Adderall vs. Strattera for ADHD

Table of ContentsView AllTable of ContentsAdderall vs. StratteraHow Strattera and Adderall WorkADHD Treatment ChoicesForms and DosagesSide EffectsRisk of AbuseWithdrawalBlack Box WarningFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Adderall vs. Strattera

How Strattera and Adderall Work

ADHD Treatment Choices

Forms and Dosages

Side Effects

Risk of Abuse

Withdrawal

Black Box Warning

Frequently Asked Questions

What is the most important information I should know about Adderall and Strattera?You should not take Adderall or Strattera if:you have taken an MAOI in the previous 14 days; oryou are allergic/hypersensitive to amphetamine or atomoxetine; oryou have glaucoma.You should also not take Adderall if you have cardiovascular disease, high blood pressure, hyperthyroidism, or a history of substance use.

What is the most important information I should know about Adderall and Strattera?

You should not take Adderall or Strattera if:you have taken an MAOI in the previous 14 days; oryou are allergic/hypersensitive to amphetamine or atomoxetine; oryou have glaucoma.You should also not take Adderall if you have cardiovascular disease, high blood pressure, hyperthyroidism, or a history of substance use.

You should not take Adderall or Strattera if:

You should also not take Adderall if you have cardiovascular disease, high blood pressure, hyperthyroidism, or a history of substance use.

Adderall and Strattera aremedicationsprescribed to treat attention disorders, including attention-deficit/hyperactivity disorder(ADHD). Both drugs improve attention span and decrease hyperactivity and impulsiveness; however, the medications are very different. The main difference is that Adderall is a stimulant, and Strattera is not.

This article discusses how Adderall and Strattera work, how they are used to treat attention disorders, and their potential side effects. It also covers how they compare in terms of efficacy and risk for abuse.

Press Play for Advice On Improving FocusThis episode ofThe Verywell Mind Podcastfeatures Amishi Jha, PhD, a psychology professor who shares how to improve your attention span amid daily distractions. Click below to listen now.

Press Play for Advice On Improving Focus

This episode ofThe Verywell Mind Podcastfeatures Amishi Jha, PhD, a psychology professor who shares how to improve your attention span amid daily distractions. Click below to listen now.

StratteraNon-stimulant2nd-line ADHD treatmentGeneric availableDose: 10mg to 100mg, oral capsuleAfter reaching therapeutic levels, effects last 24 hoursMust be taken continuouslyAdderallStimulant1st-line ADHD treatmentGeneric availableDose: 5mg to 30mg, tabletEffective almost immediately, lasts 4 hours (Adderall IR) to 12 hours (Adderall XR)Drug holidays are possiblePotential for abuse or dependence

StratteraNon-stimulant2nd-line ADHD treatmentGeneric availableDose: 10mg to 100mg, oral capsuleAfter reaching therapeutic levels, effects last 24 hoursMust be taken continuously

Non-stimulant

2nd-line ADHD treatment

Generic available

Dose: 10mg to 100mg, oral capsule

After reaching therapeutic levels, effects last 24 hours

Must be taken continuously

AdderallStimulant1st-line ADHD treatmentGeneric availableDose: 5mg to 30mg, tabletEffective almost immediately, lasts 4 hours (Adderall IR) to 12 hours (Adderall XR)Drug holidays are possiblePotential for abuse or dependence

Stimulant

1st-line ADHD treatment

Dose: 5mg to 30mg, tablet

Effective almost immediately, lasts 4 hours (Adderall IR) to 12 hours (Adderall XR)

Drug holidays are possible

Potential for abuse or dependence

Adderall and Strattera are from different drug classes and work in distinct ways in the body.

Strattera

Strattera was also the first medication to be approved for treatingadults with ADHD. It can be prescribed for people 6 years of age and older.

Strattera is a norepinephrine reuptake inhibitor, which means it allows the neurotransmitternorepinephrineto be available to the brain’s neurons for longer.

Adderall

Adderall is a brand name for the combination of drugs dextroamphetamine and amphetamine. It belongs to the amphetamine drug family. The FDA approved this medication in 1996. In addition to ADHD, Adderall is also approved to treat narcolepsy. It can be prescribed to people ages 6 and up.

Recap

ADHD medication is divided into two categories: first-line medications and second-line medications. Stimulant medications like Adderall are known to be the most effective treatment for ADHD. As such, they are considered first-line medication.

