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Intuniv vs Strattera
Introduction
For patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), certain medications that modulate the concentrations of neurotransmitters in the brain can help manage symptoms and improve focus. Intuniv and Strattera are two such drugs often prescribed for ADHD. They interact differently with neurotransmitters in the brain, yet both have been shown to improve attention, decrease impulsivity and hyperactive behavior. Intuniv is a selective alpha-2A adrenergic receptor agonist that works by increasing noradrenaline activity in the prefrontal cortex, an area associated with decision-making and impulse control. On the other hand, Strattera is classified as a norepinephrine reuptake inhibitor (NRI), primarily impacting levels of norepinephrine throughout various parts of the brain.
Intuniv vs Strattera Side By Side
| Attribute | Intuniv | Strattera |
|---|---|---|
| Brand Name | Intuniv | Strattera |
| Contraindications | Cannot be taken with MAO inhibitors, caution advised for those with serious cardiovascular conditions. | Cannot be taken with MAO inhibitors, caution advised for those with serious cardiovascular conditions. |
| Cost | For brand name, around $300 for 30 tablets (1mg). For generic guanfacine ER, costs range from $0.87 to $5 per day. | For brand name, around $400 for 30 capsules (10 mg). For generic atomoxetine HCl, costs range from about $2.50 to over $12 per day. |
| Generic Name | Guanfacine | Atomoxetine |
| Most Serious Side Effect | Increase in blood pressure or heart rate upon suddenly stopping the medication, signs of serious allergic reaction, symptoms indicating liver damage, changes in vision, irregular heartbeat patterns. | Signs of severe allergic reaction, indications of liver problems, changes in heart rhythm, new psychiatric symptoms, unexplained wounds on fingers and toes. |
| Severe Drug Interactions | MAO inhibitors due to potential dangerous interactions. | MAO inhibitors due to potential dangerous interactions. |
| Typical Dose | 1-7 mg/day, with a maximum daily dose of 4 mg for children aged 6–12 years and 7mg for adolescents aged 13–17 years. | Starts at 40 mg per day, can be increased to 80 mg/day, with a maximum dose of 100 mg/day. |
What is Intuniv?
Guanfacine (the generic name for Intuniv) was initially developed as a drug to treat high blood pressure, but it has been found effective in treating ADHD and was approved by the FDA for this use in 2009. Intuniv functions by stimulating receptors in the prefrontal cortex of the brain that regulate attention and impulse control. It is prescribed primarily for children between ages 6-17 who have ADHD.
On the other hand, Atomoxetine (the generic name for Strattera) is a selective norepinephrine reuptake inhibitor (NRI), which increases levels of norepinephrine available in the synapses between nerve cells. This increased availability can enhance focus and decrease impulsivity and hyperactivity in patients with ADHD. Unlike Intuniv, Strattera affects only norepinephrine rather than multiple neurotransmitters, which often results in fewer side effects compared to medications that influence multiple neurotransmitters.
What conditions is Intuniv approved to treat?
Intuniv is approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients:
- As a monotherapy, it can be used alone to treat ADHD
- It can also work as an adjunctive therapy, meaning it's used alongside another primary drug to increase its efficacy.
Strattera has been approved for similar uses:
- Treating ADHD in both children and adults.
- Strattera may be used alone or with other medications.
How does Intuniv help with these illnesses?
Intuniv works to manage symptoms of ADHD by stimulating receptors in the brain known as alpha-2A adrenergic receptors. This action enhances inhibitory signaling in the prefrontal cortex, an area of the brain that is crucial for attention and impulse control. Neurotransmitters are chemicals that transmit signals from one nerve cell to another, and in this case, Intuniv's effect on these neurotransmitters can help increase attention and decrease impulsive behaviors.
Strattera, however, manages ADHD differently. It increases levels of norepinephrine around nerve paths in the brain by blocking its reabsorption into neurons – a similar mechanism to how some antidepressants work but targeting different neurotransmitter systems. Norepinephrine is involved with attention and response actions, which helps reduce symptoms of ADHD such as impulsivity and hyperactivity while increasing focus.
Therefore, both Intuniv and Strattera are effective at managing ADHD symptoms but do so through different mechanisms; understanding these differences can help patients choose the right medication for their situation.
