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Strattera vs Concerta
Introduction
For patients diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), certain medications can help manage symptoms by altering the balance of neurotransmitters in the brain. Strattera and Concerta are two such drugs that are commonly prescribed for ADHD. They each impact different neurotransmitters, but both have been found to improve focus, reduce impulsivity, and control hyperactive behavior. Strattera is a selective norepinephrine reuptake inhibitor (NRI), primarily affecting levels of norepinephrine in the brain. On the other hand, Concerta is a long-acting formulation of methylphenidate, which works by increasing dopamine and norepinephrine levels in the brain.
What is Strattera?
Atomoxetine (the generic name for Strattera) was the first drug of its kind, a non-stimulant approved to treat attention-deficit hyperactivity disorder (ADHD). It represents a significant development from the earlier class of stimulant drugs. Atomoxetine was first approved by the FDA in 2002. Strattera increases levels of norepinephrine in the brain, which helps increase attention span and decrease impulsive behavior and hyperactivity often associated with ADHD. Unlike Concerta, which affects both dopamine and norepinephrine neurotransmitters, Strattera selectively targets only norepinephrine. This selectivity means it tends to have fewer side effects related to appetite suppression or insomnia than other medications that also affect dopamine such as Concerta.
What conditions is Strattera approved to treat?
Strattera is approved for the treatment of various types of Attention Deficit Hyperactivity Disorder (ADHD):
- Pediatric ADHD in children six years and older
- Adult ADHD
- Adolescent ADHD
Unlike many other medications used to treat ADHD, Strattera is not a stimulant medication.
How does Strattera help with these illnesses?
Strattera, also known as atomoxetine, assists in managing symptoms of attention deficit hyperactivity disorder (ADHD) by increasing the amount of norepinephrine available in the synapses of the brain. It does this by inhibiting its reuptake into neurons, allowing levels to remain higher for longer periods. Norepinephrine is a neurotransmitter that plays a significant role in attention and focus — two areas often compromised in individuals with ADHD. By boosting norepinephrine levels, Strattera can alleviate some of the negative impacts of ADHD and assist patients in better controlling their symptoms.
On the other hand, Concerta works differently but has similar effects. It contains methylphenidate which increases both dopamine and norepinephrine availability within nerve synapses by blocking their reabsorption into neurons. This dual-action effect on these key neurotransmitters aids patients with ADHD maintain focus, control impulsive behavior and reduce hyperactivity.
What is Concerta?
Concerta is a brand name for methylphenidate, which is a central nervous system stimulant. It works by increasing the levels of dopamine and norepinephrine in the brain by reducing their absorption into neurons, similar to an NDRI. This mechanism of action helps improve concentration and decrease impulsivity and hyperactivity in patients with ADHD.
Methylphenidate was first approved by the FDA in 1955. As it's not a selective serotonin reuptake inhibitor (SSRI), it does not inhibit serotonin uptake, leading to different side effects compared to SSRIs like Prozac.
Its lack of action on serotonin means that its side-effect profile differs from that of Strattera; it generally doesn't cause sedation or sexual dysfunction but may lead to insomnia or decreased appetite (commonly reported effects). The increased levels of dopamine could be particularly beneficial for treating attention deficit hyperactivity disorder (ADHD), especially those who don't respond well to non-stimulant medications like Strattera.
What conditions is Concerta approved to treat?
Concerta is a popular medication approved for the treatment of:
- Attention deficit hyperactivity disorder (ADHD) in adults and children aged 6 to 17.
- Narcolepsy, a condition characterized by an excessive urge to sleep during daytime.
It can help increase attention and decrease impulsiveness and hyperactivity in patients with ADHD.
How does Concerta help with these illnesses?
Dopamine is a neurotransmitter that plays significant roles in various processes in the body, including motivation, reward, and motor control. Just as low levels of norepinephrine are implicated in depression, insufficient dopamine can lead to attention deficit hyperactivity disorder (ADHD). Concerta works by increasing the availability of dopamine within certain areas of the brain, thereby improving focus and reducing impulsivity. It does this through slowly releasing methylphenidate – a stimulant medication designed to act on parts of the brain responsible for impulse control and attention span - over 12 hours. Unlike Strattera which increases norepinephrine levels without significantly affecting dopamine levels, Concerta has an impact on both these neurotransmitters. This makes it particularly effective for those who do not respond well to non-stimulant ADHD medications like Strattera or may be taken alongside them when necessary.
How effective are both Strattera and Concerta?
