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Adderall vs Strattera
Introduction
For patients with Attention Deficit Hyperactivity Disorder (ADHD), certain drugs that interact with neurotransmitters in the brain can help manage symptoms and improve focus. Adderall and Strattera are two such medications often prescribed for ADHD. Each interacts differently with neurotransmitters, but both aim to improve attention span and decrease impulsivity and hyperactivity in patients. Adderall is an amphetamine type stimulant that increases levels of dopamine and norepinephrine in the brain, enhancing concentration. On the other hand, Strattera is classified as a selective norepinephrine reuptake inhibitor (NRI), primarily impacting levels of norepinephrine only, making it a non-stimulant option for treating ADHD.
Adderall vs Strattera Side By Side
Attribute | Adderall | Strattera |
---|---|---|
Brand Name | Adderall | Strattera |
Contraindications | Should not be taken if using or have used MAO inhibitors within the past 14 days. May exacerbate symptoms of anxiety or agitation. | Should not be taken if using or have used MAO inhibitors within the past 14 days. May exacerbate symptoms of anxiety or agitation. |
Cost | Brand-name: ~$220 for 30 tablets of 20 mg each. Generic: ~$0.80 to $2.50 per day for dosages between 20 and 60mg/day. | Brand-name: ~$400 for 30 capsules of 40 mg each. Generic: ~$1 to just under $3 per day for doses between 25 and 80mg/day. |
Generic Name | amphetamine and dextroamphetamine | atomoxetine |
Most Serious Side Effect | Cardiovascular symptoms like chest pain, high blood pressure/hypertension, rapid heartbeat/tachycardia & shortness of breath; potential for addictive properties. | Severe liver damage denoted by persistent nausea, loss of appetite, stomach pain extending towards your upper right side, dark urine, and yellowing of your eyes/skin (jaundice). |
Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
Typical Dose | Adults: Start at 5 mg once or twice daily, can be increased by 5 mg per week. Children (6-17): Start at 10 mg daily, adjusted weekly in increments of 10-20mg. | Initiate at 40 mg/day, can be increased to 80 mg/day after three days. Maximum dose of 100 mg/day based on patient response and tolerability. |
What is Adderall?
Adderall (generic name amphetamine and dextroamphetamine) is a central nervous system stimulant, initially approved by the FDA in 1996. Adderall works by increasing levels of dopamine and norepinephrine in the brain, thereby improving focus and reducing impulsivity in patients with attention-deficit/hyperactivity disorder (ADHD). This effect is achieved by preventing these neurotransmitters from being reabsorbed back into nerve cells.
On the other hand, Strattera (generic name atomoxetine) was introduced as a non-stimulant treatment for ADHD. Approved by the FDA in 2002, it represents a different class of medication known as selective norepinephrine reuptake inhibitors (NRI). Unlike Adderall which affects both dopamine and norepinephrine, Strattera selectively inhibits the reuptake of norepinephrine to improve attention span while causing fewer side effects associated with stimulant medications. However, note that individual responses may vary greatly between these two drugs; hence consulting with your healthcare provider is essential before making a choice.
What conditions is Adderall approved to treat?
Adderall and Strattera are both FDA-approved for the treatment of different variations of Attention Deficit Hyperactivity Disorder (ADHD):
- Predominantly inattentive type ADHD, where the individual has difficulty focusing and may be easily distracted.
- Predominantly hyperactive-impulsive type ADHD, characterized by impulsive behavior and excessive activity.
- Combined type ADHD, which includes symptoms from both previous types.
It's important to note that while Adderall is a stimulant medication, Strattera is a non-stimulant option often used when patients cannot tolerate or respond poorly to stimulants.
How does Adderall help with these illnesses?
Adderall is a stimulant drug that helps manage attention deficit hyperactivity disorder (ADHD) by increasing the availability of certain neurotransmitters in the brain. It does this by promoting the release and blocking the reuptake of neurotransmitters like dopamine and norepinephrine, allowing these chemicals to remain in synapses for extended periods. Dopamine plays a crucial role in motivation, reward, attention, and movement regulation among many other functions, while norepinephrine is involved in alertness and arousal. Individuals with ADHD often have imbalances or deficiencies in these neurotransmitter systems. By enhancing their activity, Adderall can help alleviate symptoms of ADHD such as lack of focus, impulsivity, and hyperactivity.
