), and Focalin/Focalin XR (dexmethylphenidate). There are non-stimulant treatment options for ADHD. These include Strattera (atomoxetine) and Intuniv ER (guanfacine).

Main differences between Vyvanse and Ritalin
	Vyvanse	Ritalin
Drug class	Central nervous system stimulant	Central nervous system stimulant
Brand/generic status	Brand and generic available	Brand and generic available
What is the generic name?	Lisdexamfetamine	Methylphenidate
What form(s) does the drug come in?	Oral capsule and chewable tablet	Immediate-release oral tablet and long-acting oral capsule
What is the standard dosage?	70 mg once daily	10 mg tablet twice daily
How long is the typical treatment?	Long-term (months to years)	Long-term (months to years)
Who typically uses the medication?	Children, adolescents, and adults	Children, adolescents, and adults

What are the main differences between Vyvanse and Ritalin?

Vyvanse is a central nervous system stimulant used in the treatment of ADHD and binge-eating disorder. The exact mechanism as to how Vyvanse treats these disorders is not known. Vyvanse is converted to its active metabolite, dextroamphetamine. Amphetamines stimulate the release of catecholamines, such as norepinephrine and dopamine, into the neuron synapse. We know these neurotransmitters play a critical role in mood, affect, and focus. 

The Drug Enforcement Agency (DEA) deems Vyvanse a Schedule II narcotic drug. This is due to its high abuse potential, and therefore, there may be restrictions and guidelines for obtaining Vyvanse, which differ by state. Vyvanse is an oral capsule available in 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, and 70 mg. Vyvanse is also available in a chewable tablet with the same strengths as the capsule formulation.

Ritalin is also a central nervous system stimulant used to treat ADHD and narcolepsy. Its exact mechanism is also not fully understood. Ritalin is a more mild CNS stimulant. Rather than causing the release of catecholamines, it blocks the reuptake of those neurotransmitters in the neuron synapse. The result leaves more free dopamine and norepinephrine in the neuron synapse.

Ritalin is also classified as a Schedule II narcotic by the DEA due to its abuse potential. It is available in immediate-release tablets in 5 mg, 10 mg, and 20 mg strengths. It is also available in a long-acting capsule formulation (Ritalin LA) in 10 mg, 20 mg, 30 mg, 40 mg, and 60 mg strengths.

Conditions treated by Vyvanse and Ritalin

Vyvanse and Ritalin are each used in the treatment of ADHD. Vyvanse is approved in children as young as six years old, while Ritalin is approved in children as young as three years old. Both drugs can be used in adolescents and adults. 

Vyvanse carries an indication for treatment in binge-eating disorder. Binge-eating is characterized by an overindulgence of food in one sitting. It is not always due to an underlying disease. Athletes who consume a large number of calories before an athletic event are binge eating but would not require treatment. At times, binge eating is a symptom of an underlying mental health disorder, and Vyvanse has been approved to treat binge eating disorder.

Ritalin has been approved for the treatment of narcolepsy. Narcolepsy is characterized by excessive daytime drowsiness, typically due to chronic sleep disease. The stimulant effects of Ritalin are known to at least partially relieve this drowsiness.

This is not intended to be an exhaustive list of all the possible uses of these two drugs. Consult your healthcare provider for a complete list of the possible uses of Vyvanse and Ritalin. 

Condition	Vyvanse	Ritalin
ADHD	Yes	Yes
Binge-eating disorder	Yes	No
Narcolepsy	No	Yes
Severe fatigue	No	Off-label
Major depressive disorder	No	Off-label

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Is Vyvanse or Ritalin more effective?

In 2017, a comprehensive review was published to compare the results of 34 randomized trials comparing various treatment options for ADHD, including the active ingredients in Vyvanse and Ritalin. This analysis found that ADHD symptoms were most improved in patients taking Vyvanse, though all treatment options were effective. Another important outcome shows that methylphenidate immediate-release combinations, such as Ritalin, were the best tolerated. Two important factors when considering Ritalin or Vyvanse will be cost and market availability. Ritalin has been available generically for quite some time, and the Vyvanse generic came to market in 2023. If you are covered by insurance, your formulary will determine your price along with factors like deductibles and copays. In recent years, the market availability of stimulants has made access to these prescription drugs very difficult for some. These shortages began with Adderall generics in late 2022 and have continued to haunt the medication class since. You can check the current drug shortages directly on the FDA website. If you need to determine if your local pharmacy has the medication in stock, it is best to communicate directly with them. 

