When it comes to finding the right ADHD medication, navigating the wide variety of available medications can quickly become confusing. You may find yourself asking: Do I need a central nervous system stimulant (CNS) or a serotonin-norepinephrine reuptake inhibitor (SNRI)? What’s safe to combine with my current medications and has the fewest side effects?
The goal of the guide below is to help answer these questions by comparing two common ADHD medications: Strattera and Focalin. Both are approved by the FDA to treat symptoms of ADHD. Though they both treat ADHD symptoms, each has a different mode of action. Focalin is a central nervous system (CNS) stimulant, and Strattera is an SNRI antidepressant. Learning more about their key differences will help you understand each medication.
Prepared with this information, you’ll have a better idea of which questions to ask your healthcare provider when discussing your ADHD treatment. Still looking for a provider?
Klarity has already connected thousands of people with healthcare providers who can diagnose ADHD and prescribe ADHD medication online. During your online visit, these providers will help determine whether Strattera, Focalin, or another ADHD medication is right for you.
To find a provider qualified to evaluate your symptoms and help you build a treatment plan, schedule an appointment on Klarity today. We’ll connect you with a licensed specialist in 48 hours or less.
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.
|Drug Class||Selective norepinephrine reuptake inhibitor (SNRI)||Schedule II stimulant|
|Brand / Generic Status||Brand name for atomoxetine||Brand name for dexmethylphenidate|
|Form(s) of the Drug||Capsules||Immediate-release tablets; Extended-release capsules|
|Standard Dosage||10mg to 100mg||2.5 mg, 5 mg, and 10 mg immediate-release tablets;
5 mg to 35 mg extended-release capsules
|Conditions Treated||FDA-approved uses:|
|Cost||Generic form (atomoxetine): |
• $44 for 7 10mg capsules
• $1,501 for 90 100mg capsules*
*Insurance may significantly lower the price
|Generic form (dexmethylphenidate):
• $22 for 30, 2.5 mg tablets
• $766 for 60, 35mg extended-release capsules
|Side-Effects||Common side effects:|
• Upset stomach
• Loss of appetite
• Weight loss
• Trouble sleeping
• Decrease in sexual desire
Serious side effects:
• Irregular heartbeat
• Difficulty urinating
• Stomach pain, headache
• Loss of appetite
• • Weight loss
• Signs of blood flow problems in the fingers or toes
• Unusual wounds
• Irregular heartbeat
• Behavior changes
• Uncontrolled muscle movements
• Sudden verbal outbursts
|Warnings For Use||• Potentially addictive|
• Overuse may cause serotonin syndrome
• MOA inhibitors
• Some blood pressure medications
• Some antidepressants
• May be habit-forming
• Effectiveness decreases over time
• Interactions with other drugs—consult a doctor before use
• Blood pressure medication
Are Strattera and Focalin the Same Type of Medication?
While Strattera and Focalin are both used to treat ADHD, they are not the same type of medication. Strattera is a selective norepinephrine reuptake inhibitor (SNRI), and Focalin is a central nervous system (CNS) stimulant. Each has a different mode of action in the body.
Access to various treatment options is valuable for patients because not everyone can take the first line of ADHD treatment—CNS stimulants—without complications. People with anxiety, cardiovascular, or substance abuse issues might have adverse reactions to stimulants.
These patients might consider Strattera for ADHD treatment.
What is Strattera?
Strattera is a selective norepinephrine reuptake inhibitor. It helps elevate levels of norepinephrine and serotonin in the brain’s synapses, where these neurotransmitters help regulate attention, focus, memory, and mood.
If you can’t take central nervous system stimulants—the first line treatment for ADHD—because of anxiety or cardiovascular issues, Strattera may be a good alternative for you as it is a non-stimulant ADHD treatment.
How Does Strattera Work?
As an SNRI, Strattera increases norepinephrine levels in your brain. Specifically, it prevents norepinephrine and serotonin from being absorbed into glial cells, which keeps these neurotransmitters in the synaptic cleft, where they are needed for effective brain cell communication.
Norepinephrine is both a neurotransmitter and hormone that plays a crucial role in your attentiveness, circulation, mood, and sleep-wake cycle.
Strattera can help to improve your attention span and reduce the impulsiveness or hyperactivity that patients with ADHD may experience.
Forms and Doses
You can take Strattera by mouth in a capsule form with or without food. Depending on your doctor’s advice, the dosage could be anywhere from 40 mg once a day up to a maximum daily dosage of 100 mg.
