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Focalin vs Intuniv
Introduction
For patients with attention-deficit/hyperactivity disorder (ADHD), certain drugs that alter the concentrations of compounds in the brain, called neurotransmitters, can help manage symptoms and improve focus. Focalin and Intuniv are two such drugs which are often prescribed for ADHD treatment. They each impact different neurotransmitters in the brain but both enhance concentration and decrease impulsivity in patients with ADHD. Focalin is a dopamine reuptake inhibitor (DRI), affecting levels of dopamine by blocking its reabsorption into the neurons in the brain hence increasing its availability. On contrary, Intuniv acts as an agonist to alpha-2A adrenergic receptors; it helps lower norepinephrine levels decreasing overstimulation of these receptors thereby promoting calmness.
Focalin vs Intuniv Side By Side
| Attribute | Focalin | Intuniv |
|---|---|---|
| Brand Name | Focalin | Intuniv |
| Contraindications | Should not be taken with MAOI antidepressants or within 14 days of stopping an MAOI. May increase anxiety or agitation. | Should not be taken with MAOI antidepressants or within 10 days of stopping an MAOI. May increase anxiety or agitation. |
| Cost | For the brand name, around $270 for 30 tablets of 10 mg. Generic versions range between $0.75 - $1.50 per day. | For the brand name, around $330 for 30 tablets of 2 mg. Generic versions range from about $0.90/day up to around $3/day. |
| Generic Name | Dexmethylphenidate | Guanfacine |
| Most Serious Side Effect | Unusually aggressive behavior, signs of allergic reactions, vision changes, uneven heartbeats, severe neurological reaction. | Signs of an allergic reaction, chest pain or pressure, hallucinations, uncontrolled movements, light-headed feeling, signs of liver problems. |
| Severe Drug Interactions | MAOI antidepressants due to their influence on neurotransmitters in the brain. | MAOI antidepressants due to their influence on neurotransmitters in the brain. |
| Typical Dose | Oral dosages range from 2.5–40 mg/day, with a starting dose of 10 mg/day usually effective. | Initiated at 1mg/day, can be increased weekly by increments of 1 mg up to a maximum of 4mg/day. |
What is Focalin?
Dexmethylphenidate (the generic name for Focalin) is a potent central nervous system (CNS) stimulant and was the first drug of its kind to be used in the treatment of attention deficit hyperactivity disorder (ADHD). It was approved by the FDA in 2001. Focalin works by increasing levels of dopamine and norepinephrine within the prefrontal cortex of the brain, effectively enhancing focus and reducing impulsivity. It's typically prescribed for ADHD patients who have not responded well to other treatments.
On the other hand, Guanfacine (the generic name for Intuniv) represents a completely different class of drugs known as alpha-2 adrenergic agonists. Unlike Focalin, Intuniv doesn't stimulate CNS; instead, it reduces nerve impulses in your heart and blood vessels. It helps lower high blood pressure by decreasing heart rate and relaxing blood vessels which allows your heart to pump more efficiently.
The two medications are often prescribed together because they affect different neurotransmitters – Focalin primarily affects dopamine while Intuniv impacts norepinephrine – resulting in more comprehensive symptom management with fewer side effects than if either were taken alone.
What conditions is Focalin approved to treat?
Focalin and Intuniv are both approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD), but they function differently:
- Focalin, a stimulant medication, is used to treat all types of ADHD in patients aged 6 years and above.
- Intuniv, on the other hand, is a non-stimulant drug that's approved for treating ADHD in children between ages 6 to 17. It can be used alone or combined with stimulant medications.
How does Focalin help with these illnesses?
Focalin helps manage ADHD by increasing the amount of dopamine and norepinephrine available in the synapses of the brain. It does this by blocking their reuptake into neurons, so levels can be maintained higher for longer periods. Dopamine and norepinephrine are neurotransmitters that play important roles in attention, focus, impulse control, and executive function. In individuals with ADHD, it is believed there may be insufficient amounts of these neurotransmitters available within certain areas of the brain. Therefore, by increasing dopamine and norepinephrine availability through reuptake inhibition, Focalin can help limit symptoms associated with ADHD such as distractibility or impulsivity to help patients better manage their condition.
What is Intuniv?
Intuniv is a brand name for guanfacine, which is an alpha-2A adrenergic receptor agonist. This means it works by stimulating receptors in the brain that help reduce blood pressure, and it's primarily used to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents.
