Strattera vs Adderall vs Ritalin: Comparing ADHD Medications

This post is a side-by-side comparison of the advantages/disadvantages of Strattera vs Adderall vs Ritalin.

A comparison of Adderall and Vyvanse, the bestselling prescription ADHD medication at the moment, can be found here.

Summary of Differences

Adderall is a psychostimulant which promotes catecholamine (dopamine, norepinephrine) release, increasing the synaptic concentrations of these neurotransmitters.

Ritalin inhibits the reuptake of dopamine, and has little effect on norepinephrine.

Strattera is a highly selective norepinephrine re-uptake inhibitor, that was initially developed as a treatment for depression, but demonstrated little antidepressant effects and was therefore repurposed for ADHD.

Abuse Liability

The abuse potential and likelihood of developing dependence for these medications can be ranked as follows: Adderall > Ritalin >> Strattera, where Adderall has the greatest abuse potential. Reflecting this difference, both Adderall and Ritalin are controlled substances (schedule II), whereas Strattera is uncontrolled.

Unlike Adderall and Methylphenidate, the therapeutic effects of Strattera take time to build up to be fully appreciated.

Cardiovascular Side Effects

Adderall has a greater incidence of unsavory cardiovascular side effects compared to Ritalin and Strattera, such as increased blood pressure, increased heart rate and heart palpitations. Adderall is also associated with peripheral vasocontriction, which causes the extremities (hands and feet) to feel cold.

Strattera is much less likely to cause insomnia compared with Adderall and Ritalin.

Strattera vs Adderall vs Ritalin

Medication	Strattera (atomoxetine)	Adderall (amphetamine salts)	Ritalin (methylphenidate)
Capsule Appearance
Classification	Non-stimulant; norepinephrine reuptake inhibitor (NRI)	psychostimulant; catecholamine releasing agent	psychostimulant; dopamine reuptake inhibitor (DRI)
Indications (used to treat)	ADHD	ADHD, narcolepsy, obesity (off-label), depression (off-label)	ADHD, postural orthostatic tachycardia syndrome, narcolepsy, depression (off-label)
Common side effects	Upset stomach, decreased appetite, nausea, dizziness, fatigue, mood swings	Chronic insomnia, irritability, false sense of well-being, loss of appetite, nervousness, vomiting, upper abdominal pain	Chronic insomnia, dry mouth, head pain, loss of appetite, nervousness, over excitement, upper abdominal pain
Serious side effects	Inability to empty bladder, erectile dysfunction, painful periods, depression, easily angered, rapid heartbeat	Allergic reaction, anxiety, restlessness, fever, hives, rash, difficulty breathing, urinary tract infections	Rapid heartbeat, high blood pressure, angina, chest pain, chronic muscle twitches, decreased blood platelets, fever, hives
Contraindications	Monoamine oxidase inhibitors (MAOI), hypersensitivity, narrow angle glaucoma, pheochromocytoma, severe cardiovascular disorders	Advanced arteriosclerosis, symptomatic cardiovascular disease, hypertension, hyperthyroidism, known hypersensitivity, agitation, history of drug abuse, monoamine oxidase inhibitors (MAOI)	Marked anxiety, tension, agitation, hypersensitivity, glaucoma, motor tic syndrome, Tourette’s syndrome, monoamine oxidase inhibitors
Half-life	5.2 hours; 21.6 hours (in poor metabolizers)	10 hours (adults); 11 hours (adolescents)	3.5 hours (adults); 2.5 hours (children)
Standard dose	20 mg -100 mg	5 mg – 30 mg	10 mg – 40 mg
Formulations	Strattera (Atomoxetine HCl)	Adderall, mixed amphetamine salts (generic), Vyvanse (lisdexamfetamine)	Concerta (12 hours), Ritalin SR (5-8 hours), Ritalin LA (8 hours), Metadate-CD (8-10 hours), Quillivant XR (12 hours), Daytrana (11 hours)