Header Image for Wakix vs Adderall

Wakix vs Adderall

Listen to the article instead of reading through it.
--:--
--:--

Overview

Wakix Information

Adderall Information

Comparative Analysis

Wakix Prescription Information

Adderall Prescription Information

Wakix Side Effects

Adderall Side Effects

Cost Analysis

Market Analysis

Summary

Introduction

For patients with narcolepsy, a neurological disorder that affects the control of sleep and wakefulness, medications can be used to manage symptoms such as excessive daytime sleepiness and sudden episodes of muscle weakness. Wakix (pitolisant) and Adderall are two such drugs prescribed for managing narcolepsy. They both influence different neurotransmitters in the brain but both help stimulate alertness in patients with this condition. Wakix is classified as a histamine 3 (H3) receptor antagonist/inverse agonist which increases the release of histamine, a neurotransmitter involved in regulating the sleep-wake cycle. Adderall, on the other hand, is an amphetamine type stimulant that primarily enhances the activity levels of norepinephrine and dopamine.

Wakix vs Adderall Side By Side

AttributeWakixAdderall
Brand NameWakixAdderall
ContraindicationsShould not be taken with or have recently been taking monoamine oxidase inhibitors (MAOIs)Should not be taken with or have recently been taking monoamine oxidase inhibitors (MAOIs)
CostAround $7,500 for 30 tablets (4.45 mg)Approximately $760 for 60 tablets (20 mg each)
Generic NamePitolisantAmphetamine and Dextroamphetamine
Most Serious Side EffectHallucinations or intense mental confusion, signs of an allergic reaction, changes in heart rate or rhythm, low sodium levels, severe nervous system reactionSigns of an allergic reaction, chest pain, trouble breathing, hallucinations, new behavioral problems, aggression, hostility, paranoia, circulation problems in fingers or toes, severe nervousness or restlessness, unusual sleep patterns, high blood pressure with headache blurred vision and confusion
Severe Drug InteractionsMay interact with other medications to cause serotonin syndromeIncreased risk of serotonin syndrome when combined with other drugs
Typical Dose17.8–35.6 mg/dayAdults: 10 mg/day initially, up to 20-40 mg/day; Children aged 6–12: 5mg per day initially, up to 30 mg/day

What is Wakix?

Pitolisant (the generic name for Wakix) is a first-of-its-kind drug from the class of histamine receptor antagonists, marking a revolutionary development in treating narcolepsy. Pitolisant was approved by the FDA in 2019 and works to increase dopamine levels within the brain by activating its histamine receptors, enhancing wakefulness and vigilance. It has been prescribed for managing excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy.

On the other hand, Adderall is an amphetamine type that increases levels of both dopamine and norepinephrine neurotransmitters in your brain to help control symptoms of ADHD. This increased activity can lead to better focus, reduced impulsivity, and other benefits for people with ADHD.

While both drugs aim at promoting alertness, they work on different neurotransmitters: Wakix primarily affects histamine while Adderall significantly influences both dopamine and norepinephrine pathways. As such, Wakix tends to have fewer side effects associated with stimulant medications like jitteriness or anxiety typically seen with Adderall use due to its more significant influence on these two neurotransmitter systems.

What conditions is Wakix approved to treat?

Wakix is approved for the treatment of different conditions:

  • Narcolepsy, a chronic sleep disorder that causes overwhelming daytime drowsiness
  • Excessive Daytime Sleepiness (EDS) in adult patients with narcolepsy

Adderall on the other hand, has been approved to treat:

  • Attention Deficit Hyperactivity Disorder (ADHD), a mental condition characterized by problems focusing and controlling impulsive behaviors
  • Narcolepsy

How does Wakix help with these illnesses?

Wakix helps manage narcolepsy by stimulating the production of histamine, a neurotransmitter involved in wakefulness. It does this by activating the histamine-3 (H3) receptors which leads to an increase in activity of histaminergic neurons and consequently increases wakefulness and vigilance. Histamine is a chemical that acts as a messenger not only in the brain but also throughout the body, playing crucial roles in numerous physiological processes including immune response, gastric acid secretion and neuromodulation.

Similar to how it's believed individuals with depression have relatively lower levels of serotonin, people with narcolepsy are thought to have disruptions or deficiencies within their sleep-wake cycle that can lead to excessive daytime sleepiness. Therefore, by increasing histamine action via H3 receptor activation, Wakix has been shown effective at managing symptoms associated with narcolepsy such as excessive daytime sleepiness and cataplexy.

