Focalin vs Adderall: what is the difference and which one should you take?

There are a lot of treatments available for attention deficit hyperactivity disorder (ADHD), but not every treatment will your specific needs. Focalin (dexmethylphenidate) and Adderall (amphetamine/dextroamphetamine) are prescription drugs often prescribed to treat ADHD. But when it comes to Focalin vs Adderall, which should you choose?

This article explains what you need to know about Focalin and Adderall, so you can be armed with knowledge when talking to your healthcare provider about your options.

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Focalin (dexmethylphenidate)

Forms and dosages

Focalin and generic dexmethylphenidate are available as oral tablets in both an immediate-release and extended-release formula called Focalin XR and dexmethylphenidate extended release. Immediate-release tablets come in 2.5, 5, and 10 milligrams doses. And extended release dosages include 5, 10, 15, 20, 25, 30, 35, and 40 milligrams.

Focalin XR is the same medication as Focalin but its therapeutic effects typically last 12 hours instead of 4. Both drugs take an average of 45 minutes to start working.

Indications and conditions treated

Focalin is U.S. Food and Drug Administration (FDA)-approved to treat the symptoms of attention deficit hyperactivity disorder (ADHD), including the inability to pay attention or focus for extended amounts of time, in children, adolescents, and adults. It can also help control behavior problems and may improve overall listening skills.

Costs

The cost of dexmethylphenidate, the generic version of Focalin, ranges from $31 to $55 for 100 for the oral tablet and from $282 to $582 for 100 of the extended-release oral capsules according to drugs.com. Most insurance plans cover Focalin.

The cost for brand-name Focalin ranges from $81 to $156 for 100 immediate-release oral tablets. 100 Focal XR tablets cost from $1,400 to $1,656 for the different doses.

Side effects

Some of Focalin’s more common side effects include:

• Trouble sleeping
• Nausea
• Stomach pain, headache
• Nervousness
• Loss of appetite
• Weight loss
• Dizziness 

In rare cases, Focalin can cause serious side effects. Contact your doctor immediately if you experience any of the following:

• Signs of blood flow problems in the fingers or toes
• Unusual wounds
• Irregular heartbeat
• Behavior changes
• Uncontrolled muscle movements
• Sudden verbal outbursts
• Vision changes

In rare cases, males may experience a painful or prolonged erection lasting four or more hours.

Warnings for use

Dependency warning: Focalin is classified as a Schedule II controlled substance due to its high potential for abuse and dependence. It’s most commonly prescribed to treat ADHD and should only be used under the supervision of a qualified healthcare professional — misuse or use without a prescription can lead to dependence, addiction, and serious health consequences.

It’s crucial to take Focalin exactly as prescribed and not to share it with others. Abrupt discontinuation or misuse can result in withdrawal symptoms, including extreme fatigue, depression, and mood swings. If you or someone you know is struggling with Focalin dependency, seek immediate medical assistance.

Possible drug interactions

Here are some possible drug interactions with brand-name Focalin and generic Focalin, dexmethylphenidate:

• Monoamine oxidase inhibitors (MAOIs): Ritalin and Focalin should not be taken with MAOIs or within 14 days of stopping or starting MAOI treatment due to the risk of a dangerous drug interaction.
• Blood pressure medications: Some blood pressure medications, such as beta-blockers and alpha-2 agonists, may interact with Focalin and increase the risk of side effects such as high blood pressure, heart palpitations, and arrhythmia.
• Antidepressants: Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, can increase the levels of Focalin in the body and lead to a greater risk of side effects.
• Antipsychotics: Antipsychotic medications may interfere with the effectiveness of Focalin and decrease its ability to control symptoms of attention ADHD.
• Seizure medications: Some seizure medications, such as phenytoin and carbamazepine, can increase the metabolism of Focalin, which can lower its effectiveness.
• Acid reducers: Acid reducers, like proton pump inhibitors and H2 blockers, can increase the absorption of Focalin, which can lead to higher levels of the drug in the body and an increased risk of side effects.

It’s important to talk to your healthcare provider about any medications or supplements you’re taking before starting Focalin.

Adderall

Forms and dosages

Adderall and generic amphetamine/dextroamphetamine are available as oral tablets in both an immediate-release and extended-release formula called Adderall XR and amphetamine/dextroamphetamine extended-release. The Immediate-release tablets come in 5, 7.5, 10, 12.5, 15, 20, and 30 milligrams doses. And extended release dosages include 5, 10, 15, 20, 25, and 30 milligrams.

Immediate-release Adderall and amphetamine/dextroamphetamine can often be taken two to three times a day. Adderall XR and amphetamine/dextroamphetamine extended release only need to be taken once a day.

Indications and conditions treated

Adderall is FDA-approved to treat ADHD and the sleep disorder narcolepsy but can also be used off-label (for a condition it’s not specifically approved to treat) to treat other disorders, including depression, anxiety, and bipolar disorder.

Costs

If an individual doesn’t have insurance, brand-name Adderall can cost about $1,139 for 100 immediate-release oral tablets. Adderall XR costs $760 for 100 capsules. Generic amphetamine/dextroamphetamine costs $69 for 100 extended-release capsules or from $24 to $63 for 100 immediate-release tablets. Costs are according to drugs.com.

