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Strattera vs Dexedrine
Introduction
For patients with attention deficit hyperactivity disorder (ADHD), certain drugs can help in managing symptoms by altering the concentrations of compounds in the brain linked to focus and behavior. Strattera and Dexedrine are two such drugs that are prescribed for ADHD. They each impact different neurotransmitters in the brain, but both have effects on attention span and impulse control in patients with ADHD. Strattera is a selective norepinephrine reuptake inhibitor (NRI), primarily affecting levels of norepinephrine. On the other hand, Dexedrine belongs to a class of medications called amphetamines which increase levels of dopamine and norepinephrine in the brain thereby improving concentration and reducing impulsivity.
Strattera vs Dexedrine Side By Side
| Attribute | Strattera | Dexedrine |
|---|---|---|
| Brand Name | Strattera | Dexedrine |
| Contraindications | Should not be taken with or have recently stopped taking MAO inhibitors | Should not be taken with or have recently stopped taking MAO inhibitors |
| Cost | Between $0.60 and $2.20 per day for the generic version (atomoxetine) | As low as about $0.50/day to about $3/day for the generic version (dextroamphetamine IR) |
| Generic Name | Atomoxetine | Dextroamphetamine |
| Most Serious Side Effect | Increased risk of suicidal thoughts or actions in children and teenagers | Indications of allergic response or severe skin reaction, increase in anxiety levels leading to thoughts about self-harm or suicide |
| Severe Drug Interactions | MAO inhibitors | MAO inhibitors |
| Typical Dose | For adults and children over 70 kg: 40–100 mg/day. For children and adolescents under 70 kg: starting dose of approximately 0.5 mg/kg, up to a total daily dose of approximately 1.2 mg/kg | Typically initiated at a dose of 5–10 mg/day for adults, escalated based on response and tolerance to around 20-60 mg/day divided into two or three doses |
What is Strattera?
Atomoxetine (the generic name for Strattera) is a non-stimulant medication first approved by the FDA in 2002 for the treatment of attention deficit hyperactivity disorder (ADHD). Unlike stimulant drugs, such as Dexedrine, it does not directly increase levels of dopamine or norepinephrine in the brain. Instead, Strattera works by inhibiting the reuptake of norepinephrine, effectively increasing its availability in the brain. This results in improved focus and reduced impulsivity and hyperactivity. Although it may take longer to see improvements with Strattera compared to stimulant medications like Dexedrine, it offers a lower risk of abuse and dependence because it lacks significant influence on dopamine -- a neurotransmitter associated with pleasure and reward pathways located primarily within more primitive regions of the brain.
What conditions is Strattera approved to treat?
Strattera is approved for the treatment of certain types of attention disorders:
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Attention deficit hyperactivity disorder (ADHD) in children aged six years and older, as well as adults Dexedrine, on the other hand, is approved to treat:
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Narcolepsy, a condition characterized by excessive daytime sleepiness
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ADHD in patients who are at least three years old.
How does Strattera help with these illnesses?
Strattera aids in the management of Attention Deficit Hyperactivity Disorder (ADHD) by increasing levels of norepinephrine, a neurotransmitter that plays a role in attention and memory, in the synapses of the brain. It does this by inhibiting its reuptake into neurons, thus maintaining higher levels for extended periods. Norepinephrine is crucial for cognitive functions including focus, working memory, and impulse control. In individuals with ADHD, it's believed there are relatively lower levels of norepinephrine within certain areas of the brain associated with executive function. Therefore, Strattera can limit symptoms related to decreased concentration and hyperactivity often seen in ADHD patients by raising norepinephrine levels to improve their ability to pay attention and manage impulsive behavior.
What is Dexedrine?
Dexedrine is a brand name for dextroamphetamine, which is a central nervous system stimulant. It functions by increasing the levels of dopamine and norepinephrine in the brain through promoting their release and inhibiting their reuptake. This leads to increased concentration and focus, making it beneficial for those with attention-deficit/hyperactivity disorder (ADHD). Dexedrine was first approved by the FDA in 1976.
