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Concerta: Signs, Symptoms & Side Effects of Abuse

Written by Rob Alston

& Medically Reviewed by Dr. Jessica Pyhtila, PharmD

Medically Reviewed

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Last Updated - 03/10/2022

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Updated 03/10/2022

Key Takeaways

  • Concerta is a Schedule II controlled substance used mainly for ADHD.
  • The drug is commonly misused and abused, regardless of whether a person has a prescription.
  • Short-term side effects of Concerta reflect its role as a stimulant that triggers the fight-or-flight response.
  • Over the long term, Concerta misuse can be dangerous because the body is in a chronic fight-or-flight state.
  • Overdose of Concerta can be deadly and is a medical emergency.
  • Both behavioral and drug-seeking signs may alert you to someone struggling with Concerta.

Concerta misuse can lead to short and long-term side effects that dangerously rev up the central nervous system.

Concerta is one of the brand names for the drug methylphenidate. As a central nervous system stimulant, Concerta is mainly used to treat attention-deficit hyperactivity disorder or ADHD. The drug is commonly used in ADHD and can help people with the disorder. Unfortunately, it also has a high risk of abuse and is, therefore, a Schedule II controlled substance. Although most people prescribed Concerta will use it appropriately, some people may misuse it.

Further, Concerta is sometimes abused by people who do not have a prescription and use the drug illicitly. If you or a loved one are concerned about someone’s Concerta use, knowing the signs and symptoms of possible abuse is important.

Concerta Side Effects

Most of Concerta’s side effects reflect its mechanism as a central nervous system stimulant. Concerta works by increasing the levels of the brain chemicals dopamine and norepinephrine. While dopamine can cause euphoria, norepinephrine can trigger the body’s fight-or-flight response. In adults, the most common side effects of Concerta are:

Common Concerta Side Effects

Decreased appetite


Dry mouth


Problems sleeping



Weight loss



Short-Term Side Effects

Over the short term, side effects of Concerta abuse are similar to those of other stimulants. Concerta works in part by increasing brain chemicals like norepinephrine, which stimulates the body. These chemicals activate the sympathetic nervous system and the fight-or-flight response. Short-term side effects are often similar to the fight-or-flight response and include:

  • High blood pressure
  • Fast heart rate
  • Elevated body temperature
  • Decreased need for sleep
  • Loss of appetite

Long-Term Side Effects

Abuse of stimulants like Concerta over the long term can lead to many medical problems. The body is not designed to be in permanent fight-or-flight mode like Concerta abuse can cause. Because the body is constantly stimulated and the sympathetic nervous system is always active, problems can result. These include:

  • Hostility
  • Paranoia
  • Malnutrition
  • Cardiovascular problems like stroke

Concerta Overdose Symptoms

Concerta overdose symptoms are similar to those of other stimulants. This is mainly because stimulants work by increasing activity in the central nervous system, and overdose symptoms reflect that. Symptoms include:

Symptoms of Concerta Overdose



Dry mouth

Twitching muscles

Seizure or convulsion






Fast heartbeat

Pounding heart

Irregular pulse

High blood pressure

Wide pupils

It is crucial to seek emergency medical attention if you think someone has overdosed on Concerta. People have died from heart attack and stroke after a stimulant overdose. If you are unsure what to do, call 911 or Poison Control at (800) 222-1222. You may also seek help at a detox center. Because Concerta is a long-acting drug that keeps releasing for hours after the last dose, symptoms could worsen and become deadly.

How Is Concerta Abused?

Concerta is commonly abused or misused. Up to 25% of people prescribed a stimulant like Concerta misuse the drug. Most often, people take more of the drug than was prescribed. However, sometimes people without prescriptions for Concerta obtain the medication as well, either by stealing or buying it from people with a prescription. Most people who use stimulants like Concerta illicitly are under the age of 25 and get the drug from a friend. People without prescriptions for Concerta often take the drug to:

  • Stay awake
  • Improve attention
  • Be alert
  • Feel less drunk after drinking
  • Get high
  • Suppress appetite
  • Prevent withdrawal from other stimulants, such as cocaine

Concerta is designed to only be taken orally. The medicine has a complex drug-release system that requires fluid to slowly push the drug out of the tablet over the course of hours. It does not work well if it is not used in this manner.

