Strattera, Ritalin, and Adderall are medications which are routinely prescribed for ADHD. Though they are intended to manage the symptoms of the same condition, they are some key differences between the drugs. In this article, we will look at these in detail.
What is ADHD?
ADHD (Attention deficit hyperactivity disorder) is a condition which presents with behavioural symptoms such as the inability to pay attention and focus, hyperactivity, and impulsivity.
The condition is usually diagnosed at an early age, and symptoms tend to become more noticeable when a child interacts with others under different circumstances and in different settings, such as in school. Most occurrences of ADHD are diagnosed in children between 6 and 12 years old. Symptoms can become less pronounced as people get older, though adults can continue to experience problems like anxiety and sleep disorders. Adults are not generally diagnosed with ADHD, and if they are, it is likely they have had it since childhood and it has been misdiagnosed as something else.
Symptoms of ADHD
The main symptoms of ADHD are the inability to pay attention or focus on anything, and hyperactivity and impulsivity. People with the condition may not have all these symptoms however. There is a disorder called ADD, which is essentially ADHD but without the hyperactivity. These conditions are usually referred to interchangeably, but they aren’t the same.
Symptoms in children and young people
Many children with the condition are diagnosed before the age of 6. The most noticeable signs are:
Being easily distracted
Being unable to listen to instructions and take direction
Inability to order tasks
Doing things without thinking
Interrupting other’s conversations
Obviously, these symptoms can cause problems for a child at school, and they often lead to issues with discipline and underachieving.
Symptoms in adults
The research into adult ADHD is lacking, but what is known is that because it’s a developmental disorder, the condition always appears in childhood. Adults with ADHD might display signs of depression and anxiety. By the age of 25, around 15% of people with ADHD still exhibit all of the symptoms they had as children, and 65% of people are affected in some way, even if they don’t have the full range of symptoms. Adult ADHD tends to show as inattentiveness, rather than hyperactivity. Adults may demonstrate the following symptoms:
Inability to finish tasks
Inability to focus on tasks
Mood swings and irritability
Engaging in risky behaviour
What causes ADHD?
The exact cause of the condition is unknown, but it is clear that it runs in families, and that there are certain differences in the brains of people who have ADHD compared to those who don’t. Some possible contributing factors to the development of the condition include:
Being born prematurely
Being subjected to smoke, alcohol, or drug abuse while in the womb
Treatment for the condition centres around relieving symptoms so that it has less of an effect on daily life. The usual treatments are either medication or therapy, or a combination of the two.
There are five types of medication licensed for the treatment of ADHD, though the 2 most common are methylphenidate and dexamfetamine. Medication won’t cure ADHD but it can help those with the condition to be calmer and more focused. Low doses are given initially so that side effects can be monitored. Side effects tend to become more likely at higher doses.
Therapy can be a useful addition to a medication regime, and it can help with anxiety or behavioural disorders that might develop with the ADHD.
Therapies that you may be offered include;
Those with ADHD are encouraged to talk about their condition and how it affects their lives. It can help people to cope and live with their diagnosis.
This teaches children with the condition about what constitutes appropriate behaviour, rewarding good behaviour, and withdrawing privileges for bad behaviour.
Parent training and education programmes
These programmes teach techniques to parents about how to play and work with children to improve their attention and behaviour.
There are other lifestyle factors that may improve symptoms of ADHD, however more research is needed as to whether they are actually effective.
Some studies have shown suggested that there is a link between certain types of food and worsening symptoms. Some food additives and colourings, and caffeine can make hyperactivity worse Keeping a food diary may help to identify anything that may makes symptoms worse.
Research has suggested that supplementation with omega-3 and omega-6 fatty acids might help those with ADHD, but further study is needed in this area.
Medications for ADHD
What is it used for?
Methylphenidate (Ritalin) is a man-made drug, which is classed as a stimulant. You might have also seen it under the brand names of Concerta, and Metadate, among others. The active compound in methylphenidate is dexmethylphenidate. The drug was first approved for the treatment of ADHD in 2001.
The medication treats ADHD by changing the levels of chemicals in the brain which control behaviour, attention, and focus. It is classed as a stimulant, and it is also used to treat narcolepsy, however, this would be an off-licence use for the drug.
Possible side effects include trouble sleeping, nausea, stomach problems, headaches, and dizziness. There may be issues when taking the drug for a long period of time as it can potentially affect a child’s growth rate and weight.
What is it used for?
