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Strattera vs. Ritalin: Dosage Differences & More

Strattera vs. Ritalin: Dosage
Differences & More

Strattera and Ritalin are prescription medications used to
treat attention deficit hyperactivity disorder (ADHD). Both are designed to
help decrease hyperactivity and increase focus. Ritalin is also used to treat
the sleep disorder narcolepsy.

Although they’re both prescribed for ADHD, these two drugs
are very different. Strattera’s active ingredient is atomexetine hydrochloride.
It’s a selective norepinephrine reuptake inhibitor that affects the
neurotransmitters in the brain. It does not lead to dependence and is not
likely to be abused.

Ritalin’s active ingredient is methylphenidate
hydrochloride. This is a central nervous system stimulant, which
prevents the reuptake of both norepinephrine and dopamine in the brain, which
increases their duration of action. Ritalin is a federally controlled substance
because it can be habit-forming and is sometimes abused.

Learn about the important differences between Strattera and Adderall »

Strattera and Ritalin are available in a variety of doses.
It’s not unusual to start out with a low dose and gradually increase it until
symptoms improve. Dosages may have to be adjusted from time to time.

Both medications should be taken whole and never chewed or
crushed.

Strattera Dosage Information and Interactions

Strattera is available in 10, 18, 25, 40, 60, 80, and 100 mg
capsules. It can be prescribed for use either once or twice a day. While it can
be taken with or without food, it should be taken at the same time each day.

Strattera is rapidly absorbed, and maximum concentration occurs
one to two hours after taking it. Children’s doses are based on body weight,
and Strattera is approved to be given to children age six and older.

Strattera generally takes two to four weeks to become fully
effective, but you may feel some changes during the first few weeks. A small
percentage of people metabolize the drug very slowly, and may need to be
adjusted to a smaller dose. Strattera may be less convenient for children, especially
if they have difficulty swallowing capsules or remembering to take multiple
doses.

Some drugs are processed in the body through the same
pathway as Strattera, so the combination can increase the blood level and
effect of Strattera. These include drugs like paroxetine, fluoxetine and
quinidine. The dose of Strattera may need to be decreased.

Drugs that should not be taken with Strattera include MAO
inhibitors (some antidepressants) and pimozide.

The dose of Strattera or the following drugs combined with
Strattera may need to be adjusted:

  • inhaled drugs for asthma (like albuterol)
  • other stimulants
  • dofetilide (Tikosyn, used to treat heart arrhythmias)
  • weight loss drugs
  • over-the-counter decongestants

Tell your doctor about all drugs you are taking, including
over-the-counter drugs.

Ritalin Dosage Information and Interactions

Ritalin is available in 5, 10, and 20 mg tablets (in the
fast-release form) and is available in generic form also. This form is taken two
or three times a day, about 30 to 45 minutes before a meal. Ritalin can
interfere with sleep if taken too close to bedtime.

Ritalin is also available as Ritalin LA, a capsule that has
an extended 24-hour release. You could be switched to Ritalin LA after your
doctor first gets you started on the fast-release product and decides to adjust
your dosing pattern. Ritalin LA is available in 10mg, 20mg, 30mg and 40 mg
strengths.

It may take up to four weeks for ADHD symptoms to improve
under Ritalin. Ritalin is approved for children aged six and older, and children
usually start out taking 5 mg twice a day. Children should not take more than
60 mg a day. Adults usually take 20 to 30 mg a day. Some may only need 10 to 15
mg, but others may need up to 60 mg per day.

Ritalin also interacts with several drugs, and should not be taken with
MAO inhibitors (antidepressants including phenelzine and tranylcypromine), or
with alcohol.

Ritalin may increase the blood levels and effects of:

  • drugs used to treat hypertension
  • anticoagulants like warfarin
  • anticonvulsants like phenytoin,
    primidone, and phenobarbital
  • tricyclic antidepressants
    (amitriptyline and others)
  • some drugs used to treat
    Parkinson’s disease
  • some antipsychotic drugs

Drugs that may increase the blood levels and effects of Ritalin include:

  • alcohol
  • antacids
  • antipsychotic agents
  • Strattera
  • drugs for digestive illness,
    including ranitidine and omeprazole

For a complete list of Ritalin drug interactions, visit the NIH.

Complications, Side Effects, and Other
Considerations

The Strattera label warns of the possibility of suicidal
thoughts in children and teens who take the medication. That risk is higher
early in treatment or when the dosage is adjusted. Contact your doctor
immediately if your child takes Strattera and exhibits signs of depression,
anxiety, or suicidal thinking.

Side effects of Strattera may include:

  • upset stomach
  • decreased appetite
  • nausea
  • fatigue
  • sleepiness

Children can experience slowed growth. Taking Strattera also
raises risk for liver damage and heart problems. Children should be screened
for heart problems before starting Strattera. No studies have been conducted in
children under the age of six.

People who take Ritalin can become dependent upon it, and
have difficulty stopping taking it. You should not take Ritalin if you have a
history of substance abuse. If you stop taking it suddenly, you may experience
symptoms of withdrawal, which can lead to serious depression. These symptoms
may worsen if you’re used to taking a high dose. It’s best to taper off the
medication slowly, under a doctor’s care.

Ritalin also has potential to be abused by people who don’t
have ADHD, when it’s used as a stimulant. You should never take Ritalin without
a prescription.

Ritalin can cause heart problems, especially in people with
preexisting cardiovascular issues. Some patients experience circulation
problems in fingers and toes. New or worsening psychiatric symptoms have also
been reported. Headache, upset stomach, and decreased appetite can also be side
effects of Ritalin.

Ritalin can slow growth in children. Some doctors will
advise discontinuing Ritalin for a few months each year, to help counteract
this effect.

Allergic reaction is a possibility with any medication. Notify
your doctor immediately if you experience rash, hives, or swelling. Tell your
doctor about all the medications you’re taking. Other over-the-counter and
prescription medications and supplements can interact with these medications.

Strattera and Ritalin can be stored at room
temperature, but should be kept away from moisture, heat, and light. Both
brand name drugs are available in generic form. Other brand names for methylphenidate hydrochloride include Concerta,
Metadate, Methylin, and Quillivant.

Posted by: Dr.Health

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