What is Adderall?

Adderall is a brand name for a combination of amphetamine salts (amphetamine and dextroamphetamine), which are central nervous system stimulants. These work by increasing the levels of dopamine and norepinephrine in the brain, thereby enhancing focus, attention, and impulse control. Adderall also reduces reabsorption of these neurotransmitters into neurons, effectively extending their effects.

It was first approved by the FDA in 1996 as an effective treatment for Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. As Adderall isn't classified under selective serotonin reuptake inhibitors (SSRIs), it doesn't inhibit the reuptake of serotonin.

The side effect profile for Adderall is different from that seen with SSRIs or other medications such as Wakix; it's less likely to cause weight gain or sexual dysfunction but can potentially lead to insomnia due to its stimulant properties. This stimulating effect can be beneficial particularly in patients dealing with ADHD who need increased focus during day time hours or those suffering from narcolepsy.

What conditions is Adderall approved to treat?

Adderall is a stimulant medication commonly prescribed for the treatment of:

  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden attacks of sleep

With its dual active ingredients, amphetamine and dextroamphetamine, Adderall works by increasing levels of certain chemicals in the brain that help with focus, attention, and impulse control.

How does Adderall help with these illnesses?

Adderall, like Wakix, can have an impact on wakefulness and focus. Adderall works by increasing levels of dopamine and norepinephrine in the brain, neurotransmitters that play essential roles in attention and alertness. Dopamine is associated with pleasure, attention, mood swings and impulse propagation whereas Norepinephrine is involved in responses such as stress reaction (fight or flight response), focus and retaining information. The increase in these chemicals can help to alleviate symptoms of conditions like ADHD by improving concentration and reducing impulsivity. However unlike Wakix which primarily targets histamine receptors to promote wakefulness for narcolepsy patients, Adderall has a wider range of effects due to its action on both dopamine and norepinephrine. This makes it more suitable for treating ADHD but also means it may carry a higher risk of side effects.

How effective are both Wakix and Adderall?

Both pitolisant (Wakix) and amphetamine-dextroamphetamine (Adderall) are medications used to manage symptoms of narcolepsy, though they were initially approved by the FDA nearly 20 years apart. Pitolisant was approved in August 2019 while Adderall has been in use since February 1996. Their pharmacological mechanisms differ, with Wakix being a histamine H3 receptor antagonist/inverse agonist while Adderall is an amphetamine-type stimulant. This means that they exert their effects on different neurotransmitter systems and may be prescribed under different circumstances.

The effectiveness of pitolisant and amphetamine-dextroamphetamine for managing narcoleptic symptoms like excessive daytime sleepiness (EDS) and cataplexy have been demonstrated in numerous studies over the years. For example, a double-blind clinical trial published in Sleep Medicine in 2017 compared pitolisant to placebo and found significant reductions in EDS as measured by Epworth Sleepiness Scale scores among patients receiving Wakix.

A systematic review conducted by Cochrane Database Systematic Reviews concluded that Amphetamines like Adderall significantly reduce EDS symptoms as well as increase wakefulness among adults suffering from chronic primary insomnia or narcolepsy when compared to placebo treatments. The therapeutic dose varies between patients but generally ranges between 5-60mg per day depending upon individual patient response.

Overall, both drugs offer important options for treating narcolepsy although they come with distinct safety profiles due to their differing mechanisms of action; Stimulants such as Adderall carry risk for dependence or abuse whereas Wakix presents less potential for misuse but can cause side-effects like insomnia or nausea.

abstract image of a researcher studying a bottle of drug.

Find Top Clinical Trials

Choose from over 30,000 active clinical trials.

At what dose is Wakix typically prescribed?

Oral dosages of Wakix range from 17.8–35.6 mg/day, but studies have shown that a daily dose of 17.8 mg is often sufficient for managing narcolepsy symptoms in most people. Depending on the individual response and tolerability, the dosage can be increased to a maximum of 35.6 mg/day after one week if necessary. For Adderall, adult doses typically range from 5-60mg per day used for treating ADHD and narcolepsy; children aged six years or older may start with a daily dose of 5mg which can be gradually increased by their doctor depending on therapeutic needs and responses to the medication.

At what dose is Adderall typically prescribed?

