Choices, Choices: Will Short-Acting or Long-Acting Stimulants Be Best For You?

Short-Acting vs Long-Acting Stimulants
An Adult ADHD patient juggling short-acting and long-acting stimulants to decide which is the best treatment for him.

When Stimulant Medication Is Advised For Your ADHD Treatment, How Do You Know If Extended-Release or Immediate-Release Stimulants Are a Better Fit For Your Life?

Albert Hernandez

October 5, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 19, 2022
  5 min read

October 5, 2021
 Medically Reviewed by Tanya Hernandez, PMHNP-BC
Updated on: October 19, 2022
  5 min read


When you are diagnosed with ADD/ADHD, stimulants such as Adderall, Vyvanse, or Concerta are often prescribed to help you manage your symptoms. Stimulant medication may help with symptoms of ADD/ADHD such as:

  • Inability to focus
  • Restlessness/inability to sit still
  • Trouble paying attention
  • Making mistakes or missing details at work or school
  • Talking over people and not letting people take their turn at the conversation
  • Acting impulsively/acting without thinking through what may happen

Due to these symptoms, adults with ADHD can experience:

  • Reprimands at work
  • Feeling disconnected as a parent
  • Financial stress in the form of debt or late/forgotten bill payments
  • Problems connecting sexually with their partner
  • Guilt
  • Exhaustion

Many patients find that when they begin taking a stimulant medication to treat their ADHD, their symptoms improve during the release period of the first medication dose taken. 

How Do Stimulants Work to Treat ADD/ADHD?

Stimulants like Concerta, Adderall, and Vyvanse work on neurotransmitters, or brain chemicals, in your brain. When a person has ADHD, the neurons in your brain don’t talk to each other as well as they should.

Stimulant medications specifically impact the brain chemicals dopamine and norepinephrine. Different medications will work differently for each patient. Your behavioral health prescriber will work with you to determine if the first stimulant medication you try is having the desired influence on your ADHD symptoms. 

Difference Between Immediate-Release Stimulants and Extended-Release Stimulants

Stimulant medication for ADHD can come in a long-acting formulation or an immediate-release (short-acting) formulation. Short-acting stimulants start working around 30-45 minutes after being swallowed. The effect of immediate-release stimulants on ADHD symptoms can be three to four hours long. Extended-release ADHD medications last for longer than immediate-release medications; Concerta, for example, can have effects for up to 12 hours. Depending on the design of the extended-release medication, it can also have immediate effects on ADHD symptoms.

Immediate versus Extended Release Stimulants for ADHD

Advantages of Extended-Release Stimulants for ADHD

Some of the reasons patients and prescribers like extended-release stimulants are:

  • Convenience of dosing: Only having to take a medication once a day is more convenient for many patients. You won’t have to remember to take a second dose while at work or worry about where to store your medication outside of your home. Patients have been shown to have an easier time sticking with their medication schedule when they only have to take one dose daily. 
  • Less likely for medication to be misused: Stimulants seem to be less likely to be given to others or used recreationally when they are in the long-acting form. 
  • Lower abuse/dependence risk: Due to the more steady release of the medication into the bloodstream, extended-release stimulants have a lower risk for abuse than immediate-release stimulants. When patients take stimulants as prescribed and don’t abuse them, there is less risk for substance addiction. 

Advantages of Immediate-Release Stimulants for ADHD

On the other hand, in some cases, patients might prefer a short-acting stimulant. Some reasons are:

  • If you only need ADHD symptom relief for a short period of time: If a patient’s job or school demands require focus for a three- or four-hour period, then an immediate-release stimulant may meet their needs. Then they will be able to have the focus they need for that period of time without having to worry about side effects like trouble falling asleep.
  • May be easier to make dosing changes: If a patient and prescriber are going to work together to see what medication and dose of a stimulant is going to be used to treat a patient’s ADHD, they may start with an immediate-release medication. Then it can be simpler for the provider to make dose or medication changes as the patient sees how the medication works for them. 

Will an Immediate-Release Stimulant or an Extended-Release Stimulant Be a Better Fit For Me?

A patient with Adult ADHD that is deciding between short-acting and long-acting stimulants.

For many adults with ADHD, the most convenient and best choice for their treatment will be an extended-release stimulant, like Adderall, Vyvanse, or Concerta. The ease of once-daily dosing and the lower risk of addiction or misuse makes extended-release stimulants a good fit for a lot of my patients. Others might find that they only need ADHD symptom management for a short period of time. Especially if that time is later in the day, an immediate-release stimulant, such as Ritalin, might be a better option. 

As with any medication choice, it’s important to work with an experienced provider to make decisions about your care. When choosing whether an extended-release stimulant or immediate-release stimulant will be best for your ADHD symptoms, you should work with a board-certified behavioral health expert. Working with a behavioral health expert who specializes in adult ADHD treatment is best. That way, you know your provider has the experience and education to help guide you to the medication that is right for you.

The providers at Upper Valley Behavioral Health have treated many adults with ADHD. Are you ready to be seen by our expert team? Please click here to fill out our short application for treatment. We see patients in El Paso, TX, Las Cruces, NM, and Albuquerque, NM.

I know that ADHD symptoms can have devastating consequences. Symptoms don’t go away on their own. Many of our patients feel a sense of relief just from talking to a friendly, empathetic expert, and they really notice a difference when they begin their ADHD medication. If we are able to see patients in your area, apply today to be treated for your ADHD. 

Disclaimer: This post is for informational purposes only. It does not replace instructions from your licensed prescriber. Please consult your healthcare provider for guidance on your specific medication regimen.

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