For this reason, Concerta is generally only taken by mouth and not other routes. Attempts to take the drug by other routes like snorting does not cause a high due to the complex drug design. However, other forms of methylphenidate may be snorted or injected.

Dangerous Drug Interactions

Concerta has several dangerous drug-drug interactions. These include:

Concertas Interactions with other Drugs

Monoamine Oxidase Inhibitors, or MAOIs

Using Concerta within 14 days of using an MAOI can cause dangerous spikes in blood pressure. Although rarely used, MAOIs include:

Isocarboxaxid, brand name Marplan

Phenelzine, brand name Nardil

Selegiline, brand names Emsam and Zelapar

Tranylcypromine, brand name Parnate


These drugs are designed to increase blood pressure. They are rarely given outside the hospital and include:






Concerta can increase the amount of this blood thinner in the body, leading to a higher risk of bleeding.

Seizure Drugs

Concerta may increase the concentration of certain seizure drugs in the body. Although seizure drugs are most often used to prevent seizure, they can sometimes be used for other health problems. Seizure drugs that may interact with Concerta are:





Concerta may increase the level of some antidepressants, like:


Sertraline, brand name Zoloft

Fluoxetine, brand name Prozac

Escitalopram, brand name Lexapro

Further, the amount of Concerta in the blood may also be increased by some drugs. These include:


Drinking alcohol with Concerta is risky for many reasons. Besides increasing the amount of Concerta in the body, combining the substances may make a person feel less drunk than they really are. This can be very dangerous if they decide to drive a car because they think they are sober.

Antipsychotic Drugs

These drugs can be used for many different mental health conditions and include:

Aripiprazole, brand name Abilify

Olanzapine, brand name Zyprexa

Risperidone, brand name Risperdal

Ziprasidone, brand name Geodon


This drug is sometimes used for mood and depression. However, it can also be used to help stop smoking. Because bupropion can increase seizure risk, combining it with Concerta, which can also increase seizure risk, may be dangerous.


Cannabis and cannabis-containing drugs can increase the level of Concerta in the body. Because cannabis can increase heart rate, and so can Concerta, they may have an additive effect on the heart.

Signs Of Concerta Addiction

Someone struggling with Concerta use may start showing symptoms. Many symptoms reflect attitude and behavior and are common to substance abuse regardless of the drug being used. Substance abuse symptoms include:

Signs of Concerta Abuse

Being socially withdrawn

Avoiding family or old friends

Sending an abnormal amount of time with new friends

Losing interest in things that once gave pleasure

Having mood swings

Acting irritable

Having difficulty sleeping, or sleeping at strange times

Forgetting appointments

Missing deadlines

Having problems at work or school

Having problems with family

Acting recklessly

Having legal problems

Because Concerta is a Schedule II controlled substance, doctors must prescribe it as a 30 day supply with no refills. Many people who misuse Concerta show what are called drug-seeking behaviors around medical staff. These behaviors include:

  • Constantly asking their doctor to write a new prescription before one is due
  • Asking the pharmacy to fill Concerta early
  • Claiming the pharmacy did not give as much Concerta as they were supposed to
  • Saying they lost their Concerta
  • Seeking Concerta prescriptions from multiple doctors
  • Trying to fill a fake Concerta prescription at the pharmacy
  • Going to an urgent care or the emergency room for a prescription

Related Topic: How long does it take to detox from methylphenidate?

View Sources

Substance Abuse and Mental Health Services Administration. “Adults With Attention Deficit Hyperactivity Disorder and Substance Use Disorders.” Fall 2015. Accessed October 6, 2019.

Drug Enforcement Administration. “Methylphenidate.” July 2019. Accessed October 5, 2019.

National Institute on Drug Abuse. “Stimulant ADHD Medications: Methylphenidate and Amphetamines.” January 2014. Accessed October 5, 2019.

U.S. National Library of Medicine. “Concerta.” August 15, 2019. Accessed October 6, 2019.

Jaffe, Steven L. “Failed Attempts at Intranasal Abuse of Concerta.” Journal of the American Academy of Child and Adolescent Psychiatry, January 2002. Accessed October 6, 2019.