Both atomoxetine (Strattera) and methylphenidate (Concerta) have long-standing histories of efficacy in treating attention-deficit/hyperactivity disorder (ADHD), having been approved by the FDA in 2002 and 2000, respectively. These drugs target different neurotransmitters: Strattera is a selective norepinephrine reuptake inhibitor, while Concerta is a stimulant that primarily increases dopamine levels. A randomized clinical trial conducted in 2011 found both medications to be effective for ADHD symptom management with similar safety profiles; however, no significant differences were observed between the effects of Strattera and Concerta on various measures of ADHD symptom severity.
A meta-analysis from 2016 showed that starting from the first week of treatment, Strattera alleviates symptoms of ADHD. It has a side effect profile comparable to other non-stimulant treatments for ADHD and is generally well-tolerated. The recommended dosage varies depending on patient weight but can range up to 100 mg/day; beyond its primary use for managing ADHD symptoms, it also seems to improve quality of life indicators such as social function.
On the other hand, Concerta has shown effectiveness superior to placebo in treating symptoms associated with ADHD according to another review published in 2018. While usually considered as a frontline treatment option due to its potent therapeutic effects on hyperactivity/impulsivity and attention deficits compared with second-line options like Strattera, there are still concerns about potential side-effects including appetite suppression or sleep disturbances which might make it less preferable for some patients. Nonetheless, through regular monitoring under professional healthcare supervision these risks can often be managed effectively making Concertta an important part of comprehensive care plans aimed at improving outcomes among those affected by ADHD.
At what dose is Strattera typically prescribed?
Oral dosages of Strattera for adults and adolescents over 70 kg start from 40 mg/day, which can be increased after a minimum of three days to a target total daily dose of approximately 80 mg administered as single dose in the morning or as evenly divided doses in the morning and late afternoon/early evening. After two to four additional weeks, the dosage may be increased up to maximum total daily dose of 100 mg depending on patient's response. For children and adolescents under 70 kg, initial dosage is about 0.5mg/kg with an increase after at least three days to approximately 1.2mg/kg/day but no more than 1.4mg/kg/day.
On the other hand, Concerta dosing for patients who are not currently taking methylphenidate or stimulants starts at a lower amount: typically around18-36 mg once daily in the morning before breakfast for both adults and children aged six years older. The maximum recommended dose is usually capped at around54-72 mg per day.
The selection between these medications should always be guided by healthcare professionals considering every individual's specific circumstances including age, weight, previous treatment experience among others.
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At what dose is Concerta typically prescribed?
Concerta treatment is typically initiated at a dose of 18-36 mg/day for children and adolescents, and 18-72 mg/day for adults. Dose can then be increased incrementally after a week if the response to initial dosage is insufficient. Maximum recommended daily dose should not exceed 54 mg/day in children aged between six to twelve years, whereas adolescents aged thirteen to seventeen years may take up to 72mg/day as per physician's discretion. For patients who have no improvement with Concerta treatment at an adequate dosage over an extended period, reconsideration of ADHD diagnosis may be necessary.
What are the most common side effects for Strattera?
Side effects shared by both Strattera and Concerta include:
- Nervousness, restlessness
- Difficulty sleeping (insomnia)
- Decreased appetite
- Abdominal pain or upset stomach
- Nausea and vomiting
- Dizziness, sleepiness/drowsiness
- Increased heart rate
- High blood pressure
- Sweating
- Weight loss due to decreased appetite Dry mouth
It's important to note that while these are common side effects of both medications, not every patient will experience all of them. It's also possible for a patient to experience other side effects not listed here. Always consult with a healthcare provider about potential risks before starting any new medication.
Are there any potential serious side effects for Strattera?
In some cases, Strattera can cause potentially serious side effects, which include:
- Thoughts about suicide or self-harm, especially in the first few weeks of treatment or when doses are changed. It is essential to report any such thoughts to your doctor immediately.
- Signs of allergic reaction: hives; difficulty breathing; swelling in your face or throat
- Blurred vision, eye pain or swelling; seeing halos around lights could indicate a serious eye problem that requires immediate attention
- Fast heartbeat, shortness of breath and sudden dizziness could be signs of heart problems
- Lowered sodium levels resulting in headache, confusion, slurred speech, severe weakness, vomiting and unsteadiness. Immediate medical help should be sought if these symptoms occur.
- Severe nervous system reactions such as rigid muscles high fever sweating confusion fast uneven heartbeats tremors feeling like you might pass out are very rare but require immediate medical intervention.
Always consult with a healthcare professional before making changes to medication routines and always seek immediate medical help if severe side effects occur.