Non-stimulant medications like Strattera are second-line medications. While not as effective as stimulants, they can still be effective forADHD symptoms.

Research has shown that compared to a placebo, Strattera reduced hyperactive and inattentive symptoms in adults. However, 40% of the research participants still reported significant ADHD symptoms.

Although stimulants are the most effective medication for ADHD, they don’t work for everyone. People may also experience severe side effects when taking stimulants or have a medical condition that increases the risks of taking a stimulant (such as a history of addiction, a psychiatric condition like bipolar disorder, or a heart condition or sleep disorder).

In some cases, a non-stimulant medication like Strattera is an option. However, in cases ofbipolar disorder, Strattera can precipitate mania since it has antidepressant effects. It can also increase blood pressure in people with cardiac conditions.

Strattera has also been found to help with conditions that often co-exist with ADHD, like anxiety andoppositional defiant disorder(a pattern of aggression, disobedience, and a lack of respect for authority).

RecapBecause stimulants are known for their efficacy in the treatment of ADHD, Adderall is considered a first-line treatment. While second-line treatments such as Strattera may be less effective, they can still be helpful for relieving symptoms.

Because stimulants are known for their efficacy in the treatment of ADHD, Adderall is considered a first-line treatment. While second-line treatments such as Strattera may be less effective, they can still be helpful for relieving symptoms.

Always take prescription medicine as directed. Strattera and Adderall come in a few different forms and dosage options.

Doses

Strattera is available in an oral capsule that comes in seven doses ranging from 10 to 100 milligrams (mg).

Adderall IR (immediate-release) is available in tablets from 5 mg to 30 mg. Adderall XR (extended-release) is available in six doses, from 5 mg to 30 mg.

Generics

There aregenerics for Adderall(amphetamine salt combination), but people sometimes report these medications are not as effective as the brand name drug. Generic versions of Strattera are also available in the United States, Canada, and other countries.

Timeline

It can take four to eight weeks for Strattera to reach the maximum therapeutic effect.Once therapeutic levels have been reached, the effects of the medication last 24 hours.

In contrast, the effects of Adderall IR and Adderall XR can be felt as quickly as 30 minutes to one hour. The effects of Adderall IR start to wear off after four hours (after 12 hours for Adderall XR).

Your doctor might approve taking a break from Adderall (a “drug holiday” where you do not take the medication for a weekend or over a holiday). By contrast, Strattera needs to be taken every day.

RecapBoth Strattera and Adderall are available in different dosing ranges as well as in brand name and generic forms. Adderall tends to work quickly to relieve symptoms, while Strattera can take several weeks to reach its full efficacy.

Both Strattera and Adderall are available in different dosing ranges as well as in brand name and generic forms. Adderall tends to work quickly to relieve symptoms, while Strattera can take several weeks to reach its full efficacy.

Adderall and Strattera Side Effects

Side effects of Strattera include:

Rare but serious side effects of Strattera include liver toxicity, suicidal thoughts, swelling, and heart problems.

Side effects of Adderall include:

Rare but serious side effects of Adderall include increased heart rate, high blood pressure, hallucinations, paranoia, shortness of breath, heart attack, and stroke.

Both Strattera and Adderall can cause weight loss.

Cardiac Concerns

Research has found that the likelihood of cardiac problems with the use of stimulant medications like Adderall is very low in healthy people. One study found that people taking stimulant medications for ADHD did not have an increased risk for cardiac events likeheart attack, stroke, or sudden cardiac death.

In the past, patients had electrocardiography (EKG) screenings if a stimulant medication was prescribed. With new research findings, these screenings are no longer required unless the person taking the drug (or someone in their family) has a history of cardiac problems.

If you’re taking ADHD medication and experience any severe or unusual signs or symptoms, contact your doctor immediately.

Pregnancy and Breastfeeding

Both Adderall and Strattera are category-C drugs, which means they’re considered unsafe to take during pregnancy or while breastfeeding. Talk to your doctor if you’re pregnant or planning to become pregnant.

Adderall is a schedule-IIcontrolled substance. This means there’s the potential for abuse and that extended use might cause dependence.

Adderall’s mode of action is to increase the activity ofdopamine, which affects the brain’s reward system and can lead to dependence and mis. Surges of dopamine cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, leading people to repeat the behavior again and again.

