Strattera vs Vyvanse for ADHD compared

Are you trying to choose a stimulant or non-stimulant medication for attention deficit hyperactivity disorder (ADHD)? Wondering which will be most effective and have the fewest side effects? Considering Strattera vs Vyvanse among your options? Read on to understand these 2 ADHD medication options. 

Vyvanse (lisdexamfetamine) is a stimulant medication, while Strattera (atomoxetine) is a non-stimulant medication. Vyvanse stimulates the central nervous system to produce more dopamine and norepinephrine, while Strattera prevents norepinephrine from being re-absorbed into the brain. Some people react better to one kind of medication than the other. 

In this article, we compare these medications to help you understand the differences between them and work with your provider to choose one that works best for you. 

At Klarity, our streamlined process ensures you connect with a knowledgeable professional in as little as 24 hours, so you get the answers and guidance you need to find the right medication. Schedule an appointment with a licensed ADHD professional today. 

Strattera vs Vyvanse for ADHD, how to decide

Depending on your specific ADHD condition, either Vyvanse or Strattera may be beneficial for your disorder. To discover which may be best for you, speak with an ADHD specialist who can weigh your condition and medical history before prescribing an ADHD medication. 

The FDA has approved 2 medication classes for the treatment of ADHD — stimulants and non-stimulants. Stimulants are considered first-line medications and include drugs you’ve probably heard of like Adderall or Vyvanse. Non-stimulants, like Strattera, are considered second-line medications, as stimulants are typically more effective at helping people reduce inattention, hyperactivity, and impulsivity. 

Though stimulants and non-stimulants are both effective for ADHD, there are some key differences to consider. Stimulants work on brain chemicals like dopamine and norepinephrine, while non-stimulants work on norepinephrine only. Stimulants are processed more quickly in the body, which sometimes lead to harsher side effects. Non-stimulants may take longer to build up in your body but can be gentler on your system. If you have a difficult time tolerating stimulants, you and your provider may consider this when identifying your options. 

When considering which medication may be right for you, you should know that stimulants, like Vyvanse, have the potential for substance misuse. The risk of misuse or dependency with medications like Strattera is much lower. If you have a history of substance use or addiction, let your provider know so you can decide which route may be best. 

What is Strattera?

Strattera (atomoxetine) is an ADHD medication classified as a selective norepinephrine reuptake inhibitor (SNRI). SNRIs help keep more norepinephrine (a brain chemical responsible for cognitive function and attention) available in the brain, which results in improved focus and concentration for people with ADHD symptoms. 

Strattera was approved by the FDA in 2002 for the management of ADHD in adults and children as young as 6. In addition to ADHD, providers sometimes prescribe the medication off-label to manage treatment-resistant depression. As of 2023, only the generic form, atomoxetine, is available. 

Strattera is a non-stimulant and isn’t considered a controlled substance by the federal Drug Enforcement Agency (DEA). It was the first non-stimulant ADHD medication approved by the US Food and Drug Administration (FDA) and the first non-stimulant ADHD medication approved for use in adults. 

Forms and dosages of atomoxetine, formerly sold as Statterra

Atomoxetine (Strattera) comes in 10, 18, 25, 40, 60, 80, and 100-milligram dosages. You take it 1 to 2 times a day with or without food. Strattera normally reaches maximum absorption within 1 to 2 hours of your taking it.

It takes 1 to 2 weeks for Strattera to reach full concentration in your body, which means it may take that long before you get full relief for your ADHD symptoms.

When starting Strattera, your provider may recommend you start with a lower dose (40 mg or less) for at least 3 days before gradually increasing your dosage over the next 2-4 weeks. The maximum dose of Strattera is 100 milligrams. 

Cost of atomoxetine (Strattera)

Strattera is no longer available by the brand name. Though it was discontinued in 2023, the generic atomoxetine is still available. If you pay for atomoxetine out-of-pocket, you could spend around $131 for 30 40-milligram capsules. This price can fluctuate depending on where you purchase the medication. For accurate pricing under your current health insurance plan, contact your insurance provider.

As a non-stimulant, the side effects of Strattera can be milder, however, it’s essential to be aware of them so you can share how you’re adjusting to the medication with your provider. Common side effects include (but aren’t limited to) upset stomach, nausea or vomiting, constipation, menstrual cramps, loss of appetite, tiredness, or trouble sleeping. You may also experience dizziness, dry mouth, difficulty passing urine (starting or emptying your bladder), or a decrease in sexual desire. 