Adderall treatment is typically initiated at a dosage of 10 mg/day for adults, while children aged 6–12 start with a dose of 5mg per day. This dosage can then be increased to up to 20 mg/day for adults and up to 30 mg/day for children, divided into two doses taken approximately four hours apart. The maximum daily dose generally should not exceed 40mg per day in adults or children older than twelve years and it's usually limited to no more than 30mg per day in younger children. If there is no therapeutic response after several weeks of consistent use at appropriate dosages, the physician may choose to reassess the patient’s condition and consider alternative treatments.

What are the most common side effects for Wakix?

Common side effects of Wakix can include:

  • Insomnia
  • Nausea
  • Anxiety
  • Increased heart rate
  • Hallucinations, confusion or other changes in mental status
  • Upper respiratory infection

On the other hand, Adderall has potential side effects such as:

  • Nervousness and restlessness
  • Uncontrollable shaking (tremor)
  • Headache or dizziness
  • Dry mouth or unpleasant taste in the mouth
  • Diarrhea or constipation
  • Loss of appetite and weight loss.

It is essential to contact your healthcare provider if these symptoms persist. Each individual may react differently to medication, so it's crucial to monitor any changes when starting a new drug.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Wakix?

While Wakix is generally well-tolerated, there can be severe side effects in rare instances. These include:

  • Hallucinations or intense mental confusion
  • Signs of an allergic reaction such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, and trouble breathing.
  • Changes in heart rate or rhythm; a rapid heartbeat that may cause chest pain or discomfort, shortness of breath, dizziness or fainting spells.
  • Low sodium levels - symptoms might include headache, difficulty concentrating, memory problems, feeling weak or unsteady on your feet.
  • Severe nervous system reaction could manifest as sudden high fever with sweating and fast heartbeat; muscles may feel stiff and you might tremble uncontrollably.

If serotonin syndrome occurs due to interaction with other medications: watch out for restlessness/agitation/hallucinations/rapid heart rate/fever/muscle stiffness/twitching/loss of coordination/vomiting/diarrhea.

Immediately consult your healthcare provider if you experience any aforementioned symptoms while taking Wakix.

What are the most common side effects for Adderall?

Adderall, a commonly used medication for attention deficit hyperactivity disorder (ADHD) and narcolepsy, has been known to have the following potential side effects:

  • Dry mouth and an unpleasant taste in the mouth
  • Digestive problems such as stomach pain, nausea, vomiting, loss of appetite or constipation
  • Sleep disturbances including insomnia
  • Nervousness or feelings of anxiety
  • Rapid heartbeat or palpitations
  • Mood changes which may include agitation or hostility
  • Physical symptoms like headaches, dizziness and tremors
  • Unexplained weight loss due to suppressed appetite
  • Increased frequency of urination
  • Other complications like blurred vision, muscle and joint pain, and skin rash.

It's important that individuals taking Adderall are aware of these possible side effects and report any concerns to their healthcare provider promptly.

Are there any potential serious side effects for Adderall?

While Adderall is considered safe and effective for most people, there are circumstances where it can cause severe side effects. These include:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • Chest pain, trouble breathing, feeling like you might pass out
  • Hallucinations (seeing or hearing things that are not real), new behavioral problems, aggression, hostility, paranoia
  • Circulation problems in fingers or toes - numbness, pain, cold feeling, unexplained wounds or skin color changes (from pale to blue/purple)
  • Severe nervousness or restlessness
  • Unusual sleep patterns, extreme feelings of fear
  • High blood pressure with headache blurred vision and confusion

If any such symptoms become apparent while taking Adderall discontinue its use immediately and contact a healthcare professional.

Contraindications for Wakix and Adderall?

Both Wakix and Adderall, like many other stimulant medications, may exacerbate symptoms of anxiety in some individuals. If you notice your anxiety increasing or experience panic attacks or severe restlessness after starting these medications, please seek immediate medical attention.

Neither Wakix nor Adderall should be taken if you are taking or have recently been taking monoamine oxidase inhibitors (MAOIs). Always inform your physician about any medication that you are currently using; MAOIs will require a period of about two weeks to clear from the system to prevent dangerous interactions with Wakix and Adderall.

Additionally, due to their stimulating effects on the nervous system, both Wakix and Adderall can lead to dependence and withdrawal symptoms if stopped abruptly after long-term use. Therefore it is crucial to only adjust dosages under the guidance of a healthcare practitioner.

