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Vyvanse vs Strattera
Introduction
For patients with Attention Deficit Hyperactivity Disorder (ADHD) or other types of cognitive and attention disorders, certain drugs that modify the concentrations of compounds in the brain related to focus and impulse control can aid in managing symptoms. Vyvanse and Strattera are two such medications often prescribed for ADHD. They each impact different neurotransmitters in the brain but both have effects on improving concentration, reducing impulsivity, and increasing overall attention span in patients with ADHD. Vyvanse is a central nervous system stimulant which primarily affects levels of dopamine by promoting its release and inhibiting its reuptake. On the other hand, Strattera functions as a selective norepinephrine reuptake inhibitor (NRI), primarily affecting levels of norepinephrine.
Vyvanse vs Strattera Side By Side
| Attribute | Vyvanse | Strattera |
|---|---|---|
| Brand Name | Vyvanse | Strattera |
| Contraindications | Should not be taken with MAO inhibitors or certain antidepressants like Prozac. May worsen symptoms of anxiety or agitation. | Should not be taken with MAO inhibitors or certain antidepressants like Prozac. May worsen symptoms of anxiety or agitation. |
| Cost | Around $380 for 30 capsules of 30 mg | Around $420 for 30 capsules of 40 mg, generic atomoxetine significantly less expensive at about $1 to $3 per day |
| Generic Name | Lisdexamfetamine | Atomoxetine |
| Most Serious Side Effect | Increased thoughts about suicide or self-harm, signs of allergic reaction, changes in vision, cardiovascular symptoms, low sodium levels, severe nervous system reactions. | Signs of an allergic reaction, new mental/mood changes, liver problems, uncontrolled movements or vocal outbursts, urination problems, irregular heartbeat and chest pain. |
| Severe Drug Interactions | MAO inhibitors (MAOIs), certain antidepressants. | MAO inhibitors (MAOIs), certain antidepressants. |
| Typical Dose | 30-70 mg/day | Starts at 40 mg/day for adults and children over 70 kg, and 0.5 mg/kg/day for individuals less than 70 kg. Can increase to a target dose of about 1.2 mg/kg/day. |
What is Vyvanse?
Lisdexamfetamine (the generic name for Vyvanse) is a first-line medication for Attention Deficit Hyperactivity Disorder (ADHD), and it's known as a stimulant drug. It was first approved by the FDA in 2007. Vyvanse works by increasing levels of dopamine, a neurotransmitter associated with pleasure, attention, and movement in the brain. It is prescribed for the treatment of ADHD in both children and adults.
On the other hand, Atomoxetine (the generic name for Strattera) represents a different class of treatment - it's actually a selective norepinephrine reuptake inhibitor (NRI). This means that while also used to treat ADHD like Vyvanse, its mechanism is different; Strattera selectively inhibits the reabsorption of norepinephrine which can help increase attention span and decrease impulsivity and hyperactivity often seen in individuals with ADHD.
Both medications are effective but they have different side effects profiles due to their difference in action on brain chemicals.
What conditions is Vyvanse approved to treat?
Vyvanse and Strattera are approved for the treatment of different variations of attention disorders:
- Vyvanse is used to treat Attention Deficit Hyperactivity Disorder (ADHD) in both children (6 years and older) and adults, as well as Binge Eating Disorder in adults.
- Strattera, on the other hand, is also used to manage ADHD but it's non-stimulant. It can be administered to children (over 6 years old), adolescents, and adult patients.
How does Vyvanse help with these illnesses?
Vyvanse helps manage symptoms of Attention Deficit Hyperactivity Disorder (ADHD) by increasing the amount of dopamine available in the synapses of the brain. It does this by stimulating its release and blocking its reuptake into 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, playing an important role in mood, motivation, attention and reward systems among other things. It is thought that individuals with ADHD have relatively lower levels of dopamine or disruptions in dopamine pathways. Therefore, by increasing dopamine availability, Vyvanse can limit negative effects associated with ADHD such as difficulty concentrating or remaining still, impulsivity and hyperactivity thus helping patients manage their condition more effectively.