Only your healthcare provider can decide which treatment is best for you. For reasons unknown, some treatments may be less effective in some patients than others. Your healthcare professional will work with you to find the most effective treatment.

Coverage and cost comparison of Vyvanse vs. Ritalin

Vyvanse is a prescription medication typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. The out-of-pocket price for 30 capsules of Vyvanse 70mg can be $570. A coupon from SingleCare can bring the price of generic Vyvanse 70 mg to $97 at select pharmacies.

Ritalin is a prescription medication typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. Ritalin typically retails for around $197 per 30 capsules of the 20 mg strength, but with a coupon from SingleCare, patients can get generic Ritalin 20 mg for as little as $23.

	Vyvanse	Ritalin
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare?	Possibly with prior authorization	Possibly with prior authorization
Standard dosage	30, 70 mg capsules	30, 20 mg tablets
Typical Medicare copay	Variable	Variable
SingleCare cost	$97-298	$23-53

Common side effects of Vyvanse vs. Ritalin

Vyvanse and Ritalin are both CNS stimulants, and therefore, have a similar list of potential side effects. Literature from the Food and Drug Administration (FDA) does not define the frequency of adverse events from Ritalin. Roughly one in every 2.5 patients who take Vyvanse experience insomnia. For this reason, Vyvanse and other stimulants should be taken earlier in the day.

Other similar side effects related to both Vyvanse and Ritalin include decreased appetite, upper abdominal pain, nausea, and vomiting. These side effects could lead to significant weight loss, and patients should be monitored for this effect. 

This is not intended to be a comprehensive list of side effects. Please consult your pharmacist or healthcare professional for a complete list of side effects and medical advice.

	Vyvanse		Ritalin
Side effect	Applicable?	Frequency	Applicable?	Frequency
Insomnia	Yes	39%	Yes	Not defined
Decreased appetite	Yes	22%	Yes	Not defined
Upper abdominal pain	Yes	12%	Yes	Not defined
Irritability	Yes	10%	Yes	Not defined
Vomiting	Yes	9%	Yes	Not defined
Weight decrease	Yes	9%	Yes	Not defined
Nausea	Yes	6%	Yes	Not defined
Dry mouth	Yes	5%	Yes	Not defined
Dizziness	Yes	5%	Yes	Not defined

Source: Vyvanse (DailyMed) Ritalin (DailyMed)

Drug interactions of Vyvanse vs. Ritalin

The combination of either Vyvanse or Ritalin with monoamine oxidase inhibitors is contraindicated. The combinations of these drugs should never be used in patients. MAOI antidepressants slow amphetamine metabolism, increasing the amphetamine’s effect on releasing norepinephrine and other monoamines from the nerve endings, causing headaches and other signs of hypertensive crisis. 

Using either Vyvanse or Ritalin with various serotonergic agents can increase the likelihood of serotonin syndrome. This syndrome can result in the patient feeling agitated, dizzy, and having an increased heart rate. Serotonergic agents include a variety of antidepressants, such as selective serotonin reuptake inhibitors, tricyclic antidepressants, and 5HT3 antagonists.

Ritalin is known to counteract the antihypertensive effects of common high-blood pressure medications such as lisinopril, benazepril, losartan, and irbesartan. Patients with existing high blood pressure should avoid Ritalin.

The following list is not intended to be a complete list of drug interactions. It is best to consult your healthcare provider or pharmacist for a complete list.