Guanfacine was first approved by the FDA in 2010 specifically for treating ADHD. Unlike Focalin, which is a stimulant drug that increases dopamine levels in the brain, Intuniv does not work by increasing dopamine levels. Instead, its action on the alpha-2A adrenergic receptor helps reduce hyperactive and impulsive behaviour while improving attention span.
This different mechanism of action also results in a differing side effect profile from stimulant drugs like Focalin. In particular, Intuniv has been noted to cause less insomnia than stimulant medications and it doesn't carry the risk of abuse or dependency associated with these types of drugs as well.
What conditions is Intuniv approved to treat?
Intuniv has been approved by the FDA for use in managing symptoms of:
- Attention Deficit Hyperactivity Disorder (ADHD)
- It is often used as part of a total treatment plan, including psychological, educational and social measures. Unlike many ADHD medications, Intuniv is non-stimulant and works to reduce symptoms such as interrupting or intruding on others, failing to give close attention to details or making careless mistakes in schoolwork.
How does Intuniv help with these illnesses?
Intuniv, known generically as guanfacine, is a type of medication that works on the central nervous system and acts primarily by stimulating receptors in the brain known as alpha-2A adrenergic receptors. These are involved in multiple neurological processes, including attention and impulse control. By activating these receptors, Intuniv helps to reduce hyperactivity and improve focus in patients with Attention Deficit Hyperactivity Disorder (ADHD). Unlike Focalin which primarily increases levels of dopamine—a neurotransmitter associated with pleasure, reward and concentration—Intuniv does not significantly affect dopamine levels. This makes Intuniv a good choice for those who do not respond well to stimulant medications like Focalin or for whom such medications may not be suitable due to their side effect profiles or potential for abuse.
How effective are both Focalin and Intuniv?
Both dexmethylphenidate (Focalin) and guanfacine (Intuniv) are effective in treating symptoms of attention-deficit/hyperactivity disorder (ADHD). They were approved by the FDA only a few years apart, with Focalin gaining approval in 2001 and Intuniv in 2009. These medications act on different neurotransmitters, thus they may be prescribed under varying circumstances depending on the specific needs of the patient.
The effectiveness of Focalin and Intuniv has been studied extensively. A randomized controlled trial conducted in 2012 suggested both drugs had similar efficacy for ameliorating ADHD symptoms but showed some differences in side effect profiles. Interestingly, none of the standard metrics used to measure effectiveness at managing ADHD symptoms differed significantly between patients receiving Focalin or those receiving Intuniv.
In terms of side effects, a review published in 2015 found that although both drugs can cause sleepiness and dizziness, these effects seemed more prominent with Intuniv use compared to Focalin use. However, it's worth noting that while stimulants like Focalin can sometimes increase anxiety levels or impact sleep patterns negatively due to their stimulating properties; non-stimulant options like Inutinv have less chance causing such secondary issues.
A recent meta-analysis published in 2020 indicated that both medications seem quite effective when compared against placebo treatment groups for managing ADHD symptoms; however certain situations might make one drug preferable over another based off its unique pharmacological profile: For example, if a child is having trouble sleeping as well as focusing during school hours - Guanfacine could potentially offer therapeutic benefits without further exacerbating insomnia problems often associated with other common stimulant-based treatments.
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At what dose is Focalin typically prescribed?
Oral dosages of Focalin range from 2.5–40 mg/day, but studies have shown that a starting dose of 10 mg/day is usually effective for treating attention deficit hyperactivity disorder (ADHD) in most people. Children and adolescents may be started on a lower dosage depending on their weight and response to the medication. In either population, dosage can be increased after one week if there is insufficient response. The maximum daily dose should not exceed 40 mg/day under any circumstances.
On the other hand, oral dosages for Intuniv can range between 1-4mg per day with an initial recommended dosage of 1mg/day for children/adolescents aged six to seventeen years old suffering from ADHD. This dosage can be adjusted upwards by increments of no more than 1mg every week until optimal effect is achieved or side effects become bothersome; however, it must not exceed the maximum limit of 4 mg/day.
At what dose is Intuniv typically prescribed?
Intuniv treatment is typically initiated at a dosage of 1mg/day. Depending on the patient's response and tolerability, the dose can be increased weekly by increments of 1 mg. The medication should ideally be taken once daily in the morning or evening at approximately the same time each day. The maximum recommended dose is 4mg/day which may be tested if there is no adequate improvement after several weeks on lower doses. It's important to take Intuniv consistently, either with or without food, as sudden discontinuation can cause a rapid increase in blood pressure.