It’s possible to have serious side effects with Strattera. If you experience trouble breathing, swelling or hives, irregular heartbeat, fainting, numbness, or difficulty urinating, seek immediate care and call your provider to follow up on your dosage and care plan. 

Warnings and drug interactions to know before taking Strattera

Unlike Vyvanse, Strattera isn’t a controlled substance or a stimulant medication, meaning it carries a low risk for abuse or dependence. Strattera is often recommended as an alternative medication if you have a history of substance use disorder.

If you take antidepressants like Prozac, Lexapro, or Abilify, speak with your healthcare provider before taking this medication, as it may cause dangerous drug interactions. If you experience any of the following issues, discuss them with your healthcare provider before taking Strattera:

• Cardiac issues
• Glaucoma
• Hypertension
• Liver disease
• Seizure disorders
• Mental health issues

Risk of serotonin syndrome

Serotonin syndrome is a potentially serious condition that can happen if you take Strattera or another SNRi. It’s characterized by an excess accumulation of serotonin in the body and requires prompt medical intervention. 

Symptoms of serotonin syndrome may include:

• Agitation and restlessness
• Confusion and disorientation
• Rapid heartbeat and increased blood pressure
• Loss of coordination
• Dilated pupils
• Excessive sweating
• Tremors or muscle rigidity
• Nausea, vomiting, and diarrhea
• Hallucinations
• Changes in blood pressure
• Increase in body temperature

If you or someone you know experiences these symptoms while taking Strattera, seek immediate medical attention. Getting prompt treatment can help prevent complications and ensure your safety.

What is Vyvanse?

Vyvanse (lisdexamfetamine) is a stimulant medication used to treat ADHD. It targets the neurotransmitters, like norepinephrine, in the brain that control behaviors like focus, hyperactivity, and impulsivity. 

Vyvanse was approved for use by the FDA in 2007 (its generic form was approved in 2023) and is a federally scheduled controlled substance, although it is not considered a narcotic. It is FDA-approved to treat attention deficit hyperactivity disorder (ADHD), narcolepsy, and binge eating disorder.

Real people who take Vyvanse for ADHD, according to reviews on drugs.com, rated the medication as 7.3 out of 10. Reviewers wrote about how Vyvanse helped them maintain focus, complete tasks, feel calmer, and regain control over their lives especially when taking the medication and also prioritizing sleep, movement, and nutritious meals. 

Vyvanse is known as a prodrug, which means it’s a medication that doesn’t become activated in the body until processed by the liver. As a result, Vyvanse has a lower risk of misuse and addiction compared to similar ADHD stimulant medications like Ritalin and Adderall. 

Forms and dosages of Vyvanse

Vyvanse comes in 5, 10, 20, 30, 40, 50, and 60-milligram dosages and a maximum dosage of 70 milligrams. It also comes in chewable tablets in the same dosages. You take Vyvanse first thing in the morning with or without food. 

You want to take Vyvanse in the morning and not after noon because it can interfere with your normal sleeping patterns. You don’t want to crush or chew the capsules, which can cause serotonin syndrome. Serotonin syndrome happens when the brain is flooded with serotonin and can result in seizures, heart attacks, and even death.

The cost of Vyvanse

Though Vyvanse was approved by the FDA, in 2007, lisdexamfetamine, its generic form, wasn’t approved until 2023. Still, Vyvanse remains one of the costlier ADHD medications on the market. For 100 30-milligram capsules or chewable tablets of Vyvanse, you may be spending upwards of $1370. while spending closer to $1370 for 100 30-milligram chewable tablets. For the generic lisdexamfetamine, you can anticipate spending around $570 for 100 30-milligram capsules and $1186 for 100 30-milligram chewable tablets. 

For accurate information on what this medication costs under your current health insurance plan, contact your insurance company.

Vyvanse side effects

Vyvanse has a more subtle effect than many ADHD medications because of its unique delivery mechanism. As a prodrug, it’s absorbed by your gastrointestinal tract and converted into an active medication. This process can make Vyvanse easier to tolerate and side effects a non-factor.

Still, you may have side effects if you take Vyvanse. Some of the common side effects of Vyvanse include (but aren’t limited to) anxiety, diarrhea, dizziness, dry mouth, irritability, and trouble sleeping. You may also experience nausea, vomiting, weight loss, or upper stomach pain. 