What is Strattera?
Strattera, the brand name for atomoxetine, is a selective norepinephrine reuptake inhibitor (NRI), which means it increases levels of norepinephrine in the brain by reducing its reabsorption. Strattera was first approved by the FDA in 2002 for use as a treatment for Attention Deficit Hyperactivity Disorder (ADHD). Unlike Vyvanse and other stimulant medications used to treat ADHD, Strattera is not a controlled substance, meaning it has less potential for abuse and dependence. Atomoxetine does not increase dopamine in the prefrontal cortex, which means that its side-effect profile differs from those of traditional stimulants like Vyvanse. Specifically, Strattera is less likely than stimulants to cause insomnia or decreased appetite (common side effects of stimulants). The impact on norepinephrine alone makes Strattera beneficial particularly in treating patients with ADHD who do not respond well to typical stimulant drugs such as Vyvanse.
What conditions is Strattera approved to treat?
Strattera is an FDA-approved medication utilized for the management of:
- Attention-deficit/hyperactivity disorder (ADHD) in both pediatric and adult patients
- It's unique among other ADHD medications as it's a non-stimulant, reducing concerns about abuse potential often associated with stimulant drugs.
How does Strattera help with these illnesses?
Norepinephrine, also known as noradrenaline, is an essential neurotransmitter and hormone in the body. It has various functions including enhancing memory recall, promoting focus and attention, contributing to wakefulness and preparing the body for action under stress through the "fight or flight" response. Low levels of norepinephrine have been associated with ADHD (Attention Deficit Hyperactivity Disorder). Strattera works by increasing norepinephrine levels in the brain subsequently improving symptoms of ADHD such as impulsivity, distractibility and hyperactivity. Unlike Vyvanse which primarily increases dopamine levels in the brain, Strattera does not significantly affect dopamine thus making it a non-stimulant medication suitable for patients who may not respond well to stimulants due to side effects or personal preference.
How effective are both Vyvanse and Strattera?
Lisdexamfetamine (Vyvanse) and atomoxetine (Strattera) are both FDA approved for the treatment of attention deficit hyperactivity disorder (ADHD), although they act on different neurotransmitters. Vyvanse is a stimulant that increases dopamine and norepinephrine levels in the brain, while Strattera is a non-stimulant drug that selectively inhibits the reuptake of norepinephrine.
In clinical studies, Vyvanse has shown superior efficacy in reducing ADHD symptoms compared to placebo. A 2007 double-blind clinical trial demonstrated that patients taking Vyvanse experienced significant reductions in core ADHD symptoms such as impulsivity, hyperactivity, and lack of focus compared to those receiving placebo. The same study also noted fewer reported side effects with Vyvanse than other stimulants, making it a popular choice among prescribers.
A meta-analysis conducted in 2012 showed Strattera's effectiveness at managing ADHD symptoms from the first week of treatment onward. It revealed favorable safety profiles over many other ADHD medications due to its non-stimulant nature which makes it less likely to cause addiction or physical dependence. Furthermore, this study reports Strattera being particularly effective for patients who have not responded well to stimulant drugs or have co-existing conditions like anxiety disorders which might be exacerbated by stimulants.
However, despite these promising results for both drugs, their use depends greatly on individual patient needs and responses. While some may respond better to one drug over another due to varying genetic factors affecting metabolism and absorption rates or personal tolerability towards certain side effects; others may require combination therapy involving both medications prescribed together for optimal outcomes.
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At what dose is Vyvanse typically prescribed?
Oral dosages of Vyvanse range from 30-70 mg/day, but studies have indicated that 30 mg/day is sufficient for treating attention deficit hyperactivity disorder (ADHD) in most people. Dosage may be increased by your doctor after a week if there is no response to initial dose. The maximum dosage that should not be exceeded in any case is 70 mg/day. Conversely, Strattera starts at a lower dosage which usually ranges from 10–20 mg per day for children and adolescents, while adults might start with a dosage of 40 mg per day. It can gradually increase based on the patient's weight and the physician’s guidance up to an absolute maximum of 100mg/ day.