The amphetamine salts which make up Adderall are dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulphate, and amphetamine sulphate; often abbreviated to 75% dextroamphetamine + 25% levoamphetamine. Adderall is also a man-made drug, it is classed as a stimulant, and was first approved for the treatment of ADHD in 1996. Both Ritalin and Adderall are approved to treat ADHD, although Adderall is approved to treat narcolepsy, unlike Ritalin.
Adderall works in a similar way to Ritalin, and changes the levels of chemicals in the brain which control attention and behaviour. One of its main effects is that it combats daytime sleepiness.
Possible side-effects include dry mouth, stomach upsets, nausea, headache, diarrhoea, and trouble sleeping.
This medication can also cause problems with the normal development of a child’s height and bodyweight, so monitoring is required.
What is it used for?
Strattera is also approved for the treatment of ADHD; however, this drug seems to be especially effective in treating symptoms in adults. The medication can improve attentiveness and reduce hyperactivity, but the big difference between Strattera and the other medications is that it is not a stimulant. There are no ‘jitters’, so it is effective at treating anxiety too, which many adults who have ADHD experience. It is not known exactly how Strattera works, but it does appear to have effects on the neurotransmitters in the brain.
Which ADHD Medication Is Better?
This is a question that is often asked, but the answer is that the best drug is the one that treats the patient’s symptoms effectively, without causing too many side effects. Here is a review of the similarities and differences between the medications.
All of the medications are licensed for the treatment of ADHD. Adderall is licensed to treat the sleep disorder narcolepsy, whereas Ritalin is not strictly licensed for this. Strattera treats ADHD, but is most commonly prescribed for adults who get symptoms.
Ritalin is available in immediate release form, which has an effect for between 4 and 6 hours, and a slow-release form, which acts for up to 12 hours. This is similar to the available forms of Adderall. The immediate release form of Ritalin only has 3 dosage options (2.5 mg, 5mg, and 10mg), compared to 7 for Adderall (5 mg, 7.5 mg, 10 mg, 12.5 mg, 15mg, 20 mg, and 30 mg). This gives doctors more scope for changing/adjusting dosages where needed. But Ritalin’s slow-release formulation has more dosage options than Adderall. Immediate release formulations of Ritalin are generally cheaper than the same dose of Adderall, but this largely depends on whether you opt for a brand name or a generic formula.
Strattera comes in oral capsules of 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, and 100 mg. It comes as a standard release formula.
How long does their effect last?
Both Focalin and Adderall work similarly on the brain, and are of similar potency. Both the immediate and slow-release formulations of each drug produce effects for a similar duration of time. The immediate release formula acts for between 4 and 6 hours, and the slow release formula works for up to 12 hours.
Strattera’s effects can last longer than that of the stimulant medications, and have been known to work for up to 14 hours, but it is hard to give an exact approximation, as everyone metabolises drugs differently.
Potential for abuse
Ritalin and Adderall are classed as controlled substances, which means that they have a high potential for abuse and can be habit-forming. They are only available on prescription. They medications can affect the levels of the chemical dopamine in the brain, which is a chemical associated with pleasure. High doses of the drugs can give users a euphoric feeling, which is why they can be so addictive. The user will then take more of the drug to produce the same euphoric effect as tolerance develops.
Adderall is widely available and is often abused by those who want to lose weight, be alert for studying, or even when people want to feel euphoric at parties or in nightclubs. psychosis has developed in some people as a result of the drug causing an imbalance of dopamine levels. This can manifest as hallucinations and delusions, even in those who have no history of mental illness.
Stopping either medication can be difficult for those who have taken high doses or have abused the drugs, as considerable withdrawal effects can be experienced due to changes in dopamine levels in the brain for an extended period of time.
Strattera is also a prescription drug, but the big difference with this medication is that there is no potential for developing dependence on the drug or abusing it. Unlike stimulants, which manipulate the levels of dopamine and norepinephrine in the brain, Strattera affects only the norepinephrine. Dopamine plays a role in pleasure and addiction. Strattera is not a controlled substance, and it can be prescribed with refills.
Ritalin and Adderall are relatively expensive, and cost will depend on whether you buy a brand name or a generic product, the formulation you buy, and in what dosage. Adderall’s slow-release formula costs less than the equivalent Ritalin formula but immediate-release Adderall is a lot more expensive than the same formula of Ritalin. However, generic versions of either drug cost roughly the same for a 30-day supply. Higher dosages typically cost more than lower doses whether generic or branded.
Strattera is quite expensive, and it is only currently available as a brand name. A 30-day supply will set you back between $420 and $500.
Which drug is more effective?
