How Do I Choose the Best ADHD Medication?

Short-Acting Stimulants Vs. Long-Acting Stimulants: Comparing ADHD Medications and Durations

The effects of ADHD medications may be felt immediately or hours after taking them. In different situations and scenarios, a child or adult with ADHD may benefit most from a short-acting stimulant or a long-acting stimulant. Here, we describe the differences and options.

Janice Rodden
By Janice Rodden Verified Medically reviewed by Walt Karniski, M.D. Reviewed on June 30, 2023
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There are two main types of medication used to treat ADHD: stimulants and non-stimulants. Stimulant medications are typically the first choice to treat ADHD symptoms because they work for 70-80% of people with attention deficit hyperactivity disorder (ADHD or ADD)1.

Within the class of stimulant ADHD medications, there are two main types: methylphenidates (Ritalin, Concerta, Daytrana, etc.) and amphetamines (Adderall, Vyvanse, Evekeo, etc.). Almost all stimulant medications are different forms of methylphenidate or amphetamine. The characteristics that differentiate them are as follows:

  • Form: Tablet, chewable tablet, orally disintegrating tablet, capsule, liquid, or patch
  • Delivery system: The chemical makeup of a long-acting medication, e.g., pulse delivery or continuous delivery
  • Duration: How long the medication lasts e.g., short-acting stimulants or long-acting stimulants

Short-Acting Stimulants vs. Long-Acting Stimulants

The effects of stimulant medications last for different lengths of time, though they are typically classified as one of the following:

  1. Short-acting stimulants: These medications start working within 30 to 45 minutes of administration and typically wear off in 3 to 6 hours.
  2. Long-acting stimulants: These medications work in phases to treat symptoms throughout the day. Part of the dose is immediate-release, meaning it goes into effect immediately. The rest of the dose is delayed-release, meaning it goes into effect several hours later. These stimulants typically wear off in 8 to 16 hours.

Stimulant medications enter the bloodstream quickly, then are filtered through the kidneys or liver and eliminated from the body fairly quickly2. Stimulants work by gradually increasing dopamine and norepinephrine levels and activity in the brain3. Long-acting stimulants are designed to go into effect and wear off gradually, which may reduce side effects or rebound effects.

How Long Does ADHD Medication Last?

The exact length of time a stimulant lasts depends on the patient’s metabolism. For example, long-acting stimulant medication may last for 8 hours or more. Mydayis lasts approximately 16 hours, based on information from the drug’s manufacturer. Some patients may feel its effects for 10 hours. Others may experience just six hours of symptom control. Jornay PM takes 10-12 hours before any beneficial effect is realized. This allows Jornay PM to be taken before bedtime. A dose given at 8 p.m. will begin to take effect around 6 a.m. – 7 a.m. the next morning and will then last into the afternoon or early evening.  So, in essence, this medication lasts around 36 hours but is effective for 10-12 hours.

Some people require a second, short-acting dose of medication in the afternoon or evening to alleviate symptoms after a daytime dose has worn off.  For them, and other ADHD patients, the following options are available. (View a comprehensive overview in this ADHD medication list.)

Short-Acting Methylphenidates and Typical Duration

Name Duration
Methylphenidate Methylin Liquid 3-4 Hours*
Ritalin 3-4 hours*
Dexmethylphenidate Focalin 4-6 hours*

Short-Acting Amphetamines and Typical Duration

 

Name Duration
Dextroamphetamine Dexedrine 3-4 hours*
ProCentra 3-6 hours*
Zenzedi 4-6 hours*
Amphetamine Adderall 4-6 hours*
Evekeo 4-6 hours*
Evekeo ODT 4-6 hours*

Long-Acting Methylphenidates and Typical Duration

Name Duration
Methylphenidate Aptensio XR 12 hours*
Concerta 12 hours*
Cotempla XR-ODT 12-13 hours*
Daytrana 10 hours with a 9-hour wear time**
Jornay PM 12-14 hours*
Metadate CD*** 8-10 hours*
Quillichew ER 12-13 hours*
Quillivant XR 12-13 hours*
Ritalin LA 8-12 hours*
Dexmethylphenidate Focalin XR 8-12 hours*

Long-Acting Amphetamines and Typical Duration

Name Duration
Amphetamine Adderall XR 10-12 hours*
Adzenys ER 10-12 hours*
Adzenys XR-ODT 10-12 hours*
Dyanavel XR 13 hours*
Mydayis 14-16 hours*
Dextroamphetamine Dexedrine ER 5-10 hours*
Xelstrym 4+ hours with a 9-hour wear time*
Lisdexamfetamine Vyvanse 10-13 hours*

*The medication’s estimated duration of action is based on information provided by the drug’s manufacturer. For any individual patient, this medication’s effects may last longer or shorter than indicated.

**Daytrana has been approved by the FDA for 9 hours of wearable time, but if left on longer, the patch will continue to emit methylphenidate for a total of approximately 24 hours. 

***Brand name Metadate CD was discontinued by its manufacturer in April 2017. However, multiple generics are available. 

How to Treat ADHD in Children: Next Questions

  1. What ADHD medications are used to treat children?
  2. Is ADHD medication right for my child?
  3. What are common side effects associated with ADHD medication?
  4. What natural treatments help kids with ADHD?
  5. How can I find an ADHD specialist near me?

View Article Sources

1 Advokat, Claire, et al. “Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers.” Frontiers in Neuroscience, 7: 82. 29 May 2013. doi: 10.3389/fnins.2013.00082
2 Understood. “ADHD Medication Rebound: What You Need to Know.” The Understood Team. Web. Accessed 17 June 2019.
3 NIDA. “Prescription Stimulants.” National Institute on Drug Abuse, 6 Jun. 2018, Web. Accessed 17 Jun. 2019.