Studies show that people taking a prescription stimulant medication have a lower rate of substance abuse compared to those who were not taking the medication.This could be because when ADHD is being treated safely and effectively, people with the condition are less likely to self-medicate and use non-prescription methods to manage their symptoms.

Studies show that people taking a prescription stimulant medication have a lower rate of substance abuse compared to those who were not taking the medication.

This could be because when ADHD is being treated safely and effectively, people with the condition are less likely to self-medicate and use non-prescription methods to manage their symptoms.

When stimulant medications are prescribed at appropriate doses and taken as prescribed, the risk of potentialaddictionis low. However, you should always store your medication safely and you should never share your medication with other people.

Because Strattera is not a stimulant, it does not lead to physical dependence or withdrawal symptoms if you stop taking it. People who are concerned about the use of stimulants or the potential for abuse may choose to treat their ADHD symptoms with Strattera for this reason.

Adderall can lead to dependence, which means you may experiencesymptoms of withdrawalif you stop taking it. This can happen for people who have been using Adderall to treat their attention disorder, but it can also occur among people who use the medication without a prescription.

When you stop taking Adderall, norepinephrine and dopamine levels in the brain suddenly decrease. Dopamine is a neurotransmitter that activates the brain’s reward system, while norepinephrine plays a role in regulating cognitive functions, attention, and mood.

The sudden reduction in these neurotransmitters can lead to problems with mood, alertness, sleep patterns, and concentration. Other common symptoms of Adderall withdrawal include:

The FDA places a black box warning on some prescription drug labels to bring attention to possible serious or life-threatening risks.

Strattera has a black box warning for the possible increased risk of suicidal thoughts or actions in children, teens, and young adults. Parents and caregivers of kids taking Strattera are encouraged to monitor possible changes in the child’s behavior and keep in close contact with the child’s doctor.

Adderall has two black box warnings. The first is to highlight the potential for abuse. The second is to warn about cardiac events.

If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

Summary

Adderall and Strattera can both be effective for managing symptoms of attention disorders. While Adderall is considered a first-line treatment, it may not be the right choice for everyone.

People who are sensitive to stimulants or who have concerns about the potential for dependence and abuse with stimulant medications may want to try a non-stimulant, such as Strattera. Talk to your doctor about your options to decide which medication may be right for you.

Frequently Asked QuestionsSide effects often gradually go away within a few days or a couple of weeks. If your side effects last longer or are severe, talk to your doctor. In some cases, you might need to try a different dosage or a different medication, but you should never change your dosage or stop your medication without talking to your doctor first.Strattera should not cause withdrawal symptoms. Adderall can lead to physical dependence, so you may experience withdrawal symptoms when you stop taking it, particularly if you have been taking high doses for an extended period of time. Common withdrawal symptoms include fatigue, mood changes, nausea, and difficulty sleeping.Adderall is a first-line treatment as is considered effective in the treatment of ADHD. Strattera is considered a second-line treatment, but it is still effective for the treatment of ADHD symptoms.

Side effects often gradually go away within a few days or a couple of weeks. If your side effects last longer or are severe, talk to your doctor. In some cases, you might need to try a different dosage or a different medication, but you should never change your dosage or stop your medication without talking to your doctor first.

Strattera should not cause withdrawal symptoms. Adderall can lead to physical dependence, so you may experience withdrawal symptoms when you stop taking it, particularly if you have been taking high doses for an extended period of time. Common withdrawal symptoms include fatigue, mood changes, nausea, and difficulty sleeping.

Adderall is a first-line treatment as is considered effective in the treatment of ADHD. Strattera is considered a second-line treatment, but it is still effective for the treatment of ADHD symptoms.