Unlike Strattera (atomoxetine), which is classified as a selective norepinephrine reuptake inhibitor, Dexedrine does not selectively target one neurotransmitter but influences both dopamine and norepinephrine. Due to this broader impact on brain chemistry, Dexedrine may have different side effects than Strattera. For instance, while weight loss can occur with both medications, insomnia or restlessness are more commonly associated with Dexedrine due to its stimulating effect on the central nervous system.
What conditions is Dexedrine approved to treat?
Dexedrine is approved for the treatment of:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy, a sleep disorder characterized by excessive sleepiness and sudden attacks of daytime sleep.
How does Dexedrine help with these illnesses?
Dopamine is a neurotransmitter that plays an important role in motivation, reward, and how the brain perceives reality. It significantly impacts focus and attention too. Dexedrine works by increasing the levels of dopamine available in your brain, thereby improving symptoms related to attention deficit hyperactivity disorder (ADHD). Its action on norepinephrine may also play roles in its function as a stimulant medication. Since it does not influence serotonin levels significantly, it is often prescribed when a patient does not respond well to non-stimulant ADHD medications such as Strattera, or it might be combined with them for more comprehensive management of ADHD symptoms.
How effective are both Strattera and Dexedrine?
Both atomoxetine (Strattera) and dextroamphetamine (Dexedrine) have established histories of success in treating patients with Attention Deficit Hyperactivity Disorder (ADHD), gaining FDA approval in 2002 and 1976 respectively. Because they act on different neurotransmitters, they may be prescribed under differing circumstances. The effectiveness of Strattera and Dexedrine was directly studied in a double-blind clinical trial; both drugs exhibited similar efficacy in managing symptoms of ADHD as well as promising safety profiles.
A review published by the Cochrane database suggested that Strattera is effective at alleviating symptoms of ADHD within the first week or two of treatment, with its side effect profile being comparable to other non-stimulant medications used for this condition. As one of the few non-stimulant options available for treating ADHD, it has become widely prescribed across the globe due to its unique pharmacology and because it does not pose a risk for abuse or physical dependency.
A systematic review conducted in 2017 found that although Dexedrine is generally more potent than placebo at reducing symptoms associated with ADHD, there are certain risks involved such as potential substance misuse given its status as a controlled drug. Nonetheless, Dexedrine is often considered an efficacious first-line treatment option due to its immediate-acting nature compared to non-stimulants such as Strattera which require several weeks before reaching full therapeutic effects. However, individuals who did not respond favorably to stimulants or those seeking alternatives without potential for addiction may prefer atomoxetine.
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At what dose is Strattera typically prescribed?
Oral dosages of Strattera for adults and children over 70 kg range from 40–100 mg/day, but research has shown that a common starting dosage of 40 mg/day is usually effective in managing Attention Deficit Hyperactivity Disorder (ADHD). Children and adolescents under 70 kg may be started on a daily dose of approximately 0.5 mg/kg. In either population, the dosage can be increased after at least three days to a total daily dose of approximately 1.2 mg/kg administered either as a single daily dose or divided into two doses. The maximum recommended total daily dose in children and adolescents over 70kg, and adults is 100mg.
On the other hand, Dexedrine oral dosages typically start from as low as five milligrams per day for patients new to this medication or those with lower body weight like children aged six years and above. Dosage adjustments are made gradually every week by increments of five milligrams depending on patient response until an optimal therapeutic effect is achieved.
At what dose is Dexedrine typically prescribed?
Dexedrine treatment is typically initiated at a dose of 5–10 mg/day for adults. This can then be escalated, based on the patient's response and tolerance, to around 20-60 mg/day divided into two or three doses. Each dose should be taken approximately four hours apart but no later than 6 PM to avoid interference with sleep. The maximum daily dosage is generally kept under 60mg. If there isn't an appreciable improvement in symptoms after a few weeks, your doctor may re-evaluate the dosage or consider alternative treatments.
