At Hope Integrative Medicine, when stimulant medication is clinically appropriate for ADHD, our providers prescribe long-acting stimulants only. We do not prescribe immediate-release stimulants. Here is the difference, and why.
Immediate-release vs long-acting
Immediate-release stimulants, such as Adderall IR and Ritalin, act within about 30 minutes and wear off in about four hours, so they are taken two or three times a day. Blood levels rise and fall sharply with each dose.
Long-acting stimulants release medicine gradually through the day from one morning dose:
- Lisdexamfetamine (Vyvanse): a prodrug the body converts slowly into its active form
- Extended-release mixed amphetamine salts (Adderall XR): beads that release in two stages
- Extended-release methylphenidate (Concerta): an osmotic tablet that releases steadily
- Dexmethylphenidate XR (Focalin XR): two-stage beads
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Primary care, mental health, and addiction medicine in one practice. New patients are often able to be scheduled within a week of requesting an appointment.
Why long-acting only
- Steadier symptom control through the work or school day, without mid-day gaps
- Fewer peaks and crashes, with less rebound irritability as doses wear off
- One dose a day, which is easier to take consistently
- Lower potential for misuse, because the medicine is released slowly rather than all at once
Testing comes first
If you have not completed a formal ADHD evaluation before, we require objective ADHD testing before starting treatment. Read how ADHD testing and treatment work.
Get help from Hope Integrative Medicine
If you want ADHD care from a practice with a careful, consistent approach, start with an evaluation. Our mental health team sees patients in person in West Ashley and by telehealth across South Carolina, and new patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber. If you are having thoughts of harming yourself, call or text 988 or call 911.
Frequently Asked Questions
Immediate-release Adderall lasts about four hours and is taken two or three times a day. Adderall XR uses beads that release in two stages and lasts most of the day from one dose.
Vyvanse is a long-acting prodrug the body converts slowly, giving smooth all-day coverage from one dose. Whether it is the better choice for you depends on your response and side effects.
No. When stimulant medication is clinically appropriate, our providers prescribe long-acting stimulants only.