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Focalin vs Strattera
Introduction
For patients with Attention Deficit Hyperactivity Disorder (ADHD) or other types of attention disorders, certain drugs that manage the balance of compounds in the brain linked to focus and activity can help control symptoms. Focalin and Strattera are two such medicines that are prescribed for ADHD. They each impact different neurotransmitters, but both have effects on improving concentration and reducing impulsive behavior in patients with ADHD. Focalin is a stimulant known as a dopamine reuptake inhibitor, affecting levels of dopamine. On the other hand, Strattera is classified as a norepinephrine reuptake inhibitor (NRI), primarily affecting levels of norepinephrine.
What is Focalin?
Dexmethylphenidate (the generic name for Focalin) is a psychostimulant and part of the phenethylamine class. It was approved by the FDA in 2001, marking significant progress from earlier classes of ADHD medications like amphetamines. Focalin works by increasing levels of dopamine and norepinephrine in the brain, effectively enhancing concentration and reducing impulsivity and hyperactivity often associated with ADHD. Unlike Prozac's selective action on serotonin, Focalin primarily influences dopamine and norepinephrine.
On the other hand, Atomoxetine (Strattera) represents an entirely different class of treatment for ADHD known as Norepinephrine Reuptake Inhibitors(NRIs), first approved by FDA in 2002. Strattera primarily increases levels of free norepinephrine by preventing its reabsorption into nerve cells; hence it has fewer stimulant properties than drugs that have stronger effects on dopamine such as Focalin.
What conditions is Focalin approved to treat?
Focalin is approved for the treatment of various kinds of attention deficit hyperactivity disorder (ADHD):
- ADHD in pediatric patients aged 6 to 17 years old
- ADHD in adults, alongside other therapeutic treatments
- For immediate release tablets, it is also used as an integral part of a total treatment program that may include counseling or other therapies.
How does Focalin help with these illnesses?
Focalin works to manage attention-deficit/hyperactivity disorder (ADHD) by increasing the amount of dopamine available in the synapses of the brain. It does this by preventing dopamine from being reabsorbed into the neurons, so levels can be maintained higher for longer periods of time. Dopamine is a neurotransmitter, a chemical that acts as a messenger in the brain and throughout the body, which plays an important role in mood, cognition, reward-driven learning and movement among other things. It is thought that individuals with ADHD have relatively lower levels of dopamine. Therefore, by increasing dopamine availability, Focalin can limit some negative effects associated with ADHD such as impulsivity and hyperactivity thus helping patients manage their condition more effectively.
What is Strattera?
Strattera, also known as atomoxetine, is a selective norepinephrine reuptake inhibitor (NRI) that raises the levels of norepinephrine in the brain by preventing its absorption. It was first approved by the FDA in 2002 for treating attention deficit hyperactivity disorder (ADHD). Unlike Focalin, which is a stimulant medication, Strattera is not classified as a controlled substance due to its non-stimulant nature. This means it poses less risk of abuse or dependency compared to stimulant medications like Focalin.
The side effect profile of Strattera also differs from that of Focalin and other ADHD medications; specifically because it does not have any stimulatory effects on dopamine. Some common side effects are dry mouth, loss of appetite and nausea while serious ones could include liver damage and increased heart rate.
The absence of action on dopamine can be beneficial for patients who do not respond well to typical ADHD medications such as Focalin or those at risk for medication abuse or dependency.
What conditions is Strattera approved to treat?
Strattera, unlike many other ADHD medications, is not a stimulant but a selective norepinephrine reuptake inhibitor. It has been approved by the FDA for the management of:
- Attention-deficit/hyperactivity disorder (ADHD) in children over 6 years old
- ADHD in adolescents
- Adult ADHD
How does Strattera help with these illnesses?
Norepinephrine is a neurotransmitter which also acts as a hormone, and plays roles in many processes in the body, affecting attentiveness, emotions, sleeping and dreaming. It's particularly essential for decision-making and planning ahead. As with serotonin, low levels of norepinephrine have been implicated in attention deficit hyperactivity disorder (ADHD). Strattera works by increasing the levels of norepinephrine available to brain cells by inhibiting its reuptake into neurons. This action improves concentration and reduces impulsivity and hyperactivity in patients with ADHD. Its unique mechanism makes it an effective alternative treatment when patients do not respond well or can't tolerate stimulant medications such as Focalin due to side effects or risk of abuse.
How effective are both Focalin and Strattera?
Both dexmethylphenidate (Focalin) and atomoxetine (Strattera) have been approved by the FDA for managing symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Focalin was initially approved in 2001, while Strattera received approval in 2002. The drugs function differently: Focalin is a stimulant which primarily increases levels of dopamine in the brain, whereas Strattera, a non-stimulant medication, works through selectively inhibiting reuptake of norepinephrine.
