Atomoxetine vs. Adderall

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

ADHD Symptoms in Children

Atomoxetine vs. Adderall comparison

Atomoxetine (Strattera) and Adderall (amphetamine and dextroamphetamine) are both used to treat attention deficit hyperactivity disorder ADHD (Adderall can also treat narcolepsy).

Atomoxetine, however, is the first ADHD drug that is non-addictive, whereas Adderall and other ADHD drugs (like Ritalin) are stimulants with a high potential for abuse.

Although it is not known precisely how atomoxetine reduces the symptoms of ADHD, scientists believe it works by affecting neurotransmitters in the brain, chemicals that the nerves use for communicating with one another. One neurotransmitter, norepinephrine, is considered important in regulating attention, impulsivity and activity levels, all of which are abnormal in ADHD. Researcher believe atomoxetine affects the nerves' reabsorption of neurotransmitters, making more norepinephrine available.

Amphetamines like Adderall stimulate the brain by increasing the level of neurotransmitters dopamine and norepinephrine in the brain. Researchers are still unsure of the exact mechanism that explains how Adderall relieves symptoms of ADHD

A few side effects of Adderall include:

Strattera, on the other hand, can cause gastrointestinal problems and decreased appetite, among other side effects, but does not have the potential for addiction and withdrawal symptoms.

Neither Adderall nor Strattera should be taken with MAO inhibitors. Adderall can also affect blood pressure medications, among others.

What are atomoxetine and Adderall?

Atomoxetine is from a drug class called selective norepinephrine uptake inhibitors (SNRIs). The fact that Strattera is non-addictive is the main advantage of the medication over central nervous system stimulants like amphetamines, dextroamphetamines (Dexedrine), lisdexamfetamine (Vyvanse), and methylphenidate (Ritalin) to treat ADHD.

Adderall contains both amphetamines and dextroamphetamines, and is therefore highly addictive. Even Ritalin, though not physically addictive, can be dangerously habit-forming. All the medications approved for ADHD treatment other than atomoxetine are covered by the U.S. Controlled Substances Act because of their high potential for abuse.

Quick GuideADHD Symptoms in Children

ADHD Symptoms in Children

What are the uses for atomoxetine and Adderall?

Atomoxetine is used for ADHD. Adderall also treats ADHD, as well as narcolepsy.

What are the side effects of atomoxetine and Adderall?

Both drugs can cause cardiovascular problems, insomnia and other sleep problems. Rarely, both Adderall and atomoxetine can cause priapism in men, which is an erection that lasts for more than four hours - a medical emergency if it happens.

Strattera's most common side effect includes upset stomach, decreased appetite, vomiting, dizziness, mood swings, problems sleeping, dry mouth and others. Rarer, but more serious side effects include serious allergic reaction and liver failure.

Adderall's most common side effects include excitability, anxiety, fear, tremor and even seizures. More serious possible side effects include stroke, heart attack, manic episodes, aggression, hostility, and growth suppression in children resulting from long-term use.

This is not a complete list of side effects, and if you have been prescribed either one of these drugs, ask your doctor for more information.

Can I get addicted to atomoxetine and Adderall?

Strattera is not addictive. Adderall is physically addictive. Some signs of addiction to Adderall or amphetamines in general include anxiety, restlessness, aggression, manic episodes and even psychosis that mimics schizophrenia, among others.

What are the withdrawal symptoms of atomoxetine and Adderall?

Strattera has no withdrawal symptoms. A person who immediately stops usage of Strattera will likely experience no bad effects and only a mild relapse in their ADHD - according to one study, however, the ADHD symptoms that return after stopping atomoxetine don't reach their pre-treatment severity.

The withdrawal symptoms of Adderall and other amphetamines, however, can be severe. Sleep problems, fatigue and depression are a few, as well as agitation and intense craving for the drug.

Quick GuideADHD Symptoms in Children

ADHD Symptoms in Children

How should atomoxetine and Adderall be taken (dosage)?

Atomoxetine

  • Strattera is taken once or twice daily, with or without food. Never break open the pills to sprinkle on food, however; you've got to take them whole.
  • The recommended starting dose for and children weighing more than 70 kg is 40 mg once daily. The dose is increased after 3 days to 80 mg once daily or divided and given every 12 hours. The dose may be increased up to 100 mg daily to achieve the optimal response.
  • Children older than 6 years and weighing 70 kg or less should receive 0.5 mg/kg once daily. The dose may be increased after 3 days to 1.2 mg/kg once daily or divided every 12 hours. The maximum daily dose should not to exceed 1.4 mg/kg or 100 mg, whichever is less.

Adderall

  • People prescribed Adderall take it orally in pill form once or twice a day with doses separated by four to six hours. People receive 2.5 mg to 60 mg daily, depending on age and the condition being treated.
  • Adderall XR, the extended release version, is taken once daily. The recommended dose is 5 mg to 40 mg daily administered in the morning. The entire contents of the Adderall XR capsules may be sprinkled into food if desired.
  • Abstain from doses of Adderall or other amphetamines in the evening to avoid insomnia.

Which drugs interact with atomoxetine and Adderall?

Do not take either Strattera or Adderall within two weeks of your last dose of any monoamine oxidase inhibitors (MAOIs). These include phenelizine sulfate (Nardil), and tranylcypromine sulfate (Parnate), among others.

Fluoxetine (Prozac), paroxetine (Paxil), quinidine and other medications can increase incidence of Strattera side effects because they reduce the liver's ability to break down and remove atomoxetine from the blood stream.

People taking medicine for high blood pressure could lose control over their hypertension when taking Adderall. Also, stomach antacids can increase the side effects of Adderall because they cause the body to absorb more of the drug.

Are atomoxetine and Adderall safe to take during pregnancy or while breastfeeding?

Adderall is a combination of two amphetamine drug types, and amphetamines are directly linked to low birth weight and other complications. Adderall is also passed on in breast milk, so pregnant or nursing mothers should not take it.

Research concerning atomoxetine is less complete regarding its use in pregnant woman. In very high doses (six to 23 times what a doctor would prescribe a human) pregnant rats and rabbits had pups and kits with low birth weight. Atomoxetine was also found in the milk of these animals. There hasn't been any studies on pregnant women, so doctors need to decide whether it's worth the risk to prescribe Strattera to their pregnant or breastfeeding patients or advise them to continue or discontinue use.

REFERENCE:

FDA prescribing info

"Changes in symptoms and adverse events after discontinuation of atomoxetine in children and adults with attention deficit/hyperactivity disorder: a prospective, placebo-controlled assessment."
Journal of Clinical Pharmacology
Feb, 2004

Quick GuideADHD Symptoms in Children

ADHD Symptoms in Children

Summary

Atomoxetine and Adderall are both drugs used to treat attention deficit hyperactivity disorder (ADHD). Drug interactions, warnings and precautions, and pregnancy and breastfeeding safety information should be reviewed prior to taking any medication.

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Reviewed on 2/21/2017
References
REFERENCE:

FDA prescribing info

"Changes in symptoms and adverse events after discontinuation of atomoxetine in children and adults with attention deficit/hyperactivity disorder: a prospective, placebo-controlled assessment."
Journal of Clinical Pharmacology
Feb, 2004

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