At what dose is Strattera typically prescribed?
Strattera treatment generally starts at a dosage of 40 mg/day for adults and children over 70 kg. In individuals less than 70 kg, the initial dose is typically around 0.5 mg/kg/day. The dose can then be increased after a minimum of three days to a target total daily dose of approximately 1.2 mg/kg administered either as a single daily dose in the morning or as evenly divided doses in the morning and late afternoon/early evening. The maximum recommended total daily dose in children and adolescents weighing up to 70 kg is 100mg; for those above this weight, it's usually capped at 120mg per day.
Always remember that Strattera does not have an immediate effect like stimulant medications do - it may take several weeks before optimal results are observed, so don't be discouraged if you don't see changes right away. As always, consult your doctor or pharmacist with any questions about these medications.
What are the most common side effects for Vyvanse?
Common side effects of Vyvanse and Strattera include:
- Anxiety
- Insomnia (trouble sleeping)
- Dry mouth
- Decreased appetite
- Nausea or vomiting
- Increases in blood pressure and heart rate
- Abdominal pain, discomfort, or upset stomach
- Dizziness
- Irritability
Further potentially serious but less common side effects can include:
For Vyvanse - increased heart rate, palpitations, tics, allergic reactions such as rash or hives.
For Strattera - liver damage symptoms like yellowing skin/eyes, dark urine; changes in sexual desire or ability; urination problems; abnormal thoughts.
It's important to note that each individual may react differently to these medications and this is not a comprehensive list of all possible side effects. Always consult with your healthcare provider for personalized advice.
Are there any potential serious side effects for Vyvanse?
In rare cases, Vyvanse can cause potentially serious side effects, which include:
- Increased thoughts about suicide or self-harm
- Signs of allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Changes in vision including blurred vision or eye pain
- Cardiovascular symptoms like fast heartbeats, palpitations (fluttering in your chest), shortness of breath and sudden dizziness
- Low sodium levels characterized by headache, confusion, slurred speech, severe weakness and loss of coordination
- Severe nervous system reactions like rigid muscles (stiffness), high fever and tremors
Strattera has its own set of potential risks which also include suicidal thinking. Other potential Strattera-related side effects are:
- Allergic reactions: rash, itching/swelling (especially on the face/tongue/throat)
- Dark urine
- Abnormal heartbeat/pulse rate
-Chest/jaw/left arm pain
-Signs of liver disease such as persistent nausea/vomiting/loss of appetite/stomach pain/yellowing eyes/skin/dark urine
Both medications need to be closely monitored by a healthcare provider due to these potential side effects. It is important to report any unusual behavior changes or physical health concerns immediately.
What are the most common side effects for Strattera?
Strattera, a non-stimulant medication used for attention deficit hyperactivity disorder (ADHD), has some distinct side effects that one should be aware of:
- Dry mouth and throat problems
- Upset stomach, nausea, vomiting and loss of appetite
- Sleep disturbances including insomnia
- Mood-related symptoms such as anxiety or nervousness
- Slower heart rate rather than a faster one
- Possible skin conditions like rashes
- Potential weight gain instead of weight loss
- Difficulty urinating or increased frequency
- Headaches and dizziness are also common -Muscle pain or joint discomfort.
It's important to note that not everyone experiences these side effects when taking Strattera. Always consult with your healthcare provider about any concerns you may have regarding medication.
Are there any potential serious side effects for Strattera?