Clinical trials comparing these two medications are scarce. However, generally speaking, both drugs have demonstrated effectiveness against ADHD symptoms. A study published in 2013 suggested that both medication types can improve quality of life indicators among patients with ADHD; however, children treated with stimulants like Focalin may demonstrate more significant improvements on some measures than those treated with atomoxetine.
A review from 2005 shows that dexmethylphenidate effectively reduces symptoms associated with ADHD beginning within the first week or two of treatment and has an acceptable safety profile. It is also reported to be well-tolerated among child and adolescent populations. Dexmethylphenidate's quick onset makes it especially useful for patients who need immediate symptom control.
On the other hand, a meta-analysis from 2020 showed that Atomoxetine is effective compared to placebo but might not be as powerful as stimulants such as dexmethylphenidate at controlling core symptoms of ADHD. Nonetheless its non-addictive nature makes it suitable when there’s concern about potential substance misuse or addiction – something often considered when prescribing stimulant medications like Focalin.
At what dose is Focalin typically prescribed?
Oral dosages of Focalin range from 2.5–40 mg/day, with clinical studies suggesting that a dose of 20 mg/day is often enough for managing attention deficit hyperactivity disorder (ADHD) in many patients. Children and adolescents may be started on 2.5-5 mg/day, twice daily. Depending on the patient's response, dosage can be increased after one week if there is no sufficient improvement. The maximum daily dosage should not exceed 40 mg under any circumstances.
On the other hand, Strattera doses vary based on weight but typically start from 0.5mg/kg per day for children and adolescents who weigh up to 70 kg or at a fixed dose of approximately 40mg per day in individuals over this weight limit. Dosage adjustments are usually made after a minimum of three days to a target total daily dose of approximately 1.2mg/kg administered either as a single daily dose or divided into two evenly spaced doses during the day. The highest recommended total daily dose is set at about ~1.4mg/kg or ~100mg unless side effects limit upward titration.
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At what dose is Strattera typically prescribed?
Strattera treatment is typically initiated at a dosage of 40 mg/day. This dose can then be increased after a minimum of three days to a target total daily dose of approximately 80 mg administered as either a single daily dose in the morning or evenly divided into two doses in the morning and late afternoon/early evening. After another 2-4 weeks, it may be further increased to maximum recommended total daily dose which is up to 100mg, depending on patient's body weight and response to treatment. If there's no noticeable improvement at this level, consult with your healthcare provider for possible alternatives or additional interventions.
What are the most common side effects for Focalin?
Here are some common side effects that people may experience with Focalin and Strattera:
- Anxiety, nervousness
- Trouble sleeping (insomnia)
- Somnolence (sleepiness/drowsiness)
- Fatigue or general weakness
- Tremors or unintentional trembling
- Decreased appetite
- Nausea, stomach upset or discomfort in the digestive tract
- Diarrhea, constipation
- Dry mouth
- Sexual side effects including decreased libido and erectile dysfunction
- Sweating more than normal -Unusual behavior changes, mood swings, aggression. -Dizziness, lightheadedness
Remember: everyone is different. The severity of these side effects can vary from person to person. Always consult a healthcare professional if you're experiencing severe symptoms or reactions to medication.
Are there any potential serious side effects for Focalin?
While Focalin and Strattera are both commonly used to treat ADHD, they can have different side effects. With Focalin, some people may experience:
- Increased anxiety or nervousness
- Signs of allergic reaction: hives; difficulty breathing; swelling of the face, lips, tongue, or throat.
- Changes in vision
- Rapid heartbeat or palpitations
- Shortness of breath and feeling faint
- Uncontrolled movements (tics)
On the other hand with Strattera, some individuals might encounter:
- Suicidal thoughts especially among children and adolescents within the first few months of treatment.
- Allergic reactions such as skin rash, itching or hives, swelling of the face, lips or tongue.
- Liver problems leading to dark urine or yellowish skin/eyes
- Uneven heartbeats that cause shortness of breath and chest pain
- Nervous system issues like dizziness resulting in severe nausea and vomiting.
In case you observe any such symptoms after starting these medications seek immediate medical help.
What are the most common side effects for Strattera?