What are the most common side effects for Focalin?
Common side effects of Focalin as opposed to Intuniv may include:
- Anxiety and nervousness
- Difficulty sleeping (insomnia)
- Drowsiness or fatigue
- Loss of appetite
- Nausea, indigestion, stomach pain
- Sweating excessively
- Dry mouth
- Headache and dizziness
- Weight loss
- Mood swings, irritability
On the other hand, common side effects of Intuniv can include:
- Sleepiness/drowsiness (somnolence)
- Slow heart rate (bradycardia)
- Low blood pressure (hypotension), feeling dizzy when standing up quickly from a sitting position.
- Fatigue/weakness
Remember that each individual's reaction to medication is unique. If you observe any adverse reactions or if your symptoms do not improve after taking these medications as prescribed, consult with your healthcare provider immediately.
Are there any potential serious side effects for Focalin?
While Focalin and Intuniv are both prescribed for attention deficit hyperactivity disorder (ADHD), they do carry different side effects. Here's what to watch out for with Focalin:
- Unusually aggressive behavior or hostility
- Signs of allergic reactions such as hives, difficulty breathing, swelling in your face or throat.
- Vision changes including blurred vision, eye pain or redness, seeing halos around lights;
- Uneven heartbeats, palpitations in your chest, shortness of breath and sudden dizziness;
- Lowered sodium levels: headache, confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady
- Severe neurological reaction - rigid muscles high fever sweating confusion fast or uneven heartbeats tremors fainting.
And here's what you should know about the potential side effects from using Intuniv:
- Thoughts about self-harm or suicide especially among children adolescents and young adults.
- Hypersensitivity reactions like skin rash hives difficulty breathing facial/tongue/throat swelling which could potentially be life-threatening;
- Blurred vision tunnel vision eye pain/swelling/seeing halos around lights
- Rapid heartbeat fluttering in the chest shortness of breath faint-like feelings
- Hyponatremia symptoms: headache confusion lack of energy weak/unsteady feeling accompanied by nausea/vomiting/seizures/breathing difficulties/coma.
In case any of these signs appear while on either medication you should contact your healthcare provider immediately.
What are the most common side effects for Intuniv?
Intuniv, another medication used in the management of ADHD, may have different side effects. Some users might experience:
- Dry mouth or a sore throat
- Drowsiness and fatigue
- Nausea and stomach pain
- Constipation or other digestive issues
- Sleep disturbances such as insomnia
- A slower heart rate rather than an increased one
- Potential for lowered blood pressure causing dizziness
- Weight gain instead of weight loss While every patient's response to medication is individual, it's crucial to be aware of the potential side effects when choosing between Focalin and Intuniv.
Are there any potential serious side effects for Intuniv?
Intuniv, which is usually well-tolerated by most individuals, can occasionally produce serious side effects. If any of the following symptoms manifest while on Intuniv:
- Signs of an allergic reaction such as hives; difficult breathing; swelling of your face, lips, tongue or throat
- Chest pain or pressure, fainting with a slow heartbeat
- Hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility
- Uncontrolled movements or vocal outbursts (tics)
- A light-headed feeling like you might pass out
- Signs of liver problems including nausea and vomiting that doesn't go away, loss of appetite, stomach pain on the upper right side, dark urine and yellow skin/eyes
Immediately consult with your healthcare provider if you experience any adverse reactions to ensure early detection and proper medical intervention.
Contraindications for Focalin and Intuniv?
Both Focalin and Intuniv, along with most other ADHD medications, may increase anxiety or agitation in some individuals. If you notice your symptoms worsening, or an increase in hostile behavior or suicidal ideation, please seek immediate medical attention.
Neither Focalin nor Intuniv should be taken if you are taking a type of antidepressant called a monoamine oxidase inhibitor (MAOI), have stopped taking an MAOI within the last 14 days for Focalin and within the last 10 days for Intuniv. Always inform your physician about any medications you're currently using; this is because MAOIs can interact dangerously with both drugs due to their influence on neurotransmitters in the brain.
How much do Focalin and Intuniv cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Focalin XR (10 mg) averages around $270, which works out to approximately $9 per day.
- The price for a one-month supply (30 tablets) of Intuniv (2 mg) averages about $330, equating to roughly $11/day.