What are the most common side effects for Strattera?
Common side effects of Strattera can include:
- Upset stomach, nausea or vomiting
- Decreased appetite, weight loss
- Dizziness or lightheadedness
- Mood swings, anxiety or irritability
- Insomnia (difficulty sleeping)
- Fatigue (tiredness) and somnolence (sleepiness)
- Dry mouth
- Increased blood pressure and heart rate
- Sweating -Tremor
Dexedrine's common side effects may involve:
-Anxiety or restlessness
-Nervousness
-Dry mouth
-Increased blood pressure and heart rate
-Decrease in libido (sex drive)
-Impotence or other sexual difficulties
-Diarrhea
-Loss of appetite leading to significant weight loss
-Sleep disturbances like insomnia
-General weakness
Both medications can cause more serious but less common side effects. Always consult your healthcare provider if you have any concerns about these medications' potential side effects.
Are there any potential serious side effects for Strattera?
While both Strattera and Dexedrine are used to treat attention deficit hyperactivity disorder (ADHD), they can have different side effects. For instance, with Strattera:
- There's a rare but increased risk of suicidal thoughts or actions in children and teenagers
- It may cause serious allergic reactions, such as difficulty breathing, hives or rash, swelling of the face or throat
- Vision problems could occur including blurred vision and eye pain
- If you experience an irregular heartbeat, chest pain, shortness of breath or fainting spells; this could be a sign of heart-related issues
- Hyponatremia - low sodium in the body often characterized by headache, confusion, slurred speech
- Liver damage symptoms include abdominal pain on your right side below your ribs and jaundice.
On the other hand with Dexedrine:
- You might see changes in mood or behavior such as agitation or paranoia.
- Allergic reactions like skin rash that spreads causing blistering/peeling can occur. -Blood circulation problems indicated by numbness/pain/skin color change/unusual wounds on fingers/toes. -Digestive system problems like constipation/upset stomach/diarrhea/vomiting. -Mental/mood changes (uncontrolled movements/tremor/outbursts of words/sounds) -High blood pressure which will result in severe headaches/chest tightness/breathing difficulties.
Always contact your doctor immediately if any unusual symptoms appear while taking these medications.
What are the most common side effects for Dexedrine?
While considering Dexedrine, you should be aware that it can cause various side effects:
- Dry mouth or an unpleasant taste in the mouth
- Diarrhea or constipation
- Loss of appetite, leading to weight loss
- Trouble falling asleep (insomnia)
- Headache and dizziness
- Uncontrollable shaking of a part of your body (tremors)
- Restlessness or other mood changes
- Increased heart rate
- Chest pain
- Difficulty breathing and skin rashes.
Please note that while these are possible side effects, not every individual will experience all of them. Always consult with a healthcare professional when deciding on medication options.
Are there any potential serious side effects for Dexedrine?
While Dexedrine is known to be an effective medication for managing ADHD, it's crucial to be aware of potential serious side effects. These may include:
- Indications of allergic response or severe skin reaction: symptoms can include rashes, itching, fever, swollen glands, difficulty in breathing, swelling in your face or throat area, a sore throat and burning eyes. In some cases you might also notice skin pain accompanied by a red or purple skin rash which could have blistering and peeling.
- An increase in anxiety levels leading to thoughts about self-harm or suicide
- A seizure (convulsions)
- Unusual mood swings and changes in behaviour that are not typical for the individual
- Blurred vision or tunnel vision; eye pain or swelling; seeing halos around lights
- Rapid heartbeats that are irregular
- Signs indicating a manic episode. This includes racing thoughts with increased energy levels leading to reckless behavior. The person may feel extremely happy but irritable at the same time while talking excessively than usual along with severe sleep disturbances.
If any such signs present themselves during use of Dexedrine immediately seek medical attention.
Contraindications for Strattera and Dexedrine?
Both Strattera and Dexedrine, 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 aggressive behavior or hostility, please seek immediate medical attention.
