Concerta vs. Strattera: What's the Difference?

You need to find ADHD treatment that works for you. Yet, you have to do so while battling all the symptoms of ADHD that make getting organized, focused, and on-task a challenge. Finding the right ADHD medication requires patience, trial and error, and a little help.

We’ve written this comparison article so you can better understand how two commonly prescribed ADHD medications—Concerta and Strattera—treat the symptoms of ADHD. 

The licensed medical professionals on Klarity can help you find the right ADHD treatment for your symptoms and preferences. To determine whether Concerta, Strattera, or another ADHD medication is right for you, find a provider on Klarity today.

This article discusses suicide, suicidal ideation, and self-harm. If you or someone you know is experiencing suicidal thoughts or is in crisis, contact the Suicide Prevention Lifeline immediately at 800-273-8255.

Are Concerta and Strattera the Same Type of Medication?

Concerta and Strattera are two different types of medications that can both treat the symptoms of ADHD. Concerta is a central nervous system (CNS) stimulant, and Strattera is a non-stimulant selective norepinephrine reuptake inhibitor (SNRI).

Both Concerta and Strattera work on chemicals—called neurotransmitters—which are naturally found in the brain. Concerta works on norepinephrine and dopamine, and Strattera works on norepinephrine and serotonin.

Chemically, they are different drugs, but each works to elevate the amount of norepinephrine in your brain’s synapses. In non-ADHD brains, enough norepinephrine is available for the brain to function normally. However, in an ADHD brain, low levels of norepinephrine can cause many of the common symptoms associated with ADHD.

Hyperactive/Impulsive Symptoms of ADHD

• Inability to sit still 
• Inability to remain calm
• Talking non-stop, unable to be quiet
• Unable to wait in line or wait for their turn
• Engaging in risky or impulsive behavior; acting without thinking
• Interrupting conversations
• Moving or fidgeting constantly

Inattentive Symptoms of ADHD

• Having a short attention span—being unable to concentrate on tasks 
• Becoming distracted easily and derailed from tasks at hand
• Making careless mistakes
• Losing items frequently
• Forgetting important dates, events, and appointments
• Difficulty sticking with tasks tedious and time-consuming tasks that require focus
• Difficulty carrying out instructions or remembering directions

What is Concerta?

Concerta (methylphenidate) is usually a first-line treatment for ADHD symptoms. The chemical that makes Concerta is called Methylphenidate, which belongs to a family of CNS stimulants.

How Does Concerta Work?

For brain cells (called neurons) to communicate effectively, neurotransmitters must be present in the spaces between them (called synapses). Low levels of norepinephrine in the synapses are associated with many of the inattentive and hyperactive symptoms of ADHD.

This medication elevates levels of norepinephrine and dopamine in the brain by blocking the receptors that normally reabsorb these neurotransmitters back into the brain cells. The blocking mechanism found in medications like Concerta treat ADHD symptoms by raising the number of neurotransmitters available for communication between brain cells.

It effectively helps your brain cells communicate better by ensuring enough chemical messengers are available. 

Forms and Doses

Concerta is available as tablets that have many different concentrations. This FDA-approved medication comes in four extended-release tablet strengths available in 18 mg, 27 mg, 36 mg, and 54 mg dosage strengths for individuals between 6 to 65. 

The tablet is made to be taken by mouth. It’s recommended to take it during the mornings or as prescribed by your healthcare provider. Plus, it only needs to be taken once daily because it is an extended-release tablet.

Do not break or crush the tablet. It’s very important to take it as a full tablet to get the best outcome. 

What Concerta Treats

Concerta improves ADHD symptoms in adults and children, including focus, attention, organization, and the ability to control impulsive behavior. Concerta also has an “off-label” use and is sometimes prescribed to treat a sleeping disorder called narcolepsy. 

What is the Price of Concerta?

The price of Concerta will vary depending on your insurance, dose, and pharmacy. 

The average retail price of Concerta for an 18 mg extended release is $13.41 per tablet, which is around $403 for a 30-day monthly supply. 

A higher dose of 54 mg tablets will be around $545 for a 30-day supply. 

Concerta Side Effects

It’s always important to know what you might expect when starting Concerta. Here is a list of potential side effects. 

Common side effects of Concerta include:

• decreased appetite (most common) 
• increased sweating
• weight loss 
• dizziness
• stomach ache
• dry mouth 
• headache
• nausea
• sleep disruption (insomnia) 
• irritability, especially if the dose is wearing off
• vomiting 
• skin rash 
• ​​numbness/tingling/cold feeling in the hands or feet

Less common side effects:

• high blood pressure 
• slowed growth in children 
• priapism (painful erection in males lasting more than 4 hours) 
• eyesight changes (blurred vision) 

Please tell your healthcare provider immediately if any of these symptoms don’t subside after a few weeks or get worse. 

Warnings of Drug Misuse

Concerta is considered a Schedule II (CII) drug with a risk of misuse and addiction. Concerta is not suitable for individuals with a history of substance abuse or addiction, and should consider taking a non-stimulant ADHD medication, like Strattera. 

Misuse of Concerta can lead to serious health consequences. Taking higher doses than prescribed, using the medication more frequently than recommended, or using someone else’s medication is considered misuse and can result in severe health problems. Physical dependence, heart-related issues, psychological disorders, and, in extreme cases, even death can occur as a result of misuse.

To ensure effective and safe ADHD treatment, it is crucial to follow the prescribed dosage and usage instructions provided by your healthcare professional. Regular communication with your provider about any side effects or concerns is essential to monitor your response to the medication and make any necessary adjustments to your treatment plan.