It’s important to be aware of less common but more severe side effects of Vyvanse as well. Those include circulation problems in the fingers and toes, numbness, pain, changes in skin color, or sensitivity to temperature. Other serious side effects include new or worsening tics or Tourette’s syndrome or serotonin syndrome (a potentially life-threatening condition that results from too much serotonin in the brain) if taken with other medications that also act on this brain chemical. 

Warnings and drug interactions to know before taking Strattera

Although not a narcotic, Vyvanse is a Schedule II stimulant, which is a federally controlled substance and can create addiction and abuse. If you have a history of substance abuse, tell your healthcare provider before taking Vyvanse or any stimulant ADHD medication.

You should only take Vyvanse if you have a valid prescription and work closely with a healthcare professional. Misusing the medication, such as taking higher doses than prescribed or taking it more frequently than recommended, can lead to severe health complications. You may develop physical dependence on the medication or experience heart-related issues, psychological disorders, and, in extreme cases, death.

For your treatment to be safe and effective, you need to adhere strictly to the prescribed usage guidelines for Vyvanse. Your provider will tell you what you need to know before starting the medication. Maintain regular communication with your healthcare provider regarding any side effects or concerns that you have during treatment.

If you’re experiencing or have experienced any of the following conditions, speak with your ADHD healthcare provider before taking Vyvanse:

• Heart abnormalities
• Circulation issues
• Heart disease
• Mental health issues
• History of substance use

Find the right provider for the right ADHD medication on Klarity

If you’re looking for guidance on whether Vyvanse or Strattera is right for treating your ADHD, providers on Klarity are here to help. On Klarity, you can find board-certified healthcare providers qualified to diagnose and treat ADHD. Schedule an appointment with an ADHD healthcare provider today. Appointments are often available in as little as 24 hours.

Frequently asked questions about Strattera vs Vyvanse

Is Strattera better than stimulants for ADHD?

Unlike medications such as Vyvanse or Adderall, Strattera is a non-stimulant medication approved for the management of ADHD. Strattera is an effective medication for reducing hyperactivity, impulsivity, and inattention. However, research shows that stimulants may be more effective than non-stimulants and are considered first-line treatments. However, for individuals who have difficulty tolerating stimulants, history of substance use, or certain medical conditions, Strattera may be a better option. 

What type of ADHD are Strattera and Vyvanse good for?

There are three main presentations of ADHD, inattentive, hyperactive-impulsive, and combined type. Research shows that Strattera is effective for individuals with inattentive or combined-type ADHD. Vyvanse has also been shown to reduce symptoms in people with inattentive type. Both medications can help decrease impulsivity and hyperactive behaviors. 

Do Strattera and Vyvanse have fewer side effects than Adderall?

While Strattera is a non-stimulant, Vyvanse and Adderall are both stimulant medications for ADHD. Non-stimulants are better tolerated and tend to have less side effects than stimulants. The active ingredients in Adderall (amphetamine and dextroamphetamine) and Vyvanse (lisdexamfetamine) differ and are processed differently in the body. Vyvanse is metabolized more slowly, leading to side effects that may be less harsh than Adderall. 

Sources

Adderall vs. Vyvanse: What’s the Difference? American Addiction Centers. https://americanaddictioncenters.org/stimulants/amphetamine/adderall/vs-vyvanse 

Amphetamine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK556103/ 

Atomoxetine Prices, Coupons and Patient Assistance Programs. https://www.drugs.com/price-guide/atomoxetine. 

Atomoxetine response in the inattentive and combined subtypes of attention deficit hyperactivity disorder: a retrospective chart review. (2013). Attention deficit and hyperactivity disorders. https://pubmed.ncbi.nlm.nih.gov/23737214/

Pharmacological properties and clinical effects of the ADHD drug, Lisdexamfetamine. (2020). Japanese Journal of Pharmacology. https://pubmed.ncbi.nlm.nih.gov/33132261/ 

Real-World Dosing Patterns of Atomoxetine in Adults with Attention-Deficit/Hyperactivity Disorder. (2015). CNS neuroscience & therapeutics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5049605/ 

Strattera. DailyMed. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0121363e-dcd9-4c24-940b-ea890ab762e7 

Vyvanse. DailyMed. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=704e4378-ca83-445c-8b45-3cfa51c1ecad 

Vyvanse Label. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021977lbl.pdf 

Vyvanse Prices, Coupons and Patient Assistance Programs. https://www.drugs.com/price-guide/vyvanse