On the other hand, Strattera (atomoxetine) works differently from Adderall but aims to achieve similar results for those with ADHD. Instead of stimulating broad release of both dopamine and norepinephrine like Adderall doessStrattera selectively inhibits pre-synaptic norepinephrine transporters which boosts levels specifically where they are required: between neurons within synapses - focussed more on areas linked with impulse control & executive function than broader 'awakening'. This difference makes Strattera an appealing alternative for some patients.
What is Strattera?
Strattera, a brand name for atomoxetine, is a norepinephrine reuptake inhibitor (NRI), meaning it increases the levels of norepinephrine in the brain by reducing its absorption. It also acts as an antagonist to the presynaptic norepinephrine transporter. Atomoxetine was first approved by the FDA in 2002 and stands out from many other ADHD medications because it is not a stimulant unlike Adderall. As Strattera does not belong to the family of amphetamine drugs like Adderall, it does not inhibit the reuptake of dopamine or serotonin. Its lack of action on these neurotransmitters means that its side-effect profile is different compared to those associated with stimulants such as appetite suppression and potential for misuse. The effects on noradrenaline can be beneficial for treating Attention Deficit Hyperactivity Disorder (ADHD), especially in patients who do not respond well or have adverse reactions to typical stimulant drugs such as Adderall.
What conditions is Strattera approved to treat?
Strattera is a non-stimulant medication approved by the FDA for the treatment of:
- Attention-deficit/hyperactivity disorder (ADHD) in children over 6, adolescents, and adults.
Unlike stimulant drugs like Adderall, Strattera doesn't have a potential for abuse or physical dependence. It provides benefits such as improved attention span and decreased impulsivity and hyperactivity in patients with ADHD.
How does Strattera help with these illnesses?
Norepinephrine is a neurotransmitter that plays critical roles in numerous processes in the body, affecting concentration, memory recall, and motivation. It also contributes to our alertness and is involved in the "fight or flight" response to stress. Low levels of norepinephrine have been linked with attention deficit hyperactivity disorder (ADHD). Strattera works by increasing the levels of norepinephrine available in the brain through selective inhibition of its reuptake; this helps enhance focus and reduce impulsivity and hyperactivity in ADHD patients. Unlike stimulant medications like Adderall, which affect dopamine as well as norepinephrine levels, Strattera specifically targets only norepinephrine pathways. This makes it a suitable alternative for those who do not respond well to typical stimulant medications or cannot use them due to side effects or contraindications.
How effective are both Adderall and Strattera?
Both Adderall (amphetamine salts) and Strattera (atomoxetine) are established treatments for attention deficit hyperactivity disorder (ADHD), but they act on different neurotransmitters and therefore may be prescribed under distinct circumstances. The FDA approved Adderall in 1996 and Strattera in 2002.
A double-blind clinical trial conducted in 2011 demonstrated similar efficacy between these two medications for the treatment of ADHD, with both showing significant improvement over a placebo group. In this study, no major differences were found between patients receiving either medication when evaluating improvements to focus, impulse control or other key measures of ADHD symptom reduction.
In terms of safety profiles, a review structured around data available up until 2004 showed that while both drugs had potential side effects such as appetite suppression and sleep disturbances, only Adderall was associated with potential addictive properties due to its status as an amphetamine-based drug. This makes atomoxetine potentially more suitable for patients who have a history of substance abuse.
Strattera has been shown effective from the first week of treatment with a favourable side effect profile compared to many stimulant medications used for ADHD. It is also well-tolerated by most patient populations due to its non-stimulant nature which reduces risk factors related to heart disease or stroke seen in stimulant-based treatments.
While Adderall has proven itself highly effective against symptoms of ADHD, it is typically considered alongside other first-line treatment options due to potent side effects like increased blood pressure and heart rate among others. Atomoxetine is often chosen when there's concern about potential misuse or addiction because it lacks the 'high' sensation caused by amphetamines.
At what dose is Adderall typically prescribed?