If you’ve tried Strattera and decided it isn’t the proper medication for your symptoms, consult with your doctor before stopping. Stopping Strattera suddenly can cause unwanted withdrawal symptoms. To prevent this, your healthcare provider will prescribe progressively lower and lower doses until it is safe to stop.
What Strattera Treats
Strattera can treat ADHD symptoms like lack of attention or ability to listen, inability to follow through on tasks, disorganization, forgetfulness, and distraction.
SNRIs are primarily antidepressants and are prescribed to treat depression and anxiety. For people with comorbid ADHD, depression, or anxiety, Strattera might be an effective treatment option to treat multiple diagnoses.
What is the Price of Strattera?
Without insurance, 30 capsules of Strattera can cost between $461.87 and $497.57, depending on the dosage and the pharmacy. The payment range should be outlined in your prescription coverage plan if you do have insurance.
The FDA also recently approved a generic form of Strattera called atomoxetine, which could save you money at the pharmacy.
Strattera Side Effects
Strattera has some common side effects that include:
- Increased menstrual cramps
- Dry mouth
- Digestive issues like constipation
- Rashes or itchy skin
- Lower sex drive
- Difficulty orgasming
Warnings of Drug Misuse
You should not take Strattera if you have liver or clinically significant cardiovascular disease. If you develop signs of jaundice or a yellowing of the skin or eyes, that can be a sign of liver damage, and you should stop taking Strattera immediately.
If you have cardiovascular abnormalities, taking Strattera can result in serious complications like a heart attack or stroke, high blood pressure, or an increased heart rate.
Serotonin syndrome risk: In rare cases, individuals taking Strattera may develop serotonin syndrome, a condition that causes mania, euphoria, nausea, and other severe symptoms. Consulting with a healthcare provider can help you evaluate the potential risks and benefits of using Strattera and your potential for developing this syndrome.
Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin accumulation in the brain. While Strattera alone poses a low risk of serotonin syndrome, caution should be exercised when combining it with other medications affecting serotonin levels. Discussing other medications you may be taking and your medical history with a healthcare professional are crucial for making informed decisions regarding the use of Strattera.
Black Box Warning for Antidepressants
All antidepressants come with a black box warning from the FDA. In some studies, antidepressants increased suicidal thoughts in children and adolescents. Though these findings weren’t replicated in adult populations, patients need to be aware of the increased risk of suicidal thoughts and monitor accordingly when taking antidepressants.
You should always inform your healthcare professional about any drugs (prescription or otherwise), vitamins, or supplements you’re taking prior to starting a new medication.
Strattera does have 313 drug interactions and 11 disease interactions, which could exacerbate adverse side effects.
Strattera has major interactions with medications like Lexapro and Prozac and moderate interactions with the following medications—
- Wellbutrin XL
It’s essential that you consult with your doctor to do a thorough review of your health before beginning Strattera.
Taking Strattera alongside other medications that elevate serotonin can cause an adverse, potentially fatal drug reaction called serotonin syndrome. When serotonin levels become too high, the neurotransmitter becomes toxic, leading to the following symptoms—
- High blood pressure
- Muscle rigidity
- Heavy sweating
- Rapid heart rate
- High blood pressure
- Dilated pupils
- Loss of muscle control and coordination
Serotonin syndrome usually occurs within a few hours of starting a new medication or elevating the dose of your current medication. This reaction can be fatal. Monitor for the following severe symptoms and seek medical care immediately if you experience the following—
- Irregular heartbeat
- High fever
- Tremors and seizures
Start Your Personalized Mental Health Treatment Today. Get Better Faster from the Comfort of Home.
What is Focalin?
Focalin is a CNS stimulant used to treat ADHD. It is in the same class of medication as Adderall and Ritalin and works similarly. CNS stimulants are the first line of treatment for ADHD symptoms.
However, CNS stimulants are addictive, schedule II controlled substances, and are heavily regulated by the DEA. You mustn’t share your CNS stimulant prescription with others and should only take it as directed.
How Does Focalin Work?
Focalin elevates norepinephrine and dopamine levels in the brain’s synapses, which treats the hyperactive, impulsive, and inattentive symptoms of ADHD and creates a sense of euphoria or well-being.
Forms and Doses
As always, you should follow the instructions of your doctor before taking any controlled substance. You’ll find that Focalin is available as both an immediate-release or an extended-release tablet and can be taken with or without food.
If you’ve been prescribed the immediate-release tablet and are new to taking stimulants, you’ll likely start with 2.5 mg twice daily. The maximum daily dose for the immediate-release tablets is 20 mg.
