This post is a side-by-side comparison of the advantages/disadvantages of Strattera vs Adderall vs Ritalin.
A comparison of Adderall and Vyvanse, the bestselling prescription ADHD medication at the moment, can be found here.
Adderall is a psychostimulant which promotes catecholamine (dopamine, norepinephrine) release, increasing the synaptic concentrations of these neurotransmitters.
Ritalin inhibits the reuptake of dopamine, and has little effect on norepinephrine.
Strattera is a highly selective norepinephrine re-uptake inhibitor, that was initially developed as a treatment for depression, but demonstrated little antidepressant effects and was therefore repurposed for ADHD.
The abuse potential and likelihood of developing dependence for these medications can be ranked as follows: Adderall > Ritalin >> Strattera, where Adderall has the greatest abuse potential. Reflecting this difference, both Adderall and Ritalin are controlled substances (schedule II), whereas Strattera is uncontrolled.
Unlike Adderall and Methylphenidate, the therapeutic effects of Strattera take time to build up to be fully appreciated.
Adderall has a greater incidence of unsavory cardiovascular side effects compared to Ritalin and Strattera, such as increased blood pressure, increased heart rate and heart palpitations. Adderall is also associated with peripheral vasocontriction, which causes the extremities (hands and feet) to feel cold.
Strattera is much less likely to cause insomnia compared with Adderall and Ritalin.
|Medication||Strattera (atomoxetine)||Adderall (amphetamine salts)||Ritalin (methylphenidate)|
|Classification||Non-stimulant; norepinephrine reuptake inhibitor (NRI)||psychostimulant; catecholamine releasing agent||psychostimulant; dopamine reuptake inhibitor (DRI)|
|Indications (used to treat)||ADHD||ADHD, narcolepsy, obesity (off-label), depression (off-label)||ADHD, postural orthostatic tachycardia syndrome, narcolepsy, depression (off-label)|
|Common side effects||Upset stomach, decreased appetite, nausea, dizziness, fatigue, mood swings||Chronic insomnia, irritability, false sense of well-being, loss of appetite, nervousness, vomiting, upper abdominal pain||Chronic insomnia, dry mouth, head pain, loss of appetite, nervousness, over excitement, upper abdominal pain|
|Serious side effects||Inability to empty bladder, erectile dysfunction, painful periods, depression, easily angered, rapid heartbeat||Allergic reaction, anxiety, restlessness, fever, hives, rash, difficulty breathing, urinary tract infections||Rapid heartbeat, high blood pressure, angina, chest pain, chronic muscle twitches, decreased blood platelets, fever, hives|
|Contraindications||Monoamine oxidase inhibitors (MAOI), hypersensitivity, narrow angle glaucoma, pheochromocytoma, severe cardiovascular disorders||Advanced arteriosclerosis, symptomatic cardiovascular disease, hypertension, hyperthyroidism, known hypersensitivity, agitation, history of drug abuse, monoamine oxidase inhibitors (MAOI)||Marked anxiety, tension, agitation, hypersensitivity, glaucoma, motor tic syndrome, Tourette’s syndrome, monoamine oxidase inhibitors|
|Half-life||5.2 hours; 21.6 hours (in poor metabolizers)||10 hours (adults); 11 hours (adolescents)||3.5 hours (adults); 2.5 hours (children)|
|Standard dose||20 mg -100 mg||5 mg – 30 mg||10 mg – 40 mg|
|Formulations||Strattera (Atomoxetine HCl)||Adderall, mixed amphetamine salts (generic), Vyvanse (lisdexamfetamine)||Concerta (12 hours), Ritalin SR (5-8 hours), Ritalin LA (8 hours), Metadate-CD (8-10 hours), Quillivant XR (12 hours), Daytrana (11 hours)|