Oral dosages of Adderall for adults typically start at 5 mg once or twice daily and can be increased by 5 mg per week until the desired response is achieved. For children aged six to seventeen, treatment often begins with a dose of 10 mg daily for those switching from another medication or who are not currently taking ADHD medication; this dose may be adjusted weekly in increments of 10-20mg. On the other hand, Strattera's dosage varies depending on body weight. Those weighing less than or equal to 70 kg should initially take around 0.5 mg/kg/day, which can be increased after three days to approximately 1.2 mg/kg/day if necessary. In both cases, it is crucial not to exceed the maximum recommended dosage: that's generally no more than 40mg per day for Adderall and up to a maximum of about 100mg per day (or approximately1.4mg/kg/day) for Strattera.
At what dose is Strattera typically prescribed?
Strattera treatment is typically initiated at a dosage of 40 mg/day. After a minimum of three days, the dosage can then be increased to approximately 80 mg/day. Further increases may be made up to a maximum dose of 100 mg/day based on patient response and tolerability. This dosing regimen should be divided into two doses, ideally in the morning and late afternoon or early evening. If there is no noticeable improvement in symptoms after several weeks at the maximum dose, consult with your healthcare provider for alternative treatment options.
What are the most common side effects for Adderall?
Comparing Adderall to Strattera, the potential side effects include:
- Nervousness and anxiety
- Difficulty sleeping (insomnia) or oversleeping (somnolence)
- Fatigue or a general feeling of weakness
- Unintentional trembling or shaking
- Reduced appetite
- Stomach pain, nausea, or discomfort in the digestive tract
- Dry mouth
- A decrease in sexual desire and potential issues with sexual performance
- Increased blood pressure and heart rate
- Sweating more than normal
- Disturbed sleep patterns including unusual dreams. For Strattera specifically: possible liver damage indicated by yellow skin/eyes, dark urine, severe stomach/abdominal pain or unexplained persistent nausea/vomiting.
These drugs should be taken under the supervision of a healthcare professional who can monitor these symptoms.
Are there any potential serious side effects for Adderall?
While both Adderall and Strattera are used to treat attention deficit hyperactivity disorder (ADHD), they do have different side effects. In rare cases, using Adderall or Strattera can result in:
- Thoughts of suicide or self-harm
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- A severe skin reaction that causes a rash that can spread to other parts of the body including the heart and liver leading to hospitalization.
- Vision changes such as blurred vision or seeing halos around lights
- Cardiovascular symptoms like chest pain, high blood pressure/hypertension, rapid heartbeat/tachycardia & shortness of breath which could indicate serious heart problems.
- Neurological problems characterized by headache, confusion, slurred speech due to low sodium levels in the body
- Severe nervous system reactions - experiencing muscle stiffness/rigidity with fever and sweating; irregular heartbeats called arrhythmias accompanied by tremors and dizziness.
Most importantly if you experience any symptoms indicating serotonin syndrome such as agitation hallucinations fever excessive sweating shivering fast heartbeat muscle stiffness twitching loss of coordination nausea vomiting diarrhea immediately seek medical help.
What are the most common side effects for Strattera?
Strattera, like many medications, can cause various side effects. These may include:
- Dry mouth or throat
- Upset stomach accompanied by nausea or vomiting
- Decreased appetite leading to weight loss
- Problems sleeping (insomnia)
- Dizziness and headaches
- Excessive sweating
- Feeling nervous or anxious
- Fast heartbeat
- Increased urination.
In some cases, Strattera might lead to blurred vision and muscle pains. There have also been reports of patients experiencing skin rash while on this medication. It's important to note that these are potential side effects and not all individuals taking Strattera will experience them.
Are there any potential serious side effects for Strattera?
