Strattera vs Concerta For ADHD – Differences & Side Effects

Strattera

It is the brand name of a drug called atomoxetine, that belongs to a group of drugs known as selective norepinephrine reuptake inhibitors.

Mechanism of Action

This medication works by increasing levels of norepinephrine, the main transmitter of most postganglionic sympathetic fibers.

It was originally approved by the US Food and Drug Administration in 2002. This drug is produced by Eli Lilly and Company.

Uses

This prescription medication is used to treat attention deficit hyperactivity disorder.

Dosage

The usual initial recommended dose is 40 mg per day orally. This dose is increased to 80 mg per day after a minimum of 3 days. The maximum recommended dose is 100 mg per day.

Side Effects and Precautions

Common side effects may include:

  • feeling tired;
  • constipation;
  • dizziness;
  • upset stomach;
  • mood changes;
  • vomiting;
  • loss of appetite;
  • nausea;
  • trouble having an erection;
  • urination problems;
  • dry mouth.

Rare side effects may include:

  • painful urination;
  • a feeling like you might pass out;
  • erection which is painful or lasts longer than 4 hours;
  • trouble breathing;
  • jaundice (yellowing of the skin or eyes);
  • chest pain;
  • paranoia;
  • hallucinations;
  • dark urine;
  • hostility;
  • new behavior problems.

Contraindications

Before taking this selective norepinephrine reuptake inhibitor, tell your healthcare provider if you have:

  • pheochromocytoma (tumor of the adrenal gland);
  • narrow-angle glaucoma;
  • severe heart problems.

Alcohol

Avoid drinking alcoholic beverages while taking this selective norepinephrine reuptake inhibitor since alcohol use can substantially increase the risk of severe side effects.

Drug Interactions

It may negatively interact with other medications, especially:

  • Wellbutrin (bupropion);
  • Abilify (aripiprazole);
  • Zoloft (sertraline);
  • Benadryl (diphenhydramine);
  • Prozac (fluoxetine);
  • Celexa (citalopram);
  • Lexapro (escitalopram);
  • Cymbalta (duloxetine).
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Pregnancy & Breastfeeding

There are no well-done studies to determine whether this selective norepinephrine reuptake inhibitor is safe to use during pregnancy. Tell your healthcare provider that you are pregnant or plan to fall pregnant before using it.

This medication may pass into breast milk and negatively affect the breastfed baby, hence, nursing women should avoid using this selective norepinephrine reuptake inhibitor if they are breastfeeding a baby.

Concerta

It is the brand name of a medication called methylphenidate, that belongs to a group of medications known as central nervous system stimulants.

Mechanism of Action

It works by changing the amount of natural substances in the brain to decrease hyperactivity and impulsiveness.

Uses

This prescription medication is used to treat attention deficit hyperactivity disorder, attention deficit disorder, and narcolepsy.

Pregnancy & Breastfeeding

It is not exactly known whether this medication will harm a developing fetus. Tell your healthcare provider if you are pregnant or plan to fall pregnant before taking it.

It is not known exactly whether this medication passes into breast milk or if it could negatively affect a nursing infant. Tell your healthcare provider if you are breastfeeding an infant before taking this medication.

Dosage

For adults, the usual recommended dose is 18 mg to 72 mg per day. For children, the usual recommended dose is 18 mg to 54 mg per day. For adolescents, the usual recommended dose is 18 mg to 72 mg per day.

Drug Interactions

It may negatively interact with other medications, especially:

  • adapalene topical;
  • aripiprazole;
  • Adderall XR (amphetamine/dextroamphetamine);
  • BuSpar (buspirone);
  • sertraline;
  • Abilify (aripiprazole);
  • venlafaxine;
  • cyclobenzaprine;
  • Trintellix (vortioxetine);
  • hydroxyzine;
  • alprazolam;
  • temazepam;
  • trazodone;
  • lamotrigine.
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Side Effects and Precautions

Common side effects may include:

  • mood changes;
  • weight loss;
  • fast heart rate;
  • sleep problems (insomnia);
  • increased blood pressure;
  • stomach pain;
  • loss of appetite;
  • feeling nervous or irritable;
  • nausea;
  • headaches.

Less common side effects may include:

  • trouble breathing;
  • paranoia;
  • numbness;
  • chest pain;
  • changes in your vision;
  • hostility;
  • penis erection that is painful;
  • a feeling like you might pass out;
  • cold feeling;
  • skin color changes in the fingers or toes;
  • hallucinations;
  • unexplained wounds;
  • new behavior problems;
  • a seizure (convulsions);
  • aggression;
  • muscle twitches.

Alcohol

Avoid drinking alcoholic beverages while taking this medication since alcohol use may cause methylphenidate to be released into the bloodstream too fast.

Contraindications

You should not use this medication if you have:

  • glaucoma;
  • severe anxiety;
  • a personal history of muscle twitches;
  • Tourette’s syndrome.

Bottom Line – Strattera vs Concerta    

Strattera (active ingredient – atomoxetine) is a medication that is part of a class of medications known as selective norepinephrine reuptake inhibitors. It is used for the treatment of attention deficit hyperactivity disorder.

Concerta (active ingredient – methylphenidate) is a central nervous system stimulant that is used to treat attention deficit hyperactivity disorder, attention deficit disorder, and narcolepsy. This medication has a duration of action of 10-12 hours. It works by affecting the chemicals in the brain and nerves which contribute to hyperactivity and impulse control.

According to a 2011 study, Strattera was not found superior to some extended-release stimulant products. However, Strattera resulted in higher rates of somnolence and vomiting, lower rates of insomnia, and similar rates of nausea and anorexia in comparison to stimulants.

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In addition, cardiac adverse events were not different between stimulants, differences in risk for sudden death was unclear, and cerebrovascular adverse events did not differ between stimulants and Strattera.

Regarding their price, the average retail price for 30 capsules of Strattera 40mg is $450, while the average retail price for 30 tablets of Concerta 36mg is $360.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620814/
https://clinicaltrials.gov/ct2/show/NCT00260533
https://www.ncbi.nlm.nih.gov/pubmed/15766294

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