Concerta Withdrawal

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Concerta, which is the brand name for methylphenidate hydrochloride, is a prescription stimulant medication used to treat symptoms of attention-deficit hyperactivity disorder (ADHD) in both adults and children. Chronic Concerta use can lead to a physiological dependence, which means that you need to take this prescription stimulant in order to avoid withdrawal symptoms. You can become dependent and experience Concerta withdrawal symptoms even if you are taking your medication exactly as prescribed; however, misusing or abusing Concerta can speed up the progression of dependence as well as lead to Concerta addiction.^1,2

Concerta Abuse and Misuse

When prescribed by a physician and taken exactly as directed, Concerta is a safe and effective prescription stimulant. But many people misuse or abuse Concerta for its euphoric and energizing effects.

Ways in which people may abuse or misuse Concerta include:²

Taking more than prescribed
Taking it more frequently than prescribed
Using it in a way other than prescribed (crushing and snorting or injecting)
Mixing it with other substances, such as alcohol
Taking someone else’s prescription

It is especially popular amongst high school and college students who may misuse prescription stimulants to enhance academic performance.2 This is because prescription stimulants like Concerta produce the following effects:^3,4

Increased alertness
Enhanced attention
Increased energy
Enhanced motivation
Improved cognition, memory, and learning

However, misusing or abusing Concerta can lead to many harmful consequences, such as:^2,3,5

Psychosis
Dangerously high body temperature
Stroke
Seizures
Paranoia
Cardiovascular events, such as heart failure

Misusing or abusing Concerta can also cause dependence, addiction, and withdrawal symptoms if you attempt to quit.

Concerta Dependence and Withdrawal

Chronic Concerta abuse causes complex physiological and neurological adaptations, also called neuro-adaptations. These adaptations are the body’s way of adjusting to or compensating for the effects of drugs.⁴ Eventually, and with repeated use, you’ll need more and more of the stimulant to get the same drug-induced effects, also known as tolerance. Using higher and higher doses of Concerta can then increase the risk of developing a dependence, which means you’ll experience uncomfortable withdrawal symptoms when you abruptly quit taking this drug.

Physiological dependence and addiction are not synonymous—addiction is a pattern of compulsive drug use—but dependence can contribute to the development of a Concerta addiction.

If you are dependent on Concerta and suddenly stop taking it, unpleasant withdrawal symptoms will emerge, making it much more tempting to continue use since taking Concerta will mitigate these unwanted symptoms. The time it takes to develop a Concerta dependence and addiction depends on many factors, such as:

Dose
Frequency of use
Combination with other drugs
Individual physiology
Method of administration

Rapid routes of Concerta administration, such as smoking, injecting, or snorting, can speed up the development of a tolerance and dependence on Concerta, as well as addiction.⁴

Concerta Withdrawal Symptoms

Like other prescription stimulant drugs, a person who is dependent on or addicted to Concerta will experience uncomfortable withdrawal symptoms if they stop taking the drug, such as depression, fatigue, and inability to feel pleasure.⁶ Symptoms of withdrawal from Concerta are generally opposite from the drug’s effects.

For those who are prescribed Concerta for ADHD, it increases concentration, focus, and energy levels. When you suddenly stop taking Concerta, you may experience drastic side effects or a “crash.” A crash is when your body experiences withdrawal symptoms due to having low levels of Concerta.⁷

Common Concerta withdrawal symptoms include:^3,4,6,8

Depression
Suicidal thoughts
Irritability
Anxiety
An inability to feel pleasure (anhedonia)
Mood swings
Paranoia
Lack of energy
Sleep disturbances
Intense Concerta cravings

Concerta withdrawal can be an uncomfortable process. If you are experiencing extremely intolerable feelings related to withdrawal, particularly suicidal thoughts, seek professional medical help immediately to assist you through the process.

Is Concerta Withdrawal Dangerous?

According to the Drug Enforcement Administration (DEA), methylphenidate is most closely related to cocaine, so the withdrawal syndrome can be intense and significant.⁹ The physical withdrawal symptoms associated with Concerta dependence aren’t necessarily dangerous but the psychological impact can be difficult to endure, especially if extreme depression or suicidal thoughts occur.

For this reason, 24/7 detox treatment is the safest option if you are going through severe Concerta withdrawal and are experiencing mental health concerns, such as depression, suicidal ideation, profound mood swings, anxiety, or otherwise.

The severity of Concerta withdrawal depends on:

Your history of Concerta withdrawal experiences
The presence of co-occurring disorders
Family history of substance addiction
History of trauma
Stress levels
Polydrug use

Withdrawal Timeline

The duration of withdrawal from Concerta varies, but generally speaking, most people who are dependent on Concerta will experience withdrawal symptoms within a few hours to several days after last use.¹⁰ The onset of Concerta withdrawal will depend on the method of administration. If you are taking a long-acting Concerta pill orally, then your Concerta withdrawal symptoms will be more delayed than those of someone injecting or smoking Concerta.

Concerta Detox Treatment

Because Concerta withdrawal syndrome is often an uncomfortable experience, it can be difficult to quit using Concerta on your own. That’s where professional detox treatment comes in. Detoxification is the first step on the continuum of care in which your Concerta withdrawal symptoms will be properly managed. The goal of detox is to achieve medical stabilization so that you can then begin substance abuse treatment.

Scheduling an appointment with a psychiatrist specializing in substance abuse or an addiction medicine physician is highly recommended. They will be able to refer you to the appropriate detox setting, based on your individual needs and stimulant addiction.

Inpatient detox provides you with around-the-clock care, which may be recommended if you have a severe Concerta addiction or are experiencing suicidal thoughts or severe depression. Conversely, outpatient detox involves attending scheduled meetings at a center or facility. A physician may choose to taper you off of Concerta, which means your dose will be gradually reduced to avoid withdrawal symptoms.

Detox is often not enough to maintain long-term abstinence from Concerta. It’s important to transition into a Concerta addiction treatment program where you will learn important coping strategies, relapse prevention skills, and emotional regulation skills, as well as learn to examine the connection between thoughts, feelings, and behaviors, such as Concerta abuse.

Concerta withdrawal is not easy, but you don’t have to handle it alone. If you are struggling with issues related to Concerta misuse, addiction, or experiencing withdrawal when attempting to stop, professional help is available. You can call our hotline at 800-681-1058 (Who Answers?) for more information.

Resources

Harvard Health Publishing. (2010). Methylphenidate (Concerta, Ritalin) for executive function.
National Institute on Drug Abuse for Teens. (2017). Prescription stimulant medications (Amphetamines).
National Institute on Drug Abuse. (2016). What classes of prescription drugs are commonly misused?
Substance Abuse and Mental Health Services Administration. (1993). Treatment for stimulant use disorder. Rockville, MD: SAMHSA/CSAT.
Lakhan, S. E., & Kirchgessner, A. (2012). Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects. Brain and Behavior, 2(5), 661–677. https://doi.org/10.1002/brb3.78
National Institute on Drug Abuse for Teens. (2017). Prescription stimulant medications (Amphetamines).
Healthline. (2017). Managing Concerta Crash: What You Need to Know.
Ferreira R, Bassi GS, Cabral A, Nobre MJ. Withdrawal from methylphenidate increases neural reactivity of dorsal midbrain. Neurosci Res. 2010 Dec;68(4):290-300. doi: 10.1016/j.neures.2010.08.009. Epub 2010 Sep 9. PMID: 20832433.
Drug Enforcement Administration. (2019). METHYLPHENIDATE
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Publishing.
Substance Abuse and Mental Health Services Administration (2013). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol (TIP 45).