14 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fu D, Wu DD, Guo HL, et al.The mechanism, clinical efficacy, safety, and dosage regimen of atomoxetine for ADHD therapy in children: a narrative review.Front Psychiatry. 2022;12:780921. doi:10.3389/fpsyt.2021.780921Food and Drug Administration.Adderall CII (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablets).Wietecha LA, Clemow DB, Buchanan AS, Young JL, Sarkis EH, Findling RL.Atomoxetine increased effect over time in adults with attention-deficit/hyperactivity disorder treated for up to 6 months: pooled analysis of two double-blind, placebo-controlled, randomized trials.CNS Neurosci Ther. 2016;22(7):546-557. doi:10.1111/cns.12533Food and Drug Administration.Strattera.National Alliance on Mental Illness.Atomoxetine (Strattera).Adler L, Tanaka Y, Williams D, et al.Executive function in adults with attention-deficit/hyperactivity disorder during treatment with atomoxetine in a randomized, placebo-controlled withdrawal study.J Clin Psychopharmacol.2014;34(4):461-466. doi:10.1097/JCP.0000000000000138Habel LA, Cooper WO, Sox CM, et al.ADHD medications and risk of serious cardiovascular events in young and middle-aged adults.JAMA. 2011;306(24):2673-2683. doi:10.1001/jama.2011.1830Heal DJ, Smith SL, Gosden J, Nutt DJ.Amphetamine, past and present – A pharmacological and clinical perspective.J Psychopharmacol. 2013;27(6):479-496. doi:10.1177/0269881113482532Mirzahosseini HK, Sanani MGP, Azad YM.Evaluation of the effects of atomoxetine on human organs: A systematic review.JPRI. Published online November 7, 2019:1-8. doi:10.9734/JPRI/2019/v31i330301Schwartz S, Correll CU.Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression.J Am Acad Child Adolesc Psychiatry. 2014;53(2):174-187. doi:10.1016/j.jaac.2013.11.005Chang Z, Lichtenstein P, Halldner L, et al.Stimulant ADHD medication and risk for substance abuse.J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164Yanofski J.The dopamine dilemma-part II: could stimulants cause tolerance, dependence, and paradoxical decompensation?.Innov Clin Neurosci. 2011;8(1):47-53.National Institute on Drug Abuse.Prescription stimulants.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

14 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fu D, Wu DD, Guo HL, et al.The mechanism, clinical efficacy, safety, and dosage regimen of atomoxetine for ADHD therapy in children: a narrative review.Front Psychiatry. 2022;12:780921. doi:10.3389/fpsyt.2021.780921Food and Drug Administration.Adderall CII (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablets).Wietecha LA, Clemow DB, Buchanan AS, Young JL, Sarkis EH, Findling RL.Atomoxetine increased effect over time in adults with attention-deficit/hyperactivity disorder treated for up to 6 months: pooled analysis of two double-blind, placebo-controlled, randomized trials.CNS Neurosci Ther. 2016;22(7):546-557. doi:10.1111/cns.12533Food and Drug Administration.Strattera.National Alliance on Mental Illness.Atomoxetine (Strattera).Adler L, Tanaka Y, Williams D, et al.Executive function in adults with attention-deficit/hyperactivity disorder during treatment with atomoxetine in a randomized, placebo-controlled withdrawal study.J Clin Psychopharmacol.2014;34(4):461-466. doi:10.1097/JCP.0000000000000138Habel LA, Cooper WO, Sox CM, et al.ADHD medications and risk of serious cardiovascular events in young and middle-aged adults.JAMA. 2011;306(24):2673-2683. doi:10.1001/jama.2011.1830Heal DJ, Smith SL, Gosden J, Nutt DJ.Amphetamine, past and present – A pharmacological and clinical perspective.J Psychopharmacol. 2013;27(6):479-496. doi:10.1177/0269881113482532Mirzahosseini HK, Sanani MGP, Azad YM.Evaluation of the effects of atomoxetine on human organs: A systematic review.JPRI. Published online November 7, 2019:1-8. doi:10.9734/JPRI/2019/v31i330301Schwartz S, Correll CU.Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression.J Am Acad Child Adolesc Psychiatry. 2014;53(2):174-187. doi:10.1016/j.jaac.2013.11.005Chang Z, Lichtenstein P, Halldner L, et al.Stimulant ADHD medication and risk for substance abuse.J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164Yanofski J.The dopamine dilemma-part II: could stimulants cause tolerance, dependence, and paradoxical decompensation?.Innov Clin Neurosci. 2011;8(1):47-53.National Institute on Drug Abuse.Prescription stimulants.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

