Evekeo vs Focalin

Listen to the article instead of reading through it.

0:00

Introduction

For patients with Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy, certain drugs that alter the concentrations of neurotransmitters in the brain can assist in managing symptoms. Evekeo and Focalin are two such medications prescribed for these conditions. Both impact different neurotransmitters, but have similar effects on patients' attention spans and impulsivity levels. Evekeo is an amphetamine salt combo drug that works by affecting levels of norepinephrine and dopamine to enhance focus and attentiveness. On the other hand, Focalin is a dexmethylphenidate hydrochloride, acting as a potent norepinephrine-dopamine reuptake inhibitor (NDRI), primarily impacting dopamine's levels to increase concentration ability.

What is Evekeo?

Evekeo (Amphetamine Sulfate) and Focalin (Dexmethylphenidate Hydrochloride) are two different types of medications used primarily for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Evekeo is a type of amphetamine that was first approved by the FDA in 2012. It works by increasing levels of dopamine and norepinephrine within the brain, enhancing focus, attention span, and behavioral control. On the other hand, Focalin operates similarly but with more specificity towards dopamine reabsorption, effectively increasing its concentration in the nervous system. This property makes Focalin comparatively less likely to cause side effects such as anxiety or restlessness than drugs like Evekeo that also affect norepinephrine levels significantly.

What conditions is Evekeo approved to treat?

Evekeo is approved for the treatment of certain medical conditions such as:

Attention Deficit Hyperactivity Disorder (ADHD)
Narcolepsy, a chronic sleep disorder
Exogenous obesity, as a short term adjunct in weight reduction plans.

How does Evekeo help with these illnesses?

Evekeo helps manage symptoms of attention deficit hyperactivity disorder (ADHD) by increasing the amount of norepinephrine and dopamine accessible in the synapses of the brain. It achieves this by promoting the release of these neurotransmitters, so their levels can be kept elevated for longer periods. Both norepinephrine and dopamine are crucial in regulating attention, impulsivity, activity levels, and cognition among other things. Individuals with ADHD often have imbalanced levels of these neurotransmitters. Therefore, by enhancing norepinephrine and dopamine availability, Evekeo can mitigate the negative impacts of ADHD to improve concentration and reduce impulsivity or hyperactive behavior.

What is Focalin?

Focalin is a brand name for dexmethylphenidate, which is a norepinephrine-dopamine reuptake inhibitor (NDRI), meaning it increases the levels of norepinephrine (also called noradrenaline) and dopamine in the brain by reducing their reabsorption. It does this more selectively than other stimulant medications, targeting only one form of the methylphenidate molecule rather than both. This can lead to fewer side effects and potentially better efficacy. Focalin was first approved by the FDA in 2001 as an alternative treatment for Attention Deficit Hyperactivity Disorder (ADHD). As with all stimulant medications, it can have side effects including reduced appetite and difficulty sleeping. However, being more selective means that its side-effect profile might be slightly different from other ADHD drugs like Evekeo, such as possibly causing less jitteriness or restlessness. The effects on dopamine and norepinephrine can be beneficial for treating symptoms of ADHD especially in patients who do not respond well to "typical" stimulant drugs such as Evekeo.

What conditions is Focalin approved to treat?

Focalin is a medication that has been approved by the FDA for treatment of the following conditions:

Attention Deficit Hyperactivity Disorder (ADHD) in both children and adults
Narcolepsy, which causes excessive daytime sleepiness.

It's important to note that while Focalin can be highly effective for these conditions, it must be used under medical supervision due to potential side effects and risks associated with stimulant medications.

How does Focalin help with these illnesses?

Dopamine is a neurotransmitter that plays important roles in executive functions, motor control, motivation, reinforcement and reward perception. Focalin works by increasing the levels of dopamine available in certain areas of the brain, thereby enhancing concentration and attention span and reducing impulsive behavior. Its action on norepinephrine may also play a role in its effectiveness as an ADHD medication. Since it mainly affects dopamine levels (unlike Evekeo which impacts both dopamine and norepinephrine), it might be chosen for patients who have not responded well to other stimulant medications or could be combined with them for maximized benefits.

How effective are both Evekeo and Focalin?