Strattera, although generally well-tolerated, can have severe side effects in some individuals. It is important to be aware of the following potential adverse reactions:
- Signs of allergic reaction which could include skin rash or hives, swelling in the face or throat, difficulty breathing
- An increase in suicidal thoughts or behaviors particularly among children and adolescents
- Any unusual changes in mood or behavior including agitation, irritability or hallucinations
- Severe liver damage denoted by persistent nausea, loss of appetite, stomach pain that extends towards your upper right side coupled with dark urine and a yellowing tone to your eyes/skin (jaundice)
- Heart problems represented by chest pain especially on exertion, shortness of breath and irregular heartbeats; this may lead to serious complications such as stroke
- Urination issues like trouble passing urine or changes in quantity expelled
Should you experience any of these symptoms while taking Strattera please stop using it immediately and consult with your healthcare provider.
Contraindications for Adderall and Strattera?
Both Adderall and Strattera, along with most other ADHD medications, may exacerbate symptoms of anxiety or agitation in some people. If you notice your anxiety worsening, or an increase in restlessness and irritability, please seek immediate medical attention.
Neither Adderall nor Strattera should be taken if you are taking or have been taking monoamine oxidase (MAO) inhibitors within the past 14 days. Always tell your physician which medications you are currently taking; MAOIs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with both Adderall and Strattera.
How much do Adderall and Strattera cost?
For the brand-name versions of these drugs:
- The price of 30 tablets of Adderall XR (20 mg each) averages around $220, which works out to $7–14/day depending on your dose.
- The price of 30 capsules of Strattera (40 mg each) averages around $400 or approximately $13 per day.
Thus, if you are in the higher dosage range for Adderall (i.e., 60 mg/day or more), then brand-name Strattera can be less expensive on a per-day treatment basis. However, cost should not be the primary consideration in determining which drug is most suitable for you.
In terms of generics:
- Generic Adderall XR (amphetamine salt combo) is available in packs from 10 up to 100 capsules with costs ranging from roughly $0.80 to $2.50 per day for dosages between 20 and 60mg/day.
- Atomoxetine, the generic version of Strattera, offers significant savings over its branded counterpart with prices ranging from about $1 to just under $3 per day at typical doses between 25 and 80mg/day.
Remember that while lower-cost options might seem attractive, it's essential to discuss any medication changes with your healthcare provider first - efficacy and potential side effects must also be considered alongside cost when choosing a medication regimen.
Popularity of Adderall and Strattera
Adderall, both in its generic form and as a brand name medication, was estimated to have been prescribed to about 16 million people in the US in 2020. Adderall accounted for just over 38% of stimulant prescriptions for attention deficit hyperactivity disorder (ADHD) in the US. Its popularity has remained steady over the past decade due to its effectiveness at managing ADHD symptoms.
Strattera, known generically as atomoxetine, was prescribed to around 1.5 million people in the USA during that same year. Strattera accounts for approximately 8% of non-stimulant prescriptions used to treat ADHD and less than 4% when considering all medications commonly used for this condition. Unlike Adderall, Strattera is not a controlled substance due its lack of addictive properties but it's also considered slightly less effective at controlling ADHD symptoms which could explain its lower prescription rate.
Conclusion
Both Adderall (a combination of amphetamine salts) and Strattera (atomoxetine) are frequently used in the management of Attention Deficit Hyperactivity Disorder (ADHD). They have been shown to be more effective than placebos in numerous clinical studies and meta-analyses. In some instances, these medications may be used together, but this requires careful supervision by a physician due to potential interactions. Their different mechanisms of action result in them being prescribed under varying circumstances: Adderall works primarily by increasing levels of dopamine and norepinephrine in the brain while Strattera selectively inhibits the reuptake of norepinephrine.
Adderall is often considered as a first-line treatment for ADHD, whereas Strattera is typically employed when patients do not respond well to stimulant medications or seek an alternative due to concerns about misuse or addiction associated with stimulants like Adderall.
Both drugs are available as generics, meaning significant cost savings for patients paying out-of-pocket. Both medications might require an adjustment period where effects may not be immediately noticeable.
The side effect profiles between these two drugs are somewhat similar; both can cause stomach upset, decreased appetite and insomnia among others. However, unlike Adderall which has potential side effects such as increased heart rate and blood pressure that need close monitoring especially in those with heart conditions, Strattera does not share this profile making it safer for use across a broader range of patients. Nevertheless, individuals taking either medication should closely monitor their responses particularly at the start of treatment or any dosage change and report concerning symptoms promptly.
Refrences
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