Drug	Drug Class	Vyvanse	Ritalin
Selegiline Isocarboxazid Phenelzine Linezolid	Monoamine oxidase inhibitors (MAOIs)	Yes	Yes
Fluoxetine Paroxetine Sertraline Citalopram Escitalopram	Selective serotonin reuptake inhibitors (SSRIs)	Yes	Yes
Venlafaxine Duloxetine Desvenlafaxine	Selective norepinephrine reuptake inhibitors (SNRIs)	Yes	Yes
Sumatriptan Rizatriptan Eletriptan Zolmitriptan Naratriptan Frovatriptan	5HT3 Antagonists (Triptans)	Yes	Yes
Desipramine Protriptyline Amitriptyline Nortriptyline	Tricyclic antidepressants	Yes	Yes
Lisinopril Ramipril Benazepril Enalapril Quinapril Fosinopril	Angiotensin-converting enzyme (ACE) inhibitors	No	Yes
Losartan Irbesartan Valsartan Olmesartan	Angiotensin receptor blockers (ARBs)	No	Yes
Carvedilol Metoprolol Atenolol Nebivolol	Beta blocker	No	Yes

Warnings of Vyvanse and Ritalin

Vyvanse and Ritalin are Schedule II narcotics and, therefore, have a very high potential for abuse and misuse. These medications should be taken exactly as directed, and patients must be monitored closely by their healthcare provider while on these medications. 

Sudden death, stroke, and cardiac arrest have been reported in patients taking CNS stimulants, even at recommended doses. Sudden death has occurred in children and adolescents with cardiac abnormalities. For this reason, the use of Vyvanse and Ritalin should be avoided in patients with a history of coronary artery disease or with known heart problems. 

CNS stimulants can exacerbate behavior disturbances in patients with pre-existing psychiatric disorders. These patients should be monitored closely if CNS stimulants are necessary. Bipolar patients may experience mixed or manic episodes while on CNS stimulants. Your psychiatry health professional should be involved in the decision to use stimulants for ADHD.

Frequently asked questions about Vyvanse vs. Ritalin

Are Vyvanse and Ritalin the same?

While both Vyvanse and Ritalin treat ADHD and are classified as CNS stimulants, they are not the same. Vyvanse works to increase catecholamines in the neuronal synapse by stimulating their release, while Ritalin blocks the reuptake of the catecholamines to effectively leave more free catecholamines in the neuronal synapse.

Is Vyvanse or Ritalin better?

Both Vyvanse and Ritalin have been proven effective in treating ADHD. Studies show that Vyvanse may show a greater improvement in symptomatology, but Ritalin is associated with   lower rate of side effects.

Can I use Vyvanse or Ritalin while pregnant?

Vyvanse and Ritalin are considered pregnancy category C by the FDA. This means there have not been adequate human studies to determine safety. Using amphetamines during pregnancy may lead to an increased risk of premature birth and low birth weight. Newborns may experience symptoms of withdrawal. These drugs should only be used when the benefits outweigh the risks.

Can I use Vyvanse or Ritalin with alcohol?

Alcohol use could increase the serum blood concentrations of amphetamine-related drugs, and therefore, alcohol should be avoided when on these medications.

What is the newest ADHD medication?

Onyda XR is the first liquid, non-stimulant treatment option for ADHD in children and adolescents, and it was approved by the FDA in May 2024. Onyda XT (clonidine HCl) can be used alone or in combination with stimulant drugs for the treatment of ADHD. Onyda XR is also unique because it is the first and only medication for ADHD with approved nighttime dosing.

Two newer additions to the stimulant class are Azstarys and Xelstrym. Azstays is an oral capsule formulation containing two stimulant amphetamine salts, dexmethylphenidate and dexmethylphenidate. It is a long-acting, once-daily dose intended to give extended symptom control and a gradual drop-off later in the day. Xelstrym is a transdermal patch containing dextroamphetamine and offers an innovative alternative to taking an oral medication. 

What ADHD medication is comparable to Vyvanse?

Lisdexamfetamine, the active ingredient in Vyvanse and its generic formulations, is converted in the body to dextroamphetamine. Dextroamphetamine is the active ingredient in Adderall formulations. Adderall XR formulations, as well as their generics, typically have a once-daily dosing similar to Vyvanse. Azstarys and Xelstrym may also be appropriate alternatives for some patients, though generic versions of these are not yet available.