Patients with the following underlying conditions should use Concerta with caution:

• Allergy or hypersensitivity to methylphenidate HCI 
• Monoamine oxidase inhibitor (MAOI) used in the last 14 days 

• History of severe heart disease (structural abnormalities, arrhythmias, coronary heart disease, and cardiomyopathy). 
• Untreated glaucoma
• Tourette Syndrome and motor tics 
• Severe intestinal strictures (esophagus, stomach, or intestinal problems)
• Circulation problems (hypertension or hypotension or increased JVP) 

No adverse effects during pregnancy or breastfeeding are known, but healthcare providers advise only taking it if needed. 

Drug Interactions

Before starting Concerta, ensure all your medications are documented with your medical provider. We suggest having a list of all the medications to give your healthcare provider to avoid any potential for serious drug interactions. 

WARNING: Concerta should not be taken with MAOIs, including the following medications: isocarboxazid, linezolid, methylene blue, phendimetrazine, phenelzine, safinamide, selegiline transdermal, tranylcypromine, and Yohimbe. 

When starting Concerta, be sure to stop use of MAOIs for 14 days before taking your first dose. 

Patients are advised to limit alcohol intake. 

What is Strattera?

Strattera is a selective norepinephrine reuptake inhibitor. The active ingredient in Strattera is Atomoxetine HCl. Strattera is a non-stimulant medication used primarily to treat depression. However, it is also prescribed to treat ADHD. It helps increase attention and ability to complete tasks by reducing distractions and stopping fidgeting. 

How Does Strattera Work?

SNRIs work by blocking norepinephrine and serotonin receptors in the brain’s neurons. Like Concerta, Strattera elevates levels of norepinephrine in the synapses between neurons. Unlike Concerta, Strattera doesn’t affect dopamine levels but increases serotonin.

Because this medication is not a CNS stimulant, it is an ideal alternative ADHD medication for people who can’t take stimulants for medical reasons. These medical reasons may include anxiety, cardiovascular disease, or substance abuse disorder. 

Forms and Doses

Strattera capsules come in dosages of 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, and 100 mg. The dosage varies depending on the patient’s age and body weight. 

Strattera capsules are intended to be taken by mouth, with the first dose in the morning and the second dose in the afternoon. 

Do not break or crush the capsule. Taking it as a full capsule is very important to get the best outcome. 

What Strattera Treats

Strattera (Atomoxetine HCl) is the first FDA-approved non-stimulant medication to improve the treatment of ADHD by increasing attention and decreasing impulsiveness and fidgeting. 

What is the Price of Strattera?

Prices of Strattera may vary depending on insurance, dosage, and pharmacy. 

On average, a 10 mg oral capsule of Strattera is $14.20 per capsule, roughly around $426 for a 30-day supply, and can go up to $497.57 for 100 mg of a 30-day supply ($16.59 per oral capsule). 

Strattera Side Effects

Common side effects are:

• Decreased appetite
• Constipation or upset stomach 
• Mood swings or irritability 
• Insomnia 
• Dysmenorrhea 
• Erectile dysfunction 
• Dizziness 
• Nausea or vomiting 
• Irregular heartbeat (arrhythmias) 
• Seizures 
• Rash 
• Weight Loss

Warnings

As with other antidepressants, Strattera (atomoxetine) can increase suicidal ideations in children and adolescents. Patients who are started should be closely monitored for suicidality (suicidal thinking and behavior), unusual behavior changes, and clinical outcomes. The average risk of previously observed patients was 0.4% (5/1357 patients).

Drug Interactions

Patients are advised to carefully list all medications they are currently taking—especially medications for asthma, heart conditions, and depression since Strattera can reduce the metabolism of those certain medications. 

The patient should not use Strattera if they took MAOIs within 14 days. Common MAOIs include isocarboxazid, phenelzine, selegiline, or tranylcypromine.

Serotonin Syndrome

When taking medications that elevate serotonin levels in the brain, patients need to monitor for serotonin syndrome. Serotonin syndrome is a rare but potentially fatal condition that usually occurs within a few hours of taking medication that elevates serotonin levels. 

Symptoms of serotonin syndrome include:

• Loss of muscle coordination
• Confusion
• Rapid heart rate and high blood pressure
• Agitation or restlessness
• Twitching muscles
• High blood pressure
• Muscle rigidity
• Insomnia
• Dilated pupils

Seek medical attention immediately if you experience any of these symptoms in the first couple hours after taking a new SSRI, SNRI, or MAOI or increasing your dose. 

Which ADHD Medication is Right For You?

Both Strattera and Concerta are effective at treating symptoms of ADHD. However, they use different mechanisms to do this. 

• Concerta is an SNRI and works predominantly on norepinephrine and serotonin. 
• Strattera is a CNS stimulant that works on norepinephrine and dopamine. 

They each produce different side effects on the body, meaning that one might be more suitable for your medical needs. For example, if you are someone who cannot take stimulants because you have a history of heart disease, substance abuse, or are prone to anxiety, Strattera is a non-habit-forming, non-stimulant alternative to Concerta. 

Concerta might be a better option for you if you can tolerate stimulants. Determining which ADHD medication is best for you requires patience, a bit of trial-and-error, and guidance from an ADHD-trained healthcare provider.

Klarity helps people like you find the best ADHD treatment plan through our novel telehealth services. 

How Klarity Helps You Find the Best ADHD Medication

The providers on Klarity are licensed and experienced in prescribing ADHD medication and can help find the right ADHD medication for you. We’ll connect you with a provider in as little as 48 hours so you don’t have to wait any longer to find the most effective ADHD treatment for your symptoms.

Schedule an appointment on Klarity today and determine whether Concerta or Strattera is right for you.