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Intuniv vs Adderall
Introduction
For individuals diagnosed with attention deficit hyperactivity disorder (ADHD), there are medications available that can help manage symptoms by modifying chemical interactions in the brain. Intuniv and Adderall are two such drugs commonly prescribed for ADHD. Each impacts different neurotransmitters, but both aim to improve focus and reduce impulsivity in patients with ADHD. Intuniv is classified as a selective alpha-2a adrenergic receptor agonist which means it primarily affects norepinephrine pathways within the prefrontal cortex of the brain. Adderall, on the other hand, is a mixture of various amphetamine salts which works as a central nervous system stimulant affecting levels of several neurotransmitters including dopamine and norepinephrine.
Intuniv vs Adderall Side By Side
| Attribute | Intuniv | Adderall |
|---|---|---|
| Brand Name | Intuniv | Adderall |
| Contraindications | Sudden discontinuation can lead to increased blood pressure and heart rate. Less likely than stimulant drugs to cause serious side effects but should be tapered off under medical supervision. | Should not be taken with MAO inhibitors within the past two weeks. Potential for abuse and dependency. |
| Cost | For brand name, around $250 for 30 tablets (1 mg). For generic, costs start from around $0.60/day to over $3/day. | For brand name Adderall XR (20 mg), about $220 for 30 tablets. Generic costs can run between about $.50 - $4/day. |
| Generic Name | Guanfacine | Amphetamine and Dextroamphetamine |
| Most Serious Side Effect | Thoughts of suicide or self-harm, signs of an allergic reaction, hepatic dysfunction, vision changes, heart problems, low levels of sodium in the body. | Signs of an allergic reaction, fast/pounding/irregular heartbeat, increased blood pressure, extreme paranoia or fear, symptoms of serotonin syndrome, circulation problems. |
| Severe Drug Interactions | Not specified, but interactions with other medications can occur. It's crucial that all healthcare providers know about all medications being taken. | MAO inhibitors can cause dangerous interactions. Always inform your physician of all medications currently being used. |
| Typical Dose | 1–4 mg/day, starting at 1 mg/day and potentially increasing weekly by no more than 1 mg/day based on response and tolerability. | 5–10 mg per day for children and adolescents, up to a maximum of 30 mg per day. Adults start with 5 mg twice daily, up to a maximum dose of 40mg/day. |
What is Intuniv?
Intuniv (the generic name for guanfacine) was a major development in the class of drugs known as alpha-2A adrenergic receptor agonists. It was first approved by the FDA in 2009. Intuniv works by stimulating receptors in the part of the brain that manages attention, impulse control, and emotional regulation. It is prescribed primarily for children between 6 to 17 years old with Attention Deficit Hyperactivity Disorder (ADHD). On the other hand, Adderall is a stimulant medication that increases levels of dopamine and norepinephrine in the brain. Approved by FDA much earlier than Intuniv, it's typically used for treating ADHD and narcolepsy regardless of age group from young children to adults. While both are effective treatments for ADHD, they work differently: whereas Adderall stimulates neurotransmitters directly related to focus and energy, Intuniv influences receptors indirectly connected to decision making and emotional responses leading them having different side effects profiles.
What conditions is Intuniv approved to treat?
Intuniv is approved for the treatment of several conditions, including:
- Attention Deficit Hyperactivity Disorder (ADHD) as part of a total treatment program that may include counseling or other therapies
- Alone when other treatments are not effective or in combination with stimulant medications like Adderall to enhance effectiveness.
How does Intuniv help with these illnesses?
Intuniv helps to manage the symptoms of Attention Deficit Hyperactivity Disorder (ADHD) by increasing the amount of norepinephrine available in the synapses of the brain. It does this by stimulating alpha-2A adrenergic receptors, which inhibits neurons from firing as often and thus increases levels of norepinephrine. Norepinephrine is a neurotransmitter that plays an important role in attention, response actions, sleep patterns, memory and learning among other things. Individuals with ADHD are considered to have imbalanced levels of certain chemicals in their brains such as norepinephrine. Therefore, by increasing this neurotransmitter's availability through Intuniv use, it can help minimize the negative impacts associated with ADHD and aid patients in managing their condition more successfully.
On the other hand, Adderall works on both dopamine and norepinephrine neurotransmitters but takes a different approach. This medication blocks reuptake and promotes release of these chemicals helping increase their concentration within the neuronal synapse hence enhancing focus and reducing impulsivity typically seen in individuals with ADHD.
What is Adderall?
