In the United States,
If you or your child has attention deficit hyperactivity disorder (ADHD), you may have heard that certain ADHD medications can cause a crash. This is a temporary episode that can leave you feeling tired, anxious, irritable, or angry. It can occur several hours after taking the drug.
A crash refers to certain negative feelings, such as anxiety and tiredness, that happen as a drug wears off. It’s not the same as side effects. However, side effects of a drug can also be uncomfortable.
Strattera is a drug for ADHD. It’s one of the few ADHD drugs that don’t typically cause a crash. Read on to learn why that is and what else you should know to treat your ADHD comfortably.
The key factor that affects whether an ADHD drug can cause a crash is whether it’s a stimulant or nonstimulant drug.
The majority of ADHD medications, such as Adderall, Vyvanse, and Ritalin, are stimulants. They work by increasing the levels of certain neurotransmitters, or brain chemicals, called norepinephrine and dopamine.
Crash from a stimulant medication is caused by the drug’s effects on dopamine levels in your brain. Dopamine affects learning, attention, and mood. The drug increases your levels of dopamine. As it wears off, these levels go down. This causes the crash.
Strattera, on the other hand, is a nonstimulant medication. It works by increasing levels of norepinephrine only. Norepinephrine has lesser effects on attention and mood than dopamine does. Since Strattera doesn’t affect your levels of dopamine, there’s no risk of a crash.
Some people think of a crash as any negative effect from taking a drug. While Strattera doesn’t cause a crash in the sense described above, it can cause side effects.
The mild side effects of Strattera can be similar to those of stimulants and can include nervousness, trouble sleeping, and irritability.
The most serious potential side effect of Strattera is thoughts of suicide in children and adolescents. This side effect is described in a black box warning as being possible in about 0.4 percent of those who take it.
When taking this medication, children should be watched closely for suicidal thinking or unusual changes in behavior. Other rare but serious side effects of Strattera can include seizures and liver problems.
The differences between how stimulants and nonstimulants work also impact other risks linked with ADHD drugs.
Because of the effects on dopamine levels in your brain, stimulants raise your risk of dependency. Stimulant medications contain amphetamines or amphetamine-like chemicals. These are controlled substances, which are drugs that can easily become habit-forming.
Stimulant drugs can also cause withdrawal if you stop taking them suddenly. Symptoms of withdrawal from stimulants can include tiredness, depression, and problems concentrating and sleeping.
If you want to stop taking a stimulant, your doctor will slowly taper you off the drug to help avoid withdrawal symptoms.
Strattera, on the other hand, isn’t a stimulant. It’s not a controlled substance, and it’s not habit-forming or prone to misuse. Also, it doesn’t cause withdrawal when you