Switching from Strattera to Concerta: Protocol and Considerations

Transition Protocol

• An immediate transition from Strattera to Concerta can be made without a washout period, as these medications have different mechanisms of action 1
• Start Concerta on the morning after the last dose of Strattera 1
• Initial Concerta dosing should be based on clinical assessment rather than direct conversion from atomoxetine dose, typically starting with lower doses and titrating up 1

Dosing Guidelines

• Typical starting doses for Concerta range from 18mg to 36mg once daily, depending on previous medication response and body weight 2
• Titrate Concerta dose as needed, with maximum daily doses typically not exceeding 54mg for children/adolescents or 72mg for adults 2

Managing Side Effects During Transition

• Nausea occurs in up to 25% of patients starting methylphenidate-based medications; taking Concerta with food may help reduce this side effect 1
• If oral tics develop with Concerta, consider adjunctive therapy with alpha-agonists such as clonidine or guanfacine 3

Special Considerations

• The once-daily dosing of Concerta may improve medication adherence compared to multiple daily dosing regimens 1
• Concerta has a lower potential for abuse compared to immediate-release stimulant formulations due to its specialized delivery system 1

Monitoring Recommendations

• Monitor vital signs regularly, as methylphenidate can cause small increases in blood pressure and heart rate 2