Both amphetamine sulfate (Evekeo) and dexmethylphenidate hydrochloride (Focalin) have proven effectiveness in treating patients with attention deficit hyperactivity disorder (ADHD), and they were initially approved by the FDA several years apart. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The efficacy of Evekeo and Focalin in managing ADHD symptoms was directly studied in multiple clinical trials; both drugs exhibited similar efficacy in controlling symptoms of ADHD as well as promising safety profiles.

A 2007 randomized controlled trial demonstrated that Focalin is effective at alleviating symptoms of ADHD from the first week of treatment, that its side effect profile is manageable compared to many other stimulant medications, and that it is generally well-tolerated even across age groups. This same study reports that Focalin has become one of the most widely prescribed stimulant medications for children with ADHD due to its twice-a-day dosing schedule.

A review published in CNS Drugs indicated that Evekeo seems to be more effective than placebo in treating ADHD symptoms, showing similar efficacy to other commonly used stimulants such as methylphenidate or dextroamphetamine. Nonetheless, because Evekeo contains a racemic mixture of levo- and dextro-amphetamine while Focalin only contains dexmethylphenidate which tends to have fewer side effects - this makes it typically considered after or alongside these other treatments. However, due to its unique pharmacology including action on norepinephrine transporter besides dopamine transporters unlike Focalin's primary focus on dopamine transporters alone -- Evekeo might be an optimal treatment for patients who did not respond well or have adverse effects like insomnia or reduced appetite with exclusively dopamine-focused therapies.

abstract image of a researcher studying a bottle of drug.

At what dose is Evekeo typically prescribed?

Oral dosages of Evekeo for treating Attention Deficit Hyperactivity Disorder (ADHD) range from 2.5–40 mg/day, usually divided into two doses. For Focalin, the dosage varies depending on whether you're using the immediate-release or extended-release version. Immediate-release Focalin is typically started at 2.5 mg twice a day in children and can be titrated up based on response and tolerability, with a maximum dose of 20 mg/day. Extended-release Focalin (Focalin XR) is usually started at 5mg once daily in the morning for both children and adults, which can also be adjusted upwards as needed to a maximum of 40mg per day.

Find Top Clinical Trials

Choose from over 30,000 active clinical trials.

At what dose is Focalin typically prescribed?

Focalin therapy is typically initiated at a dosage of 2.5–5 mg/day. The dose can be gradually increased to a maximum of 20 mg/day, divided into two doses taken approximately 4 hours apart. If there's no response or insufficient improvement in symptoms after an initial few weeks on the lower dosage, the increase may be considered. However, it's essential not to exceed the maximum recommended daily dose of 20 mg. It should also be noted that Focalin should only be used under medical supervision and as part of a comprehensive treatment program for ADHD that may include counseling or other therapies.

What are the most common side effects for Evekeo?

Some common side effects of Focalin and Evekeo may include:

Nervousness, anxiety
Insomnia, sleep disturbances
Dizziness, jitteriness (unintentional trembling or shaking)
Decreased appetite
Nausea, stomach pain
Dry mouth
Sweating
Weight loss
Mood swings or aggression These medications can also potentially increase heart rate and blood pressure. It's crucial to monitor these parameters while on either medication. Persistent headaches should also be reported to your healthcare provider as they might indicate an adverse reaction.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Evekeo?

While both Evekeo and Focalin are effective medications for ADHD, they can have serious side effects in rare instances. For example:

An increased risk of mental/mood changes (such as agitation, aggression, mood swings, depression, hallucinations, suicidal thoughts or attempts)
Signs of an allergic reaction may occur such as hives; difficult breathing; swelling of your face, lips, tongue or throat
Changes in vision including blurry vision or difficulty focusing
Heart-related problems: fast/pounding/irregular heartbeat which may lead to serious (rarely fatal) heart issues
Low potassium levels - leg cramps, constipation irregular heartbeats
Severe nervous system reactions could include hyperactivity and restlessness

In extremely rare cases these drugs might cause serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin. Symptoms include: severe dizziness , nausea/vomiting/diarrhea , twitching muscles.

If you experience any of the above symptoms while on either medication stop using it immediately and consult with your healthcare provider.

What are the most common side effects for Focalin?

Focalin, a medication used to manage ADHD symptoms, can cause several side effects. These may include:

Dry mouth or throat
Stomach discomfort including nausea and loss of appetite
Sleep problems such as insomnia
Nervousness or anxiety
Increased heart rate
Dizziness or headaches
Weight loss due to decreased appetite Moreover, some individuals might also experience blurred vision, sweatiness and occasionally muscle or joint pain. Less common but more serious side effects could involve agitation and confusion. Always consult your healthcare provider if you notice any unusual changes while taking Focalin.