Fu D, Wu DD, Guo HL, et al.The mechanism, clinical efficacy, safety, and dosage regimen of atomoxetine for ADHD therapy in children: a narrative review.Front Psychiatry. 2022;12:780921. doi:10.3389/fpsyt.2021.780921Food and Drug Administration.Adderall CII (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablets).Wietecha LA, Clemow DB, Buchanan AS, Young JL, Sarkis EH, Findling RL.Atomoxetine increased effect over time in adults with attention-deficit/hyperactivity disorder treated for up to 6 months: pooled analysis of two double-blind, placebo-controlled, randomized trials.CNS Neurosci Ther. 2016;22(7):546-557. doi:10.1111/cns.12533Food and Drug Administration.Strattera.National Alliance on Mental Illness.Atomoxetine (Strattera).Adler L, Tanaka Y, Williams D, et al.Executive function in adults with attention-deficit/hyperactivity disorder during treatment with atomoxetine in a randomized, placebo-controlled withdrawal study.J Clin Psychopharmacol.2014;34(4):461-466. doi:10.1097/JCP.0000000000000138Habel LA, Cooper WO, Sox CM, et al.ADHD medications and risk of serious cardiovascular events in young and middle-aged adults.JAMA. 2011;306(24):2673-2683. doi:10.1001/jama.2011.1830Heal DJ, Smith SL, Gosden J, Nutt DJ.Amphetamine, past and present – A pharmacological and clinical perspective.J Psychopharmacol. 2013;27(6):479-496. doi:10.1177/0269881113482532Mirzahosseini HK, Sanani MGP, Azad YM.Evaluation of the effects of atomoxetine on human organs: A systematic review.JPRI. Published online November 7, 2019:1-8. doi:10.9734/JPRI/2019/v31i330301Schwartz S, Correll CU.Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression.J Am Acad Child Adolesc Psychiatry. 2014;53(2):174-187. doi:10.1016/j.jaac.2013.11.005Chang Z, Lichtenstein P, Halldner L, et al.Stimulant ADHD medication and risk for substance abuse.J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164Yanofski J.The dopamine dilemma-part II: could stimulants cause tolerance, dependence, and paradoxical decompensation?.Innov Clin Neurosci. 2011;8(1):47-53.National Institute on Drug Abuse.Prescription stimulants.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

Food and Drug Administration.Adderall CII (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate and amphetamine sulfate tablets).

Wietecha LA, Clemow DB, Buchanan AS, Young JL, Sarkis EH, Findling RL.Atomoxetine increased effect over time in adults with attention-deficit/hyperactivity disorder treated for up to 6 months: pooled analysis of two double-blind, placebo-controlled, randomized trials.CNS Neurosci Ther. 2016;22(7):546-557. doi:10.1111/cns.12533

Food and Drug Administration.Strattera.

National Alliance on Mental Illness.Atomoxetine (Strattera).

Adler L, Tanaka Y, Williams D, et al.Executive function in adults with attention-deficit/hyperactivity disorder during treatment with atomoxetine in a randomized, placebo-controlled withdrawal study.J Clin Psychopharmacol.2014;34(4):461-466. doi:10.1097/JCP.0000000000000138

Habel LA, Cooper WO, Sox CM, et al.ADHD medications and risk of serious cardiovascular events in young and middle-aged adults.JAMA. 2011;306(24):2673-2683. doi:10.1001/jama.2011.1830

Heal DJ, Smith SL, Gosden J, Nutt DJ.Amphetamine, past and present – A pharmacological and clinical perspective.J Psychopharmacol. 2013;27(6):479-496. doi:10.1177/0269881113482532

Mirzahosseini HK, Sanani MGP, Azad YM.Evaluation of the effects of atomoxetine on human organs: A systematic review.JPRI. Published online November 7, 2019:1-8. doi:10.9734/JPRI/2019/v31i330301

Schwartz S, Correll CU.Efficacy and safety of atomoxetine in children and adolescents with attention-deficit/hyperactivity disorder: results from a comprehensive meta-analysis and metaregression.J Am Acad Child Adolesc Psychiatry. 2014;53(2):174-187. doi:10.1016/j.jaac.2013.11.005

Chang Z, Lichtenstein P, Halldner L, et al.Stimulant ADHD medication and risk for substance abuse.J Child Psychol Psychiatry. 2014;55(8):878-885. doi:10.1111/jcpp.12164

Yanofski J.The dopamine dilemma-part II: could stimulants cause tolerance, dependence, and paradoxical decompensation?.Innov Clin Neurosci. 2011;8(1):47-53.

National Institute on Drug Abuse.Prescription stimulants.

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (5th ed.).

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What is the most important information I should know about Adderall and Strattera?#

Press Play for Advice On Improving Focus#

Strattera#

Adderall#

Recap#

Doses#

Generics#

Timeline#

Adderall and Strattera Side Effects#

Cardiac Concerns#

Pregnancy and Breastfeeding#

Summary#