Strattera is the first non-stimulant medication approved by the Food and Drug Administration (FDA) for the treatment of attention deficit hyperactivity disorder (ADHD). The majority of ADHD medications are central nervous system stimulants.
Strattera mainly increases norepinephrine levels in the brain. Stimulant ADHD medications, by comparison, increase the levels of norepinephrine and dopamine in the brain.
Cleveland Clinic found that Strattera does not perform as well as stimulants. They have gone on to recommend the medication only as a second option. A study published in Paediatric Drugs, on the other hand, reported that Strattera is effective and well tolerated. It performed comparably to nearly all major stimulants. This study did find that Strattera was not as effective as the time-release formulation of methylphenidate (Ritalin).
Stimulant medications, such as Ritalin, amphetamine and dextroamphetamine (Adderall), and dextroamphetamine (Dexedrine), contain amphetamines or amphetamine-like chemicals. They are controlled substances and can easily become habit-forming.
Strattera, on the other hand, is not habit-forming and not prone to abuse. Because of this, it is not a controlled substance. This simplifies the prescription process. You also do not have to gradually taper off of Strattera the way you do with stimulants. As a result, you are also less likely to experience the “crash” people often experience when stimulant medications wear off. Symptoms of a crash can include anger, anxiety, fatigue, and distractibility.
In addition to being less addictive and having few, if any, withdrawal symptoms, you are less likely to experience serious side effects while on Strattera. The medication is also less likely to cause sleep problems.
While there are many benefits to taking Strattera, there are also some potential downsides.
While some initial effects of the medication may be noticeable after one week, according to a study published in CNS Drugs, it can take several weeks for Strattera levels to build up in the blood, which means it can take six to nine weeks to achieve full effect. You need to continue taking the medication with no breaks for a positive effect. As with many medications, you may find it necessary to adjust dosages before you find what works best for you or your child.
Strattera is sometimes used in combination therapy with other ADHD medications. Currently, there is no generic version of Strattera, so it may be more costly than generic medications.
It’s common to experience side effects when first taking Strattera or when increasing your dose. Common side effects include:
- jitteriness or nervousness
- loss of appetite
- increase in blood pressure
- sexual dysfunction
Some children taking Strattera may grow more slowly and should be monitored while taking the medication.
Strattera may also cause thoughts of suicide in children or adolescents. When taking this medication, children should be watched closely for suicidal thinking or unusual changes in behavior.
Strattera is a viable option for most children older than age 6, adolescents, and adults who have ADHD. For some people Strattera may be especially appropriate, particularly in those who:
- don’t tolerate stimulant medications
- have a history of drug abuse
- have a vocal or motor tic disorder, which can be made worse by stimulants
- have depression or anxiety, the symptoms of which may improve with Strattera
Strattera should not be used if you have the following conditions:
- narrow-angle glaucoma
- heart disease
- pheochromocytoma, a condition effecting the adrenal gland
You should also avoid Strattera if you take monoamine oxidase inhibitors
Pregnancy and Breastfeeding
Strattera is listed as an FDA category C drug. This means that in animal testing, adverse effects in fetuses have been observed. There are insufficient studies in humans to determine the drug’s safety in human fetuses. You should discuss the issue with your doctor to determine if the benefits of taking Strattera outweigh the potential risks.
There are numerous advantages and disadvantages to Strattera use. People taking Strattera do not experience a crash when the medication wears off. Strattera is not habit-forming, but it may not be as effective as stimulants for some people. Talk with your doctor or psychiatrist about the pros and cons of Strattera.