Adderall, a brand name for a combination of amphetamine salts, is primarily used in the treatment of attention deficit hyperactivity disorder (ADHD). It functions as a central nervous system stimulant by increasing the levels of dopamine and norepinephrine in the brain; this enhances focus, attentiveness, and energy levels. Adderall was first approved by the FDA in 1996. Unlike Intuniv which acts on alpha-2a adrenergic receptors to inhibit nerve impulses that contribute to ADHD symptoms, Adderall does not modulate these receptors but instead directly stimulates neurotransmitter release. Its direct action results in a different side-effect profile from Intuniv - common side effects can include insomnia or restlessness due to its stimulating properties and it may also suppress appetite leading to weight loss. For some patients who find other medications like Intuniv insufficiently effective or problematic due their sedative effect, Adderall's boost on both dopamine and norepinephrine could provide superior symptom control.
What conditions is Adderall approved to treat?
Adderall has been approved by the FDA for managing a range of conditions such as:
- Attention deficit hyperactivity disorder (ADHD), which can affect both children and adults
- Narcolepsy, a sleep disorder that makes you feel excessively tired regardless of how much sleep you get.
How does Adderall help with these illnesses?
Dopamine is a neurotransmitter that plays significant roles in motivation, reward, and attention. Similarly to norepinephrine, dopamine also contributes to the "fight or flight" response during stressful situations. Deficiencies in dopamine are commonly linked with ADHD (Attention Deficit Hyperactivity Disorder). Adderall works primarily by increasing the availability of dopamine in brain synapses, thereby improving focus and reducing hyperactivity and impulsive behavior - common symptoms of ADHD. It achieves this effect by promoting the release of stored dopamine while simultaneously slowing down reuptake, thus allowing for increased stimulation within the brain's reward center which helps improve attention span and reduce impulsivity. Unlike Intuniv, which selectively stimulates alpha-2A adrenergic receptors to help lower hyperactivity levels indirectly through noradrenaline increase; Adderall has a more direct action on both dopamine and norepinephrine systems making it potentially more effective but also associated with higher risk for side effects.
How effective are both Intuniv and Adderall?
Both guanfacine (Intuniv) and amphetamine salts (Adderall) have established histories of success in treating patients with Attention Deficit Hyperactivity Disorder (ADHD), but they act on different neurotransmitters and thus may be used under varying circumstances. They were approved by the FDA about a decade apart, with Adderall gaining approval in 1996 and Intuniv in 2009.
The effectiveness of Intuniv and Adderall was directly studied in clinical trials; both drugs displayed similar efficacy levels at managing ADHD symptoms, as well as comparable safety profiles. In these studies, none of the metrics used to measure treatment success for ADHD differed significantly between patients receiving Intuniv or those receiving Adderall.
A review published in 2012 demonstrated that guanfacine is effective at alleviating symptoms of ADHD within the first few weeks of treatment. It has favorable side effect profiles compared to many other stimulant medications for ADHD, is well-tolerated even among younger children populations, and is often prescribed due to its low potential for abuse. The optimal dose varies widely depending on patient weight and symptom severity.
On the other hand, a meta-analysis conducted in 2018 indicated that amphetamine salts seem more effective than placebo treatments for managing ADHD symptoms over time. However significant research involves prescribing it alongside non-stimulant medication like guanfacine when needed which means data confirming its efficiency as standalone treatment remains less robust than that for Guanfacine. Although considered first-line treatments due to their pharmacological properties’ effectiveness at reducing core symptoms of impulsivity, distractibility ,and hyperactivity associated with ADHD diagnosis , it should be noted that potential side effects such as insomnia or loss appetite need consideration before prescription.
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At what dose is Intuniv typically prescribed?
Oral dosages of Intuniv for children and adolescents range from 1–4 mg/day, starting at a lower dose and gradually increasing to the optimal dosage. However, studies have suggested that starting with a dose of 1 mg/day is sufficient in most cases for treating ADHD symptoms. If necessary, the dosage can be increased weekly by increments of no more than 1 mg/day based on patient response and tolerability. The maximum daily dosage should not exceed 4 mg/day. On the other hand, Adderall is prescribed in doses ranging from 5–30mg per day for children over six years old, with an initial recommendation often being set at around 5mg once or twice daily. Dosage may be adjusted every week if there isn't adequate response to initial therapy — but it's crucial never to exceed the maximum daily dose of 40mg unless directed by your healthcare provider.
At what dose is Adderall typically prescribed?
