Two Approaches to ADHD
Strattera and Vyvanse are
two types of drugs used to treat attention deficit hyperactivity disorder
(ADHD). While both are FDA-approved for ADHD treatment, these prescription
medications are not the same. Strattera is a selective norepinephrine
reuptake inhibitor (SNRI). Vyvanse is a stimulant. These ADHD drugs work in two
distinct ways, and they carry separate risks for side effects. Work with your
doctor to determine the best treatment approach.
How They Work
Strattera is the brand name
for the active ingredient atomoxetine hydrochloride. Though many SNRIs are used
to treat depression, Strattera is only used for ADHD. It works by changing both
the way the brain absorbs the chemical norepinephrine and how the chemical acts
in the body. Also called a neurotransmitter, norepinephrine affects your
overall mood. In managing the chemical, Strattera may be able to:
- reduce impulsive
Vyvanse is the formal name
for the active stimulant ingredient lisdexamfetamine dimesylate. It is an
amphetamine. This medication has the same treatment goals as Strattera, but it
achieves them quite differently. Like Strattera, Vyvanse also alters brain
chemicals. However, its focus is on dopamine and norepinephrine.
Understand the potential problems of mixing Vyvanse and alcohol »
Vyvanse increases the
duration of the two neurotransmitters in neurons in the brain, which may help
with ADHD symptoms. Vyvanse converts into the active form of the drug after it
enters your the body. Because of this, the drug may have less abuse potential
than other stimulants.
The U.S. Food
and Drug Administration (FDA) has approved
Strattera for the use in ADHD patients six years and older. It comes in the
form of capsules that are taken one to two times per day; its action lasts
several hours. Your doctor will recommend the smallest dose possible to start.
Strattera comes in the following dosing options:
- 10 milligrams
- 18 mg
- 25 mg
- 40 mg
- 60 mg
- 80 mg
- 100 mg
Conversely, Vyvanse is a
long-acting medication. According to the Cleveland Clinic, it works for approximately 13 hours. Vyvanse lasts longer than both Strattera
and other ADHD stimulants. It also works quicker than Strattera.
Vyvanse is taken once a day.
It enters your body in an inactive form. As you digest the drug, your body
slowly converts it into its active form. You should take a capsule in the
morning to gain the most benefits during waking hours.
According to DailyMed,
Vyvanse is also approved for people ages six and older. Most doctors prescribe
30 mg to start. The maximum dose is 70 mg per day. If the starting dose isn’t
enough, your doctor might increase it by 10 to 20 mg per week until the desired
dose is reached. Vyvanse has the
following dosing options:
- 20 mg
- 30 mg
- 40 mg
- 50 mg
- 60 mg
- 70 mg
Warnings and Side Effects
Strattera may cause the following
- abdominal pain,
- decreased sexual
- dry mouth
cardiovascular events, including sudden death, in patients with pre-existing
- tiredness and/or
- thoughts of
suicide (especially in children and teens)
- weight loss
SNRIs like Strattera may not
be safe if you have high blood pressure (hypertension) or liver disease. A
history of depression may also increase the risk for side effects.
Vyvanse may cause:
- dry mouth
- loss of appetite
- increased blood pressure
- weight loss
- increased heart
cardiovascular events, including sudden death in people with pre-existing heart
- vision changes
Vyvanse and other stimulants
are not recommended for people who have a history of:
- drug or alcohol
- use of an MAO
inhibitor within the previous 14 days
- heart disease
- irregular heart
thyroid gland (hyperthyroidism)
Drug interactions should be
considered when taking any kind of medication. In some cases, a doctor might
prescribe more than one drug for ADHD. Vyvanse is not an antidepressant, so it
might be combined with antidepressants. Strattera, on the other hand, is not
recommended for use with other antidepressants.
Talk to your doctor if you
currently take any:
- MAO inhibitors
For a complete list of
Vyvanse drug interactions, see a complete list from the National Institutes of Health (NIH).
Strattera drug interactions
- drugs to treat
hypertension or to raise blood pressure. These drugs should be used cautiously
and carefully monitored.
- MAO inhibitors.
These should never be taken at the same time as Strattera.
Some of these drugs may
require dose adjustments and some should not be used with Strattera. Tell your
doctor about all prescription and non-prescription drugs you are using. Visit DailyMed
for more information on drug interactions with Strattera.
Which Is Best for ADHD?
Stimulants like Vyvanse are
the most common form of ADHD treatment. They often work in the body quickly so
that the medication may alleviate symptoms faster. However, this doesn’t mean
that stimulants are your only option. Strattera is one example of an ADHD
medication that doesn’t fall under the common class of stimulant-type drugs.
Ultimately, you and your
doctor can decide which of these two ADHD medications might work best for you. It’s
important to remember that there is no cure for ADHD. Relief is best achieved
through consistent treatment, which can also include therapy in some cases.