ADHD Medication in Japan: Your Options, the Registration System, and the Concerta Shortage
Japan has four approved ADHD medications: methylphenidate (Concerta), atomoxetine (Strattera), guanfacine (Intuniv), and, for children only, lisdexamfetamine (Vyvanse). The two stimulants are dispensed through a nationwide registration system, and Concerta has been on limited shipment since September 2025. This article is part of our guide to ADHD in Japan.
Last updated October 16, 2026. Supply conditions change; we revise this article as they do.
What are the four options?
Two stimulants and two non-stimulants, and only the stimulants need registration.
| Medication | Type | Who can use it in Japan | Registration required? |
|---|---|---|---|
| Concerta (methylphenidate ER) | Stimulant | Children from age 6, and adults | Yes: doctor, pharmacy, and patient |
| Vyvanse (lisdexamfetamine) | Stimulant | Children (ages 6 to 17 to start); cannot be started in adults | Yes |
| Strattera (atomoxetine) | Non-stimulant | Children from age 6, and adults | No; generics available |
| Intuniv (guanfacine ER) | Non-stimulant | Children from age 6, and adults | No |
Two names you might expect are missing:
- Adderall is illegal in Japan (see our import-rules guide).
- Ritalin is sold here but approved only for narcolepsy.
How does the registration system work?
Your doctor, the dispensing pharmacy, and you are all registered before Concerta or Vyvanse can be dispensed. Concerta has been dispensed since December 2019 through a distribution management system (ADHD適正流通管理システム, ADHD tekisei ryutsu kanri shisutemu) that the manufacturer runs under the health ministry's approval conditions (in Japanese), and Vyvanse is handled through the same system under its own ministry notice. You are registered as a patient at the first prescription, with your identity checked and written consent, and you receive a patient card that the pharmacy checks at each dispensing.
Once you are registered, repeat prescriptions are routine. The registration is a pharmaceutical control run by the manufacturer, not a government register, and the usual medical confidentiality applies.
Where does the Concerta shortage stand?
Concerta has been on limited shipment since September 2025, and the manufacturer's latest notice says the restriction continues. The health ministry's notice (in Japanese) gives increased demand as the reason. Brand-name Strattera stopped new production in September 2024 after a nitrosamine impurity review, and the manufacturer expected its remaining stock to run out during 2025; generic atomoxetine remains available. The manufacturer's latest Concerta notice (in Japanese) says supply is improving gradually but is not yet enough, and asks prescribers to adjust the number of days supplied and to consider alternative medicines.
What this means for you:
- Already on Concerta in Japan: an earlier notice asked prescribers to hold off new starts and dose changes because many pharmacies were short of stock for existing patients; under the latest notice, your doctor may check how much you have left, adjust the number of days supplied, or suggest another medicine.
- Newly diagnosed and hoping to start Concerta: be prepared for a wait, a reduced initial supply, or a suggestion to start with a non-stimulant. Availability varies by clinic and by month, so ask before booking.
- Moving to Japan on methylphenidate: you can carry a personal supply under the psychotropic rules, with no advance permit within the allowance (import-rules guide), which gives you time to get registered here. Build in weeks of margin.
Are the non-stimulants real options?
Both non-stimulants are approved for adults, and neither label requires another medicine to be tried first.
- Atomoxetine: the dose is raised in steps over several weeks, and it gives steady coverage through the day; nausea is the most common side effect (patient guide).
- Guanfacine: the other non-stimulant, also taken once a day. It can lower blood pressure and cause drowsiness, so blood pressure and pulse are checked, and it should not be stopped abruptly (patient guide).
They work through different mechanisms, so a non-stimulant is not a weaker version of Concerta.
Concerta, Strattera, or Intuniv: which is right for me?
There is no universal winner; the three have different strengths, and the choice is individual.
| Concerta (stimulant) | Atomoxetine (non-stimulant) | Guanfacine (non-stimulant) | |
|---|---|---|---|
| Speed | Works from the first dose | Dose raised in steps over several weeks | Dose raised in steps at least a week apart |
| Effect | Somewhat larger average effect than atomoxetine in children; similar in adults (Cortese et al. 2018) | Steady through the day | Steady through the day |
| Coverage | About 12 hours, according to the Japanese label; can fade in the evening | Around the clock | Around the clock |
| Rules | Controlled medicine: registered doctors, pharmacies, and patients only | Ordinary medicine: any doctor, normal import rules | Ordinary medicine: any doctor, normal import rules |
| Habit-forming potential | Can be misused, so it is controlled (Class 1 psychotropic) | Not controlled; no dependence warning on the label | Not controlled; no dependence warning on the label |
| Getting it right now | Shipments restricted since September 2025 and still restricted under the latest notice; ask your clinic | Brand-name Strattera is no longer made; generic atomoxetine is prescribed | Not part of the Concerta restriction; ask your clinic |
Which non-stimulant is tried first depends on the symptoms that accompany the ADHD and on your doctor's judgment. Switching from one to another is possible.
Frequently asked questions
This article is general information, not medical advice for your individual situation. Decisions about medication belong in a consultation with a doctor who knows your history.
Medically reviewed by our psychiatrist (M.D.). Updated October 16, 2026.