Thus, if you are on an average dosage regime for either medication, then branded Focalin is less expensive on a daily treatment basis. It's important to remember that cost should not be a primary consideration in determining which drug is right for you—efficacy and tolerability also matter significantly.
For the generic versions Dexmethylphenidate (Focalin) and Guanfacine ER (Intuniv), costs will tend to be lower:
- Generic Focalin comes in packs from 100 capsules with approximate costs ranging between $0.75 - $1.50 per day depending on dosages from 5mg up to even 40mg per day.
- Guanfacine ER is available typically starting at packs of 60 tablets with cost varying from as low as about $0.90/day up to around $3/day based on typical dosages ranging between 1mg -4mg per day.
Bear in mind prices can vary widely based upon pharmacy location and insurance coverage among other factors.
Popularity of Focalin and Intuniv
Dexmethylphenidate, in generic form as well as brand names such as Focalin, was estimated to have been prescribed to about 2.4 million people in the US in 2020. Dexmethylphenidate accounted for approximately 8% of prescriptions for ADHD medications in the US. It is a type of stimulant medication that increases attention and decreases impulsiveness and hyperactivity in patients with ADHD.
On the other hand, guanfacine extended-release tablets (brand name Intuniv) were prescribed to nearly 1.2 million people in the USA during the same year. Guanfacine accounts for roughly 3-4% of all ADHD drug prescriptions within America's borders, but it's used more commonly among younger children because it isn't a stimulant like dexmethylphenidate or amphetamine-based drugs often used to treat this condition.
The popularity of both dexmethylphenidate and guanfacine has seen an increase over recent years due to their effectiveness at managing symptoms related to attention deficit hyperactivity disorder (ADHD). However, they work differently: while dexmethylphenidate works by altering amounts of certain natural substances in the brain, guanfacine does so by affecting receptors on nerve cells within parts of your prefrontal cortex that helps manage behavior control functions.
Conclusion
Both Focalin (dexmethylphenidate) and Intuniv (guanfacine) have established uses in managing symptoms of Attention Deficit Hyperactivity Disorder (ADHD), and their efficacy is backed by a number of clinical studies demonstrating they are more effective than placebo treatments. They can sometimes be used in combination, but such decisions must always be made under the careful supervision of a physician, as both drugs have distinct mechanisms of action and sets of contraindications.
Focalin primarily works by increasing levels of dopamine in the brain, while Intuniv acts on alpha-2 adrenergic receptors to help manage impulsivity and hyperactivity associated with ADHD. Therefore, they may be prescribed under different circumstances: Focalin is often considered a first-line treatment for ADHD due to its stimulant nature; whereas Intuniv tends to be used as an adjunct or alternative therapy - especially when patients do not respond well to stimulants or wish to avoid certain side-effects such as appetite suppression or insomnia that can accompany them.
Both medications are available in generic form which offers significant cost savings for patients who must pay out-of-pocket. An adjustment period may be necessary when starting either drug since effects might not become apparent immediately.
As far as side effect profiles go, both Focalin and Intuniv are generally well-tolerated but carry potential risks: common side effects include decreased appetite with Focalin and drowsiness with Intuniv. It's vital that patients closely monitor any changes especially during initial stages of medication use, seeking immediate medical attention if adverse reactions worsen.
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Refrences
- WIGAL, S., SWANSON, J. M., FEIFEL, D., SANGAL, R. B., ELIA, J., CASAT, C. D., … CONNERS, C. K. (2004, November). A Double-Blind, Placebo-Controlled Trial of Dexmethylphenidate Hydrochloride and d,l-threo-Methylphenidate Hydrochloride in Children With Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry. Elsevier BV.http://doi.org/10.1097/01.chi.0000138351.98604.92
- &NA;. (2002). Dexmethylphenidate ??? Novartis/Celgene. Drugs in R & D. Springer Science and Business Media LLC.http://doi.org/10.2165/00126839-200203040-00010
- Connor, D. F., Findling, R. L., Kollins, S. H., Sallee, F., López, F. A., Lyne, A., & Tremblay, G. (2010, July). Effects of Guanfacine Extended Release on Oppositional Symptoms in Children Aged 6–12 Years with Attention-Deficit Hyperactivity Disorder and Oppositional Symptoms. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11537790-000000000-00000
- Bello, N. (2015, June). Clinical utility of guanfacine extended release in the treatment of ADHD in children and adolescents. Patient Preference and Adherence. Informa UK Limited.http://doi.org/10.2147/ppa.s73167