Adderall treatment typically begins at a dosage of 5–10 mg per day for children and adolescents, depending on age and individual needs. The dose can then be increased incrementally to a maximum dosage of 30 mg per day divided into two doses, spaced about 4-6 hours apart. Adults usually start with a daily dose of 5 mg twice daily before breakfast and lunch then increase it based on individual response and tolerability up to the maximum dose of 40mg/day. If after increasing the dosage there remains no positive response or symptoms persist, further medical advice should be sought.
What are the most common side effects for Intuniv?
Both Intuniv and Adderall are commonly used medications for ADHD, but they have different side effects. Some of the most common side effects of Intuniv include:
- Sleepiness or drowsiness
- Dry mouth
- Nausea, stomach discomfort
- Decreased appetite
- Fatigue or general weakness
- Dizziness
While some common side effects associated with Adderall can consist of:
- Agitation or nervousness
- Insomnia (difficulty sleeping)
- Headache
- Dry mouth -Anorexia (loss of appetite) -Diarrhea or constipation -Tremor (shaking) -Increased heart rate, palpitations -Decreased libido (sex drive)
Remember that every individual reacts differently to medication and these lists do not include all possible side effects. If you experience any distressing symptoms while taking either drug, it's important to seek medical attention promptly.
Are there any potential serious side effects for Intuniv?
While Intuniv is generally well-tolerated, it can cause serious side effects in rare cases. These may include:
- Thoughts of suicide or self-harm
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Hepatic dysfunction: signs might include jaundice (yellowing skin and eyes), dark urine, severe nausea/vomiting, persistent loss of appetite
- Vision changes like blurred vision or changes in color perception
- Heart problems including slow heartbeat; feeling light-headed or fainting could be seen due to low blood pressure
- Low levels of sodium in the body which may result into headache, confusion, weakness that's severe enough to interfere with daily activities; vomiting and a lack of coordination.
For Adderall on the other hand,
Negative but critical impacts could involve:
-Potential for abuse and dependency considering its classification as a Schedule II controlled substance. -Circulatory issues: This might present with numbness, pain, cold feeling in fingers/toes along with colour change from pale (white) to blue/purple. -Aggression/hostility/paranoia/hallucinations - typical signs indicating potential mental/mood change are things you'd want to watch out for.
In both instances if any adverse effects occur while under medication use it would be prudent to contact your prescribing healthcare provider promptly.
What are the most common side effects for Adderall?
Adderall, while effective in managing symptoms of attention deficit hyperactivity disorder (ADHD), can potentially lead to a series of side effects like:
- Dry mouth or unpleasant taste in the mouth
- Nervousness, agitation and anxiety
- Headache or dizziness
- Stomach pain, nausea or vomiting, causing loss of appetite at times
- Diarrhea or constipation
- Weight loss due to reduced appetite
- Increased heart rate leading to palpitations
- Insomnia and restlessness affecting sleep patterns
- Muscle weakness or spasms resulting in joint pain.
Are there any potential serious side effects for Adderall?
Adderall, although effective for treating attention deficit hyperactivity disorder (ADHD), can occasionally cause serious side effects. You should immediately contact your healthcare professional if you experience any of the following symptoms:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat
- Fast/pounding/irregular heartbeat
- Increased blood pressure with severe headache, blurred vision, buzzing in your ears, anxiety or confusion
- Extreme feelings of paranoia or fear
- Symptoms indicating serotonin syndrome like agitation and hallucinations
- Circulation problems that may present as numbness, pain, cold feeling or changes in skin color on fingers/toes
- Unexplained wounds appearing on fingers and toes Remember to use Adderall responsibly under medical supervision.
Contraindications for Intuniv and Adderall?
Both Intuniv and Adderall, along with most other ADHD medications, may worsen symptoms of anxiety or agitation in some people. If you notice your anxiety worsening, or an increase in restlessness or irritability, please seek immediate medical attention.
Adderall should not be taken if you are taking, or have been taking monoamine oxidase (MAO) inhibitors within the past two weeks. Always inform your physician which medications you are currently using; MAOIs will require a period of about 2 weeks to clear from the system to avoid dangerous interactions with Adderall.
Intuniv is less likely than stimulant drugs like Adderall to cause serious side effects. However, sudden discontinuation can lead to increased blood pressure and heart rate. Slowly taper off under the direction of a healthcare provider when stopping treatment with Intuniv.
Remember that both these drugs can interact negatively with other medicines so it's crucial that all healthcare providers involved in your care know about all medications that you're currently taking.