Neither Strattera nor Dexedrine should be taken if you are taking, or have recently stopped taking monoamine oxidase (MAO) inhibitors (MAOIs). Always inform your physician about any medications you are currently using; MAOIs will require a period of at least 14 days to clear from the system to prevent dangerous interactions with both Strattera and Dexedrine.
How much do Strattera and Dexedrine cost?
For the brand name versions of these drugs:
- The price for 30 capsules of Strattera (40 mg) averages around $400, which works out to approximately $13-$27/day, depending on your dose.
- The price for 60 tablets of Dexedrine (5mg) is about $300, working out to roughly $10/day.
Thus if you are in the higher dosage range for Strattera (i.e., 80 mg per day or higher), then brand-name Dexedrine may be less expensive on a per-day treatment basis. Remember that cost should not be the primary consideration when determining which medicine is right for you.
As far as generic versions go:
- Atomoxetine (Strattera's generic version) costs between $0.60 and $2.20 per day for dosages from 10 mg up to 100 mg daily.
- Dextroamphetamine IR, available in packs ranging from 15 to hundreds of tablets with doses from 5mg up to potentially more typical dosages at your doctor's suggestion can cost as low as about $0.50/day and reach up to about $3/day depending on quantity bought and frequency used.
Keep in mind prices can vary based on location and insurance coverage among other factors.
Popularity of Strattera and Dexedrine
Atomoxetine, available under the brand name Strattera, was prescribed to about 2.5 million people in the United States in 2020. Atomoxetine is a selective norepinephrine reuptake inhibitor (NRI) and it's the only non-stimulant medication approved by FDA for ADHD treatment. It accounted for just over 7% of prescriptions for ADHD medications. Its use has been steady since its approval by FDA in late 2002.
On the other hand, Dextroamphetamine, known as Dexedrine among other names, was prescribed to around 1 million individuals in the USA during that same year. In terms of overall stimulant prescriptions for ADHD treatment, dextroamphetamine accounts for nearly 5%. As one of older drugs used to treat ADHD symptoms (first synthesized in early 1920s), its prescription rate has remained relatively constant over recent years.
Conclusion
Both Strattera (atomoxetine) and Dexedrine (dextroamphetamine) have been used extensively in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), with numerous clinical studies indicating their effectiveness over placebo. There may be instances where the two drugs are combined, but this necessitates careful consideration by a physician as they can interact with each other. The difference in their mechanisms of action is crucial; Strattera primarily increases norepinephrine levels while Dexedrine boosts both dopamine and norepinephrine, leading to varying prescription contexts.
Strattera, being a non-stimulant medication for ADHD, is often considered first-line therapy particularly when there's concern about potential abuse or addiction associated with stimulant medications like Dexedrine. On the other hand, Dexedrine might be added to Strattera if an adequate response hasn't been achieved or could be chosen as initial treatment based on patient-specific factors such as comorbid conditions and personal history.
Both medications are available in generic forms which can significantly reduce cost especially for out-of-pocket patients. They may require an adjustment period before benefits become noticeable.
Side effect profiles are somewhat similar between these two drugs - they're usually well-tolerated but do carry risks of certain side effects: Strattera has less potential for insomnia and loss of appetite than Dexedrine but it notably carries a risk of suicidal ideation in children and adolescents. As always when starting new treatments, monitoring symptoms closely is critical – worsening ADHD symptoms or emerging thoughts about self-harm should prompt immediate contact with healthcare providers.
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Refrences
- Garnock-Jones, K. P., & Keating, G. M. (2009, May). Atomoxetine. Pediatric Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00148581-200911030-00005
- Childress, A. (2015, December). A critical appraisal of atomoxetine in the management of ADHD. Therapeutics and Clinical Risk Management. Informa UK Limited.http://doi.org/10.2147/tcrm.s59270
- Gibson, A. P., Bettinger, T. L., Patel, N. C., & Crismon, M. L. (2006, June). Atomoxetine Versus Stimulants for Treatment of Attention Deficit/Hyperactivity Disorder. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.1g582
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