Side effects

The side effects of Adderall are similar to Focalin. Common side effects include: 

• Loss of appetite
• Weight loss
• Dry mouth
• Nausea
• Headache
• Fever
• Trouble sleeping

Notify your provider or seek medical attention if you experience more severe side effects, including:

• Signs of blood flow problems
• Behavior changes
• Uncontrolled movements
• Shortness of breath
• Irregular heartbeat
• Seizures
• Trouble speaking

Warnings for use

Dependency warning: Adderall contains mixed amphetamine salts and is classified as a Schedule II controlled substance, which means it has one of the highest potentials for abuse or dependence compared to other stimulant medications. Though it has medical uses as a treatment for ADHD, misuse, overuse, or use without a prescription can lead to addiction, dependence, and severe health consequences. It’s crucial to take Adderall as prescribed and under the supervision of a healthcare provider. 

Abrupt discontinuation or misuse of Adderall can result in withdrawal symptoms. such as extreme fatigue, depression, and mood swings. If you experience these symptoms or believe you may be dependent, seek medical assistance immediately or call 911. 

Those with bipolar disorder or other mood disorders should talk to their healthcare provider before taking Adderall, as it can cause mania.

Possible drug interactions

There are several possible drug interactions you need to look out for when taking Adderall and generic Adderall:

• Monoamine oxidase inhibitors (MAOIs): Adderall should not be taken with MAOIs or within 14 days of stopping or starting MAOI treatment due to the risk of a dangerous drug interaction.
• Blood pressure medications: Some blood pressure medications, such as beta-blockers and alpha-2 agonists, can interact with Adderall and increase the risk of cardiovascular side effects, such as high blood pressure, heart palpitations, and arrhythmia.
• Antidepressants: Some antidepressants, including SSRIs and tricyclic antidepressants, can increase the levels of Adderall in the body and lead to a greater risk of negative side effects.
• Antipsychotics: Antipsychotic medications may interfere with the effectiveness of Adderall and decrease its ability to control symptoms of attention deficit hyperactivity disorder (ADHD).
• Seizure medications: Some seizure medications, such as phenytoin and carbamazepine, can increase the metabolism of Adderall, which can lower its effectiveness.
• Acid reducers: Acid reducers like proton pump inhibitors and H2 blockers can increase the absorption of Adderall, which can lead to higher levels of the drug in the body and an increased risk of side effects.
• Vitamin C: High doses of vitamin C can increase the levels of Adderall in the body, increasing the risk of side effects.

You must consult with your healthcare provider about any medications or supplements you are taking before starting Adderall.

Focalin vs Adderall

Both Focalin and Adderall are central nervous system (CNS) stimulants that affect certain neurotransmitters in the brain. While both medications improve the effectiveness of norepinephrine (a neurotransmitter and a hormone), Focalin targets the brain’s usage of dopamine (a neurotransmitter), while Adderall targets serotonin (a chemical that transmitts messages between nerve cells). For individuals with ADHD, an increase in the efficacy of these neurotransmitters can help reduced the lack of focus most commonly associated with the disorder.

Focalin contains dexmethylphenidate, a mild stimulant that is used to treat ADHD. Adderall contains amphetamine salts, which are central nervous system stimulants that work to restore imbalance in the brain.

Focalin and Adderall come in similar dosages, but Adderall has more available dosages for an individual’s unique needs. Both medications also come in an extended-release form that doesn’t have to be taken as often, though Adderall is often slightly more expensive than Focalin. Focalin and Adderall can have serious interactions with other medications and should only be taken under the supervision of a licensed clinician.

Some studies have shown that the methylphenidate, an ingredient n Focalin, is more effective in treating children and adolescents, while the amphetamines in Adderall are more effective in adults. Adderall is the most common prescription treatment for ADHD and is one most prescribed by mental health providers.

Due to the stimulant nature of Focalin and Adderall, individuals with high blood pressure or any other heart condition should exercise caution when taking either one of them. If you experience a severe headache, anxiety, chest pain, uneven heartbeat, or shortness of breath after taking either of these drugs, you should stop taking them and contact your medical provider immediately.

Risk of dependency for Focalin and Adderall

Both Focalin and Adderall are CNS stimulant medications classified as Schedule II controlled substances by the US Drug Enforcement Administration (DEA). This means that they have a high potential for abuse and dependence.

As Schedule II substances, Focalin and Adderall have restrictions on how they can be prescribed and dispensed. In addition, possession of Focalin and Adderall without a valid prescription is illegal and can result in criminal charges. It’s important to use these medications only as prescribed and to keep them in a secure location to prevent misuse or diversion.

Focalin vs Adderall: which ADHD medication should you take?

Finding the right ADHD medication can be a complex process, so it’s important to consider all possible factors to avoid a negative outcome. Speak with your healthcare provider about your medical history and all of the medications you take to avoid any serious drug interactions or side effects.

Find out which ADHD treatment is right for you

Focalin and Adderall can appear to be similar medications, but their differences make talking to an ADHD-trained medical provider a must. When you book on Klarity Health, you can speak with a board-certified health professional to get up to date on the Focalin vs Adderall question. And to determine which one, if either, is right for your treatment plan.

Klarity Health offers modern mental health treatment designed by busy people for busy people. 

• No more waiting weeks for an appointment and even more weeks for a follow-up. 
• Meet at your convenience at a time and place you choose.
• ADHD treatment delivered right to your pharmacy if medically necessary.

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