While Strattera is a commonly prescribed drug used to manage ADHD symptoms, it can occasionally cause serious side effects. These may include:
- Signs of an allergic reaction such as skin hives, itching, difficulty breathing or swallowing; swelling of your face, lips, tongue or throat
- New mental/mood changes (such as agitation, panic attacks, hostility), abnormal thoughts/behavior including suicidal ideation or attempts
- Liver problems marked by upper right abdominal pain; dark urine; yellowing eyes/skin
- Uncontrolled movements (motor tics) or vocal outbursts
- Urination problems (trouble urinating or urinary retention)
- Irregular heartbeat and chest pain
If you experience any of these symptoms while taking Strattera seek medical attention immediately.
Contraindications for Vyvanse and Strattera?
Both Vyvanse and Strattera, 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, irritability or other unusual behavior, please seek immediate medical attention.
Neither Vyvanse nor Strattera should be taken if you are taking, or have recently been taking monoamine oxidase (MAO) inhibitors (MAOIs). Always inform your physician about the medications you are currently on; MAOIs will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with Vyvanse and Strattera. Both these drugs can also interact adversely with certain antidepressants like Prozac. Hence it is crucial that all current medication information is shared with your healthcare provider for safe usage.
How much do Vyvanse and Strattera cost?
For the brand name versions of these drugs:
- The price of 30 capsules of Vyvanse (30 mg) averages around $380, which works out to about $12.60/day.
- The price of 30 capsules of Strattera (40 mg) is approximately $420, or roughly $14/day.
Thus, if you are in the higher dosage range for Vyvanse (i.e., 70 mg/day), then brand-name Strattera may be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which one of these drugs is right for you as both treat ADHD but they belong to different drug classes and have different mechanisms.
As far as generic options go:
- There currently isn't a generic version available for Vyvanse.
- Generic atomoxetine (the active ingredient in Strattera) can reduce costs significantly with prices ranging from about $1 to $3 per day depending on dosages and quantity purchased.
Popularity of Vyvanse and Strattera
Lisdexamfetamine, in generic form as well as brand names such as Vyvanse, was estimated to have been prescribed to about 10.7 million people in the US in 2020. Lisdexamfetamine accounted for just over 26% of prescriptions for ADHD medications in the US. It appears to be one of the most commonly prescribed stimulant drugs used to treat attention deficit hyperactivity disorder (ADHD). The prevalence of lisdexamfetamine has generally increased since its approval by the FDA in 2007.
Atomoxetine, including brand versions such as Strattera, was prescribed to around 2.3 million people in the USA during that same year. In terms of non-stimulant ADHD medication prescriptions within the US, atomoxetine takes up a significant share due to it being one of few approved non-stimulant options available and because some patients respond better or can tolerate this type compared with others. While overall prescription numbers are less than those for lisdexamfetamine and other stimulants primarily because these latter ones tend to be more effective on average across individuals with ADHD, atomoxetine's usage has remained relatively stable over recent years.
Conclusion
Both Vyvanse (lisdexamfetamine) and Strattera (atomoxetine) have been proven to be effective in the management of Attention Deficit Hyperactivity Disorder (ADHD), with numerous clinical studies and meta-analyses supporting their usefulness over placebo treatments. Occasionally, these drugs may be used in combination, but this would require careful evaluation by a physician as they also carry potential contraindications. Because of their different mechanisms of action - with Vyvanse being primarily a central nervous system stimulant and Strattera being a selective norepinephrine reuptake inhibitor - they are often prescribed under diverse circumstances.
Vyvanse is typically considered first-line for ADHD treatment due to its immediate release and quick effects, whereas Strattera might be preferred when there's concern about misuse or addiction since it doesn't provide an immediate "high". Both medications come in generic forms offering cost savings for patients who must pay out-of-pocket.
It's important to note that both Vyvanse and Strattera may necessitate an adjustment period before full benefits can be felt. Side effects between the two vary; while both are generally well-tolerated, Vyvanse tends to have more side effects like loss of appetite or insomnia than Strattera. As with all medications used for mental health conditions, patients should closely monitor any changes in mood or behavior, especially during initial treatment phases or dose adjustments.
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Refrences
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- 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
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