When it comes to Strattera, you may encounter some of these common side effects:
- Dry mouth or throat
- Sleep problems including insomnia and unusual dreams
- Decreased appetite leading to weight loss
- Nausea, vomiting, upset stomach or constipation
- Increased blood pressure resulting in headaches, dizziness, and fast heartbeat
- Excessive sweating
- Frequent urination
- Mood swings including feelings of anxiety or agitation
- Possible blurred vision
Remember that while Strattera may cause these symptoms they are generally manageable. However if you experience rash, muscle pain, joint pain or signs of hostility such as confusion or extreme agitation seek immediate medical attention.
Are there any potential serious side effects for Strattera?
Strattera, although generally well-tolerated, can cause severe side effects in a small number of cases. These may include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Symptoms related to liver problems such as pain in the upper right area of the stomach, dark urine or yellowing skin/eyes (jaundice)
- Unusual thoughts or behavior
- A light-headed feeling similar to that experienced just before fainting
- Hallucinations (seeing or hearing things that are not there)
- Painful erections lasting longer than 4 hours
- Rapid heart rate and shortness of breath.
If any such symptoms occur while taking Strattera, seek immediate medical attention.
Contraindications for Focalin and Strattera?
Both Focalin and Strattera, like many other medications used in the treatment of attention deficit hyperactivity disorder (ADHD), may sometimes exacerbate symptoms such as restlessness, agitation or anxiety. If you notice a worsening of your ADHD symptoms or an increase in distressing thoughts or behaviors while taking either medication, it's crucial to seek immediate medical help.
Neither Focalin nor Strattera should be taken if you are also using monoamine oxidase inhibitors (MAOIs) or have been doing so recently. Always inform your healthcare provider about any and all medications that you're currently taking; MAOIs will need approximately two weeks to clear from the system in order to prevent dangerous drug interactions with both Focalin and Strattera.
How much do Focalin and Strattera cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Focalin (10 mg) averages around $280, which works out to approximately $9–18/day, depending on your dose.
- The price for 30 capsules of Strattera (25 mg) averages at about $420, working out to roughly $14/day.
Thus, if you are in the higher dosage range for Focalin (i.e., 20 mg/day or higher), then brand-name Strattera is less expensive on a per-day treatment basis. However, remember that cost should not be the primary consideration in determining which drug is right for you.
When it comes to the generic versions:
- Dexmethylphenidate HCL (the active ingredient in Focalin) costs significantly less. A pack of 60 tablets with a strength of 5mg each ranges from $30-$80 translating into daily costs between $.50 and $1.33 based on typical dosages.
- Atomoxetine HCI (generic form of Strattera), however, remains relatively expensive even as a generic product - costing approximately between$100 and$400 for a month's supply(40mg). This makes daily expenditures fall within the range from around $3.33 up to nearly$13.
Popularity of Focalin and Strattera
Dexmethylphenidate, known by the brand name Focalin, was estimated to have been prescribed to about 1.2 million people in the US in 2020. It is a stimulant medication primarily used for treating attention deficit hyperactivity disorder (ADHD). Dexmethylphenidate accounted for just over 6% of stimulant ADHD prescriptions in the US and its prevalence has seen an overall increase since it was first approved by FDA back in 2001.
Atomoxetine, or Strattera, on the other hand, saw almost half as many prescriptions with approximately around 600 thousand patients receiving it during the same year. This accounts for nearly all non-stimulant ADHD medications prescribed within that period due to its unique characteristic as being one of few non-stimulant drugs indicated for this condition. Atomoxetine's usage has remained steady throughout recent years reflecting consistent medical application despite newer alternatives.
Conclusion
Both Focalin (dexmethylphenidate) and Strattera (atomoxetine) are commonly used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), with numerous clinical studies validating their efficacy over placebo treatments. They may be used in combination, though this requires careful consideration by a physician as they have different mechanisms of action: Focalin primarily blocks the reuptake of dopamine and norepinephrine, while Strattera selectively inhibits the pre-synaptic transporter for norepinephrine.
Focalin is often considered first-line therapy due to its rapid onset of effects; however, it has potential for abuse given that it's a stimulant drug. Conversely, Strattera can serve as an alternative to those who do not respond well to typical stimulant ADHD medications or who wish to avoid certain side-effects associated with such drugs.
Both medicines are available in generic form which can translate into significant cost savings especially for patients paying out-of-pocket. While the effects from both Focalin and Strattera might not be noticeable immediately upon starting treatment—Strattera in particular could take several weeks before benefits are observed—their impact on improving focus and reducing impulsivity can be substantial.
The side effect profiles differ somewhat between these two drugs: both tend to cause dry mouth and loss of appetite but nausea appears more common with atomoxetine while insomnia seems more prevalent with dexmethylphenidate. It’s essential that patients closely monitor changes particularly when initiating therapy, promptly seeking medical attention if any alarming symptoms arise.