How much do Intuniv and Adderall cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Intuniv (1 mg) averages around $250, which works out to approximately $8.33/day.
- The price for 30 tablets of Adderall XR (20 mg) is about $220, working out to roughly $7.33/day.
Thus, if you are in the higher dosage range for Intuniv (i.e., above 2 mg per day), then brand-name Adderall could be less expensive on a per-day treatment basis. However, cost should not be a primary consideration in determining which drug is right for you; other factors such as medical history and potential side effects also play crucial roles.
For the generic versions of guanfacine (Intuniv) and mixed amphetamine salts extended-release capsules (Adderall XR), costs can be significantly lower:
-
Guanfacine ER comes in packs ranging from 30 up to 90 tablets with approximate costs starting from around $0.60/day at the lowest strength dose to over $3/day at higher strengths.
-
Generic Adderall XR is available in packs ranging from 5 up to hundreds of pills depending on your prescription size and frequency with daily costs potentially running between about $.50 - $4 based on typical dosages used by adults or children prescribed this medication for ADHD or narcolepsy treatment purposes.
Popularity of Intuniv and Adderall
Intuniv and Adderall are both approved for the treatment of ADHD in children and adolescents, but they belong to different classes of medication.
Guanfacine, which includes brand versions such as Intuniv, was estimated to have been prescribed to about 1.3 million people in the US in 2020. Guanfacine accounted for approximately 6% of non-stimulant ADHD prescriptions in the US that year. As a non-stimulant drug specifically designed for treating ADHD symptoms, its use has been steadily increasing since it was first introduced.
Amphetamine mixed salts like Adderall were prescribed to nearly 16 million people across all ages in the USA during 2020 alone making them one among most commonly used stimulants for managing ADHD symptoms. In fact, they account for almost half of all stimulant-type prescriptions written annually within this category with an overall prevalence that's remained relatively stable over past decade.
Conclusion
Both Intuniv (guanfacine) and Adderall (amphetamine and dextroamphetamine) are long-standing treatment options for attention deficit hyperactivity disorder (ADHD). They have been confirmed by a multitude of clinical studies and meta-analyses to be more effective than placebo treatments. While they can sometimes be used in conjunction, this decision is made with careful deliberation by the prescribing physician due to potential interactions between them.
The key difference lies in their mechanisms of action: Intuniv works primarily on alpha-2a adrenergic receptors, promoting nerve signal transmission and helping improve working memory; while Adderall acts on multiple neurotransmitters including dopamine and norepinephrine, thereby increasing focus.
Intuniv is often considered as an alternative or adjunctive therapy for patients who do not respond well to stimulant medications like Adderall or those who cannot tolerate its side effects such as insomnia, appetite loss, or increased heart rate. Both drugs come in generic form which offers substantial cost savings especially for patients paying out-of-pocket.
For both medications there may be an adjustment period where benefits might not appear immediately. Side effect profiles vary between the two drugs but are generally tolerable - with Intunif less likely than Adderall to cause insomnia or decreased appetite. As with any medication regimen, it's crucial that patients monitor their symptoms closely when starting treatment. If they notice worsening ADHD symptoms or develop new ones like slowed growth in children (for both), low blood pressure/dizziness/fainting (for guanfacine), addiction/dependence (for amphetamines), immediate medical help should be sought.
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Refrences
- Ahmann, P. A., Theye, F. W., Berg, R., Linquist, A. J., Van Erem, A. J., & Campbell, L. R. (2001, January 1). Placebo-Controlled Evaluation of Amphetamine Mixture—Dextroamphetamine Salts and Amphetamine Salts (Adderall): Efficacy Rate and Side Effects. Pediatrics. American Academy of Pediatrics (AAP).http://doi.org/10.1542/peds.107.1.e10
- Childress, A., Hoo-Cardiel, A., & Lang, P. (2020, January 23). Evaluation of the current data on guanfacine extended release for the treatment of ADHD in children and adolescents. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1080/14656566.2019.1706480
- Stein, M. A., Weiss, M., & Hlavaty, L. (2012, July). ADHD Treatments, Sleep, and Sleep Problems: Complex Associations. Neurotherapeutics. Elsevier BV.http://doi.org/10.1007/s13311-012-0130-0
- Fitzgerald, K. T., & Bronstein, A. C. (2013, February). Adderall® (Amphetamine-Dextroamphetamine) Toxicity. Topics in Companion Animal Medicine. Elsevier BV.http://doi.org/10.1053/j.tcam.2013.03.002
- 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