If you’ve been prescribed extended-release tablets and are new to stimulants, you’ll take 10 mg once a day. Dosage will vary if you’re currently on another stimulant, so you should be sure to inform your doctor if you’re taking any other medications immediately.
Unlike Strattera, Focalin can be sprinkled into food if you’re unable or don’t like to swallow pills. If you take it with food, you should not chew it and instead swallow it whole in something like applesauce.
Because Focalin is a controlled substance, you will not be able to stop taking it abruptly and will have to consult with your doctor about how to taper off the use of the medication safely.
What Focalin Treats
Focalin is primarily prescribed to treat common symptoms of ADHD like impulsiveness, hyperactivity, and inattentiveness. The FDA also approves it for use as a narcolepsy treatment.
What is the Price of Focalin?
If you are paying for Focalin without insurance, you’ll pay around $79 for a supply of 100 2.5 mg tablets depending on the pharmacy. Your payment will vary based on your prescription coverage if you have insurance.
Focalin Side Effects
Similar to Strattera, Focalin’s side effects also include digestive issues, insomnia, nausea, dry mouth, and dizziness.
Beyond those shared side effects, people taking Focalin may also experience:
- Sore throat
- Loss of appetite
- Weight loss
- Circulation issues
- Painful prolonged erection
Focalin, like other central nervous system stimulants, has the potential for dependency and abuse. It should only be used under the supervision of a healthcare professional and as prescribed. It is important to follow the prescribed dosage and not increase or decrease it without medical advice.
Abruptly stopping Focalin can lead to withdrawal symptoms. If you have a history of substance abuse or dependency, it is crucial to discuss it with your healthcare provider before starting Focalin.
Since Focalin is a stimulant, it may not be the right medication for you if you have heart-related problems, experience psychosis, have anxiety, or have a history of substance abuse.
Stimulants can cause strokes, heart attacks, or sudden death if you have high blood pressure or other cardiovascular abnormalities. If you have a history of depression or bipolar disorder, Focalin may cause new or worsening thoughts or behaviors.
Additionally, you should not take Focalin if you have glaucoma or Tourette’s syndrome.
Focalin interacts with 180 drugs, with 152 moderate and ten minor interactions. For medications frequently checked for interactions, clonidine, Lexapro, Prozac, and Zoloft have moderate interactions with Focalin.
Which ADHD Medication is the Right Choice For You?
While Focalin and other CNS stimulants are typically the first-line treatment for ADHD, they’re not always suitable for everyone. As an SNRI, Strattera is a non-stimulant ADHD treatment option that can also help treat other mental illnesses comorbid with ADHD, like depression and anxiety.
You’ll need to consider your medical history, current medications you take, and other important factors when figuring out which ADHD treatment is best for you.
Luckily, you don’t have to do it alone.
How Klarity Helps You Find the Best ADHD Medication
Unsure whether Strattera or Focalin is better for managing your ADHD? Find out with the help of a telehealth medical professional—we connect patients with healthcare providers specializing in diagnosing and prescribing medications for ADHD, making it easier than ever to determine which medication is right for you.
If your provider determines that medication is the right treatment option for your ADHD, we immediately send it to your preferred pharmacy, so you can begin your treatment as quickly as possible.
With telehealth appointments available in 48 hours or less,you’ll be able to skip the long wait times, avoid that commute, and save time and money. Book an appointment on Klarity today.
“Dexmethylphenidate (Focalin).” GoodRx. https://www.goodrx.com/dexmethylphenidate/what-is
Gerardo Sison. “Focalin vs. Adderall: Differences, similarities, and which one is better for you.” The Checkup. https://www.singlecare.com/blog/focalin-vs-adderall/
“Focalin Interactions.” Drugs.com. https://www.drugs.com/drug-interactions/dexmethylphenidate,focalin.html
John P. Cunha. “Focalin vs Strattera.” RxList. https://www.rxlist.com/focalin_vs_strattera/drugs-condition.htm
Juhi Modi. “The Pros and Cons of Strattera—A Nonstimulant medication for ADHD.” BuzzRx. https://www.buzzrx.com/blog/the-pros-and-cons-of-strattera-a-nonstimulant-medication-for-adhd
Larry Silver. “Strattera: ADHD Medication FAQ.” ADDitude Mag. https://www.additudemag.com/strattera-adhd-medication-faq/
Mayo Clinic Staff. “Serotonin Syndrome.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
“Strattera Interactions.” Drugs.com. https://www.drugs.com/drug-interactions/atomoxetine,strattera.html