What is Strattera?
Strattera, a brand name for atomoxetine, is a norepinephrine (noradrenaline) reuptake inhibitor primarily used to treat attention deficit hyperactivity disorder (ADHD). This medication works by increasing the levels of norepinephrine in the brain, leading to increased focus and decreased impulsivity. Atomoxetine was first approved by the FDA in 2002. Unlike stimulant medications often used for ADHD such as Adderall or Ritalin, Strattera does not have potential for abuse or physical dependence due to its lack of effect on dopamine release. Its side-effect profile also differs from that of traditional stimulants; while it may cause some initial sedation and gastrointestinal effects like nausea or reduced appetite, it's less likely to cause insomnia or aggravate anxiety symptoms. The specific actions on norepinephrine make Strattera an effective treatment option particularly for patients who do not respond well to standard stimulant therapies.
What conditions is Strattera approved to treat?
Strattera has been approved by the FDA for treating attention deficit hyperactivity disorder (ADHD) in both children and adults. This medication is particularly significant as it's one of the few non-stimulant treatments for ADHD, making it a valuable option for patients who prefer to avoid stimulants due to side effects or personal choice. Strattera is celebrated not only for its effectiveness in managing ADHD symptoms but also because it can be used long-term without risk of dependency, unlike some other treatment options.
How does Strattera help with these illnesses?
Norepinephrine is a neurotransmitter that also acts as a hormone, playing roles in various processes in the body, including focus and attention, wakefulness, response to stress, and memory recall. Imbalances of norepinephrine have been implicated in ADHD (Attention Deficit Hyperactivity Disorder). Strattera works by preserving the levels of norepinephrine available in the brain through inhibiting their reuptake into nerve cells. This increases concentration span and reduces hyperactivity and impulsive behavior associated with ADHD. The action on dopamine may also play roles in its therapeutic effect for ADHD treatment. Since it does not significantly affect serotonin levels like many other psychiatric drugs do, Strattera can be an option when patients do not respond well to stimulant medications or cannot tolerate their side effects. It's worth noting that unlike Intuniv which primarily treats symptoms of impulsivity rather than attentiveness issues linked with ADHD; Strattera addresses both these concerns making it more versatile.
How effective are both Intuniv and Strattera?
Both guanfacine (Intuniv) and atomoxetine (Strattera) have been shown to be effective in treating patients with attention deficit hyperactivity disorder (ADHD), although they were approved by the FDA several years apart, with Strattera being granted approval in 2002 followed by Intuniv in 2009. They work on different neurotransmitters and may therefore be prescribed under varying circumstances depending on individual needs.
The effectiveness of Intuniv and Strattera was investigated in a double-blind clinical trial conducted in 2010; both medications exhibited similar efficacy at managing symptoms of ADHD, including improved focus, decreased impulsivity and enhanced cognitive function. The results suggested that neither medication outperformed the other when it came to reducing core ADHD symptoms. A separate study carried out in 2011 found that Intuniv might cause fewer gastrointestinal side effects compared to Strattera.
A review of meta-analyses reports from 2016 showed that Strattera is effective starting from the first week of treatment. It has a favorable side effect profile compared to many stimulant medications used for ADHD, making it a good choice for those who cannot tolerate such treatments. Furthermore, as it was one of the first non-stimulant options developed specifically for ADHD management, substantial research supports its use.
Another review done recently indicated that while Intuniv seems more effective than placebo at treating ADHD symptoms, its overall efficacy appears comparable to other common non-stimulant treatments like Strattera. However, due to its unique mechanism targeting prefrontal brain receptors crucial for attention regulation and impulse control, Intunif might offer optimal benefit for certain patients who do not respond well or cannot tolerate stimulants or drugs like Straterra due their specific side effects.
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At what dose is Intuniv typically prescribed?
Oral dosages for Intuniv (guanfacine) typically range from 1-7 mg/day. This medication is used to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents, who may start on a dose of 1 mg/day. The dosage can be increased after one week based on the response and tolerability, with increments of no more than 1 mg/week. In any case, the maximum daily dose should not exceed 4 mg for children aged 6–12 years and 7mg for adolescents aged 13–17 years.