How much do Wakix and Adderall cost?

For the brand-name versions of these drugs:

  • The price of 30 tablets of Wakix (4.45 mg) averages around $7,500, which works out to about $250/day.
  • The price for 60 tablets (20 mg each) of Adderall is approximately $760, working out to roughly $12–25/day depending on your dose.

Thus, if you are in a higher dosage range for Adderall (i.e., 40 mg/day or higher), then brand-name Wakix may be more expensive on a per-day treatment basis. However, cost should not be the primary consideration when determining which drug is right for you.

As it pertains to generic versions:

  • Currently there is no generic version available for Wakix.
  • Generic Adderall (amphetamine salts), however, significantly lowers costs. It's available in packs starting from 15 up to several hundred capsules with an approximate cost ranging from as low as $0.80 per day and typically does not exceed about $2.50 per day depending on your dosage level and where you purchase the medication.

Popularity of Wakix and Adderall

Pitolisant, marketed under the brand name Wakix, is a relatively new medication approved in 2019 by the FDA for treating excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy. As it's recently introduced to the market, its prescription numbers are not as high when compared to other established medications. Pitolisant offers a novel approach to managing narcolepsy symptoms as it enhances wakefulness by stimulating histamine-3 receptors.

On the other hand, Adderall has been widely prescribed since its approval in 1996 and was estimated to have been prescribed to about 16 million people annually in recent years. It is used primarily to treat attention deficit hyperactivity disorder (ADHD), but also can be used off-label for conditions like narcolepsy due its stimulant properties that promote wakefulness. The prevalence of Adderall use has seen an increase over time because of increased recognition and diagnosis of ADHD.

Conclusion

Both Wakix (pitolisant) and Adderall (amphetamine and dextroamphetamine) are approved by the FDA for the treatment of narcolepsy, a sleep disorder characterized by excessive daytime sleepiness. They differ significantly in their mechanisms of action: Wakix is a selective histamine H3 receptor antagonist/inverse agonist that activates histaminergic neurons to promote wakefulness, whereas Adderall stimulates the release of norepinephrine, dopamine and serotonin in the brain to improve focus and reduce impulsivity.

Wakix is typically considered as an alternative therapy for patients who did not respond well or have contraindications to first-line stimulant medications like Adderall. However, it's important to note that while both drugs can be effective treatments for narcolepsy, they should not be used together without careful consideration due to potential interactions.

While generic versions of Adderall are available leading to cost-savings especially for out-of-pocket payers, currently there is no generic form of Wakix which might make it more expensive.

Starting either drug may require an adjustment period where effects may not be noticeable immediately but gradually improve over time. The side effect profiles between these two drugs show some differences; with Adderall being associated with higher rates of cardiovascular events and dependency issues compared to Wakix. However both carry risks including worsening mental health symptoms or causing new ones such as hallucinations or delusions. Close monitoring from healthcare professionals during treatment initiation or dosage changes is recommended.

Refrences

  • Fitzgerald, K. T., & Bronstein, A. C. (2013, February). Adderall® (Amphetamine-Dextroamphetamine) Toxicity. Topics in Companion Animal Medicine. Elsevier BV.http://doi.org/10.1053/j.tcam.2013.03.002
  • May, D. E., & Kratochvil, C. J. (2010, January). Attention-Deficit Hyperactivity Disorder. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11530540-000000000-00000
  • Biederman, J., Swanson, J. M., Wigal, S. B., Kratochvil, C. J., Boellner, S. W., Earl, C. Q., … Greenhill, L. (2005, December 1). Efficacy and Safety of Modafinil Film–Coated Tablets in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Results of a Randomized, Double-Blind, Placebo-Controlled, Flexible-Dose Study. Pediatrics. American Academy of Pediatrics (AAP).http://doi.org/10.1542/peds.2005-0617
  • Ahmann, P. A., Theye, F. W., Berg, R., Linquist, A. J., Van Erem, A. J., & Campbell, L. R. (2001, January 1). Placebo-Controlled Evaluation of Amphetamine Mixture—Dextroamphetamine Salts and Amphetamine Salts (Adderall): Efficacy Rate and Side Effects. Pediatrics. American Academy of Pediatrics (AAP).http://doi.org/10.1542/peds.107.1.e10