What are the most common side effects for Concerta?
When comparing Strattera to Concerta, it is important to note that use of Concerta can lead to certain side effects. These include:
- Dry mouth and sore throat
- Increased heart rate
- Headache or dizziness
- Difficulty sleeping (insomnia)
- Anxiety or nervousness
- Stomach pain, loss of appetite, or weight loss
- Nausea, vomiting, constipation
- Sweating
- Muscle tension or twitches
Remember that these are possible side effects and may not appear in all individuals who take the medication.
Are there any potential serious side effects for Concerta?
While Concerta is generally well-tolerated, it can sometimes cause serious side effects. Be aware of the following symptoms:
- Signs of an allergic reaction: hives, difficulty breathing, swelling in your face or throat
- Increased heart rate or irregular heartbeat
- Changes in vision or blurred vision
- Mood swings, unusual behavior or thoughts, hallucinations (seeing or hearing things that are not real)
- Severe headaches and dizziness could be signs of increased blood pressure
- Chest pain; shortness of breath; sudden numbness on one side of your body - these could indicate a potential heart problem
-Increased agitation and restlessness
If you experience any one of these signs while taking Concerta, consult with your doctor immediately.
Contraindications for Strattera and Concerta?
Both Strattera and Concerta, as with most other ADHD medications, may worsen symptoms of anxiety or agitation in some people. If you notice your anxiety intensifying, or an increase in aggressive behavior or thoughts, please seek immediate medical attention.
Neither Strattera nor Concerta should be taken if you are taking, or have recently been taking monoamine oxidase (MAO) inhibitors. Always inform your healthcare provider about any medications you're currently on; MAOIs will require a period of around 2 weeks to clear from the system before starting either Strattera or Concerta to prevent dangerous drug interactions.
How much do Strattera and Concerta cost?
For the brand name versions of these drugs:
- The price of 30 capsules of Strattera (40 mg) averages around $400, which works out to approximately $13–26/day, depending on your dose.
- The price for 30 tablets of Concerta (18 mg) is about $300, working out to roughly $10/day.
Thus, if you are in the higher dosage range for Strattera (i.e., 80 mg/day or higher), then brand-name Concerta is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
As far as generic versions go:
- Atomoxetine (generic Strattera) costs between $1 and $3 per day for typical dosages ranging from 40 to 100 mg daily.
- Methylphenidate ER (generic Concerta) has an average cost range from about $0.50 to up to more than several dollars per pill depending upon strength and quantity.
Remember that while generics offer great savings over their branded equivalents, it's important that you work with your healthcare provider before making any changes based solely on cost considerations.
Popularity of Strattera and Concerta
Atomoxetine, commonly known by the brand name Strattera, was prescribed to an estimated 1.6 million people in the US in 2018. Atomoxetine is a selective norepinephrine reuptake inhibitor (NRI) and accounts for around 5% of ADHD medication prescriptions in the US. The use of atomoxetine has remained relatively steady over recent years.
On the other hand, methylphenidate hydrochloride, also known as Concerta among its various brand names, was prescribed to approximately 3.2 million individuals in the USA during that same year. In America alone, methylphenidate makes up just under 30% of stimulant prescriptions used to treat ADHD and just under one fifth of all medications prescribed for this condition overall. The prevalence of Concerta has been generally increasing since it's approval by FDA back in 2000.
Conclusion
Both Strattera (atomoxetine) and Concerta (methylphenidate) have long-standing records of usage in patients with attention-deficit/hyperactivity disorder (ADHD), supported by numerous clinical studies and meta-analyses indicating that they are more effective than placebo treatments. On occasion, the drugs may be combined under careful medical supervision due to their distinct mechanisms of action; Strattera works primarily on norepinephrine while Concerta acts mainly on dopamine.
Strattera is often considered a second-line treatment option for ADHD after stimulants like Concerta, or in patients who did not respond well to first-line stimulant medications or have a need to avoid potential substance abuse associated with these kinds of drugs. Both Strattera and Concerta are available as generic medicines which can significantly cut costs for out-of-pocket payers.
The side effect profile is broadly similar between the two drugs, but there are some key differences: unlike Concerta, Strattera does not typically cause insomnia or decrease appetite, but it may increase suicidal thinking in children and adolescents at the start of treatment. For both medications, close monitoring of symptoms especially when initiating therapy is strongly advised. If worsening behavior or mood changes occur such as agitation/irritability/anxiety/depression/suicidal thoughts or other unusual changes in behavior occur, immediate medical help should be sought.