On the other hand, Strattera (atomoxetine), another ADHD treatment option, has recommended initial doses at around 0.5 mg/kg/day in children weighing up to 70 kg or starting at a flat rate of approximately40 mg/day in adults and kids over this weight limit. After a minimum of three days at these initial levels, doctors may increase their patients' intake based on individual needs & tolerance but should never surpass a total daily dosage of about ~100mg.
At what dose is Strattera typically prescribed?
Strattera therapy typically starts at a dosage of 40 mg per day. The dose can then be increased to 80 mg/day, taken as a single daily dose or divided into two doses: one in the morning and another in the evening. A maximum dose of 100 mg/day may be tested if there is no response to treatment at 80 mg/day after several weeks. It's important to remember that Strattera should not be discontinued abruptly; any changes in dosing should always be done under the guidance of your healthcare provider.
What are the most common side effects for Intuniv?
Common side effects of Intuniv may include:
- Somnolence (sleepiness/drowsiness)
- Dry mouth
- Headache
- Fatigue and general weakness
- Stomach pain, nausea
- Decreased appetite
- Weight gain
- Dizziness
While Strattera is also known to potentially cause:
- Nausea and vomiting
- Upset stomach or constipation
- Decreased appetite leading to weight loss
- Cough, dry mouth, and throat irritation
- Erectile dysfunction or decreased libido in some cases -Increased heart rate or blood pressure
Always consult with your healthcare provider if you experience any of these symptoms while taking either medication.
Are there any potential serious side effects for Intuniv?
While both Intuniv and Strattera are used in managing ADHD, they can have different side effects. Here are some potential adverse reactions to be aware of when taking Intuniv:
- An increase in blood pressure or heart rate upon suddenly stopping the medication
- Signs of a serious allergic reaction, such as difficulty breathing, hives, swelling in your face or throat
- Symptoms indicating liver damage like upper right abdominal pain, fatigue, dark urine coloration and jaundice (yellowing of skin or eyes)
- Changes in vision - blurry vision or seeing halos around lights may indicate an issue
- Irregular heartbeat patterns - rapid pounding heartbeats that cause shortness of breath could be a sign of heart issues.
In rare cases you might also experience:
- Low sodium levels leading to symptoms including headache confusion severe weakness vomiting loss of coordination feeling unsteady Severe nervous system reaction - very stiff rigid muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out.
It's important to remember that everyone reacts differently to medications. If you start experiencing any unusual symptoms while on Intuniv consult with your healthcare professional immediately.
What are the most common side effects for Strattera?
Strattera, a non-stimulant drug used for managing ADHD, can cause an array of side effects. These may include:
- Dry mouth or throat
- Decreased appetite leading to weight loss
- Nausea, vomiting, and stomach upset
- Difficulty in sleeping or insomnia
- Increased blood pressure causing headache or dizziness
- Unusual sweating and feeling nervousness or anxiety
- Urinary problems including increased frequency
- Skin rash In rare cases, Strattera might lead to blurred vision and liver issues. It's important to communicate with your healthcare provider if you experience any uncomfortable side effects while taking this medication.
Are there any potential serious side effects for Strattera?
While Strattera is commonly prescribed for ADHD, it's important to be aware of potentially serious side effects. These can include:
- Signs of a severe allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat
- Indications of liver problems like itching, right upper belly pain, dark urine and yellow skin or eyes
- Changes in heart rhythm including fast or irregular heartbeat
- New mental (psychiatric) symptoms like depression-related thoughts/actions and aggressive behavior
- Unexplained wounds appearing on fingers and toes.
If you notice any of these signs after starting Strattera, contact your healthcare provider immediately.
Contraindications for Intuniv and Strattera?
Both Intuniv and Strattera, like most ADHD medications, may cause some side effects such as drowsiness, fatigue or changes in mood. If you notice your symptoms worsening significantly--for instance an increase in aggressive behavior or suicidal thoughts--it's vital to seek immediate medical attention.
Neither Intuniv nor Strattera can be taken alongside certain other medications such as monoamine oxidase (MAO) inhibitors due to potential dangerous interactions. It's important to always inform your physician of any medication you are currently taking or have recently stopped taking; MAOIs will require a period of about 2 weeks to clear from the system prior to starting treatment with either Intuniv or Strattera.