All of the drugs are used to treat ADHD and are considered preferred treatments. Neither of the drugs are considered among experts to be better than the others. In a study, Adderall’s immediate-release formula was found to reduce the symptoms of ADHD by 80% compared to the same formulation of Ritalin, which reduced them by 79%; the difference is negligible.
Both drugs are very potent, and both did better than a placebo in tests. Some studies have suggested that Adderall may be more effective for treating ADHD than Ritalin. The studies appeared to show that one dose of Adderall was more effective than 2 doses of Ritalin. However, everyone reacts to drugs differently, and the most effective drug is the one that works for the individual.
There is an alternative, however. Strattera, is the only nonstimulant ADHD drug available, and is the first such drug to be approved for use in treating adult symptoms. Research has shown that it is safe and effective for long-term use, although it may not take effect as quickly as stimulants.
A 2008 study looked at 400 adults with ADHD who took Strattera for up to 4 years. Those who took part saw their ADHD symptoms reduce by more than 30%, and what’s more, they experienced no side effects.
How do they work?
The medications have a similar action, in that they manipulate the levels of chemicals in the brain which control behaviour and attention. But while Adderall and Ritalin inhibit dopamine and norepinephrine, Strattera only works on norepinephrine. Strattera does not cause as many side effects or a jittery feeling, which is associated with stimulant use.
The side effects of Ritalin and Adderall are similar. Everybody reacts to drugs differently, so side effects will vary, but with both drugs, there appears to be a common set of side effects, such as dizziness, nervousness, stomach problems, insomnia, and weight loss.
The side effects people experience will strongly influence which medication they prefer. Some studies suggest that Ritalin produces less of a jittery feeling and less of a ‘rebound’ effect than Adderall. A rebound effect is when an individual can feel low and depressed after a certain number of hours after they have taken the medication.
Side effects of Strattera can include:
In children and teenagers: upset stomach, decreased appetite, nausea or vomiting, dizziness, tiredness, and mood swings.
In adults: constipation, dry mouth, nausea, decreased appetite, dizziness, sexual side effects, and problems passing urine.
An important point to make about Strattera is that some children and teenagers taking the drug will experience suicidal thoughts. This seems to occur in 4 out of every 1000 patients.
Heart-related problems have also been reported with Strattera. Sudden death has been reported in patients who have existing heart problems or heart defects. There have also been reports of stroke and heart attack in adults, and increased blood pressure and heart rate.
Whichever drug you take, the likelihood of side effects increases as dosage increases.
Adults can suffer from ADHD, and often they experience a continuation of symptoms that started in childhood. ADHD is a developmental disorder, which means that it begins at an early age. The condition will manifest differently in adults and children however, and as a person gets older, they will tend to have less hyperactivity and demonstrate more inattentiveness and risk-taking behaviour.
Available treatments are focus on controlling the symptoms so that the condition impacts less upon daily life. There is no cure for ADHD. Medication and various psychological/behavioural therapies are usually the treatments of choice.
Therapy usually focuses on getting a person to talk about their condition, to make sense of it, and to teach them how to cope. It can help to teach parents of children with the condition to learn how to manage their behaviour and to support their child accordingly.
Medications, such as Focalin, Adderall, and Strattera are very effective first-line treatments for ADHD. They work by acting on the levels of chemicals in the brain that affect behaviour, focus and attention. They have a calming effect on the person who takes them, which means that their symptoms should be less disruptive to their everyday lives.
As with all drugs, they can have side effects. As the drugs act on the chemicals in the brain, side effects are normally quite standard for most people. They range from headaches, insomnia, stomach problems, and weight loss, to dizziness and nervousness. As everyone is different, however, people tolerate the drugs in different ways. The side effects that are experienced will generally affect someone’s perception of how a medication works.
Ritalin and Adderall are available in immediate-release and slow-release formulas, which are effective for similar durations of time. Strattera is potentially longer-acting than either medication, but it tends to take longer to take effect.
Ritalin and Adderall are expensive if you buy the branded version. You can buy cheaper generic versions of both medications, but Strattera is only available as a branded drug currently, and is pretty expensive.
Ritalin and Adderall can potentially cause dependence, and more people tend to abuse Adderall, as it tends to be more popular and more widely available. People will abuse the medication to experience a euphoric high, to lose weight, and to be more alert when studying. The effect that the medication has on the brain in terms of increasing dopamine levels explains why it can easily become addictive.
Strattera does not cause dependence because it only works on one of the brain’s chemicals.
Whether Adderall, Focalin, or Strattera is your drug of choice, the choice should be determined by how effective it is for you and whether the side effects (if any) are tolerable.