Are there any potential serious side effects for Focalin?

Focalin, while effective in treating ADHD, can sometimes lead to severe side effects. These may include:

Signs of allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
Heart problems: chest pain, trouble breathing, feeling like you might pass out
Psychiatric problems: new or worsening behavior problems, aggression, hostility, paranoia
Circulation issues such as numbness and changes in skin color (pale to blue)
Vision disturbances including blurred vision and increased sensitivity to light
Unexplained wounds on fingers or toes.

If any of these symptoms are experienced while taking Focalin it is important that the usage is stopped immediately and medical help is sought. It's also crucial to note that sudden discontinuation should be avoided without speaking with a healthcare provider due its potential withdrawal effect.

Contraindications for Evekeo and Focalin?

Both Evekeo and Focalin, in common with most other stimulant medications, may exacerbate symptoms of nervousness or anxiety in some individuals. If you notice your anxiety worsening, or an increase in restlessness or change in behavior, please seek immediate medical attention.

Neither Evekeo nor Focalin should be taken if you are currently using, or have recently used monoamine oxidase (MAO) inhibitors. Always inform your healthcare provider about all the medications you are taking; MAOIs will require a period of about two weeks to clear from your system to prevent dangerous interactions with both Evekeo and Focalin.

How much do Evekeo and Focalin cost?

For the brand name versions of these drugs:

The price of 60 tablets of Evekeo (10 mg) averages around $338, which works out to approximately $11.25/day for a typical dose.
The price for 30 capsules of Focalin XR (20 mg), on the other hand, is about $237, working out to roughly $7.90/day.

Thus, if you are in the higher dosage range for Evekeo (i.e., 20 mg/day or higher), then brand-name Focalin will be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which medication is right for you.

As with most medications, costs decrease significantly when considering generic versions:

Amphetamine sulfate (the generic version of Evekeo) can vary widely in cost depending on your insurance and pharmacy but typically ranges from about $0.50 to $2 per day.
Dexmethylphenidate HCL ER (generic Focalin XR) can also fluctuate in price based on multiple factors but generally falls within an approximate range from as low as $.75 up to about $3 per day.

Popularity of Evekeo and Focalin

Evekeo and Focalin are both stimulant medications used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD).

In its various forms, which include generic versions as well as brand names such as Evekeo, amphetamine was prescribed to about 4.7 million people in the USA in 2020. Amphetamine accounted for just over 10% of ADHD prescriptions in the US. It has been generally increasing in prevalence since it received FDA approval for treating ADHD.

On the other hand, dexmethylphenidate - more commonly known by brand name Focalin - was prescribed to approximately 2 million individuals within that same year. Dexmethylphenidate accounts for around 6% of all ADHD medication prescriptions nationwide and its use has remained relatively steady over recent years.

Conclusion

Both Evekeo (amphetamine sulfate) and Focalin (dexmethylphenidate) have established records of usage in patients with attention deficit hyperactivity disorder (ADHD), backed by numerous clinical studies indicating their efficacy compared to placebo treatments. In some cases, these medications may be combined, but this is subject to careful consideration by a physician due to potential contraindications. They operate via different mechanisms of action; Evekeo works by increasing the levels of norepinephrine and dopamine in the brain while Focalin primarily inhibits the reuptake of dopamine.

Evekeo is often used as a first-line treatment option for ADHD, whereas Focalin might generally be considered as an adjuvant therapy or for patients who did not respond well to first-line stimulants or need a medication with less potential for abuse due its single-isomer formulation.

Both drugs are available in generic form which can lead to significant cost savings for those paying out-of-pocket. The effects from both Evekeo and Focalin may not be noticeable immediately upon starting treatment so patience during this adjustment period could be required.

The side effect profile between the two drugs is relatively similar, though individual responses can vary significantly. These medications are typically well-tolerated but common side effects include decreased appetite, insomnia, abdominal pain and weight loss. As with any medication that affects neurotransmitter levels, it's important for patients on either drug to closely monitor their moods especially at the beginning of treatment - any signs such as increased agitation or mood swings should prompt immediate medical help.