Furthermore, individuals with serious cardiovascular conditions should exercise caution when considering these medications. Always discuss any pre-existing health conditions with your healthcare provider before commencing use of new medicines.
How much do Intuniv and Strattera cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Intuniv (1mg) averages around $300, which works out to about $10/day.
- The price for 30 capsules of Strattera (10 mg) is roughly around $400, working out to approximately $13/day.
Thus, if you are in the higher dosage range for Intuniv (i.e., up to 7 mg/day), then brand-name Strattera could be less expensive on a per-day treatment basis due to its maximum dose being only 100mg. However, cost should not be your primary consideration when determining which drug is right for you.
For generic versions guanfacine ER (Intuniv equivalent) and atomoxetine HCl (Strattera equivalent), costs are significantly lower:
- Guanfacine ER can be found in packs ranging from 15 -120 tablets with approximate costs between $0.87 and $5 per day depending on your required dose.
- Atomoxetine HCl comes in similar quantities and ranges from about $2.50 up to nearly over $12 per day depending on daily dosage.
Remember that it's important consult your healthcare provider before deciding what medication is best suited for your needs based upon factors beyond just cost alone such as side effects or how well each possible drug may work with any other medications you're currently taking.
Popularity of Intuniv and Strattera
Intuniv, a brand name for guanfacine, is primarily used for the treatment of attention deficit hyperactivity disorder (ADHD). In 2020, it was estimated that about 1.2 million prescriptions were filled in the US. Over the past decade, its usage has been relatively stable with minor fluctuations.
Strattera, or atomoxetine by generic name, is another medication prescribed for ADHD and had approximately 2.8 million prescriptions filled in the US in 2020. Strattera accounts for roughly around 20% of non-stimulant ADHD medication prescriptions in America and has maintained steady use over recent years.
Both Intuniv and Strattera are classified as non-stimulants and offer alternatives to those who either cannot take stimulant medications due to health reasons or have not found them effective. However, they work differently: Intuniv works on alpha-2 receptors to help reduce hyperactivity and improve focus while Strattera inhibits reuptake of norepinephrine which helps increase attention span and decrease impulsivity.
Conclusion
Both Intuniv (guanfacine) and Strattera (atomoxetine) have established records of usage in patients with attention deficit hyperactivity disorder (ADHD), backed by numerous clinical studies indicating that they are more effective than placebo treatments. In some cases, the drugs may be combined under careful consideration by a physician due to their different mechanisms of action. Intuniv acts primarily on the alpha-2A adrenergic receptor while Strattera inhibits the reuptake of norepinephrine.
Strattera is often considered as a first-line treatment option for ADHD, whereas Intuniv would typically be used as an adjuvant therapy along with stimulants or in patients who did not respond well to first-line stimulant medications or have a particular need to avoid common side effects such as appetite suppression and insomnia associated with these types of drugs.
Both drugs are available in generic form which represents significant cost savings especially for those paying out-of-pocket. Both Intuniv and Strattera may require an adjustment period where effects may not be noticeable right away.
The side effect profile is similar between the two drugs, both being generally well-tolerated, but Strattera has been linked slightly more with nausea and decreased appetite compared to Intuniv. For both medications, it's important for patients to closely monitor any changes in mood or behavior when starting treatment and seek medical help immediately if symptoms worsen.
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Refrences
- Kratochvil, C. J., Vaughan, B. S., Harrington, M. J., & Burke, W. J. (2003, July). Atomoxetine: a selective noradrenaline reuptake inhibitor for the treatment of attention-deficit/hyperactivity disorder. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.4.7.1165
- Kratochvil, C. J., Vaughan, B. S., Daughton, J. M., Mayfield-Jorgensen, M. L., & Burke, W. J. (2004, July). Atomoxetine in the treatment of attention deficit hyperactivity disorder. Expert Review of Neurotherapeutics. Informa UK Limited.http://doi.org/10.1586/14737175.4.4.601
- 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
- Wigal, S. B., Chae, S., Patel, A., & Steinberg-Epstein, R. (2010, December). Advances in the Treatment of Attention-Deficit/Hyperactivity Disorder: A Guide for Pediatric Neurologists. Seminars in Pediatric Neurology. Elsevier BV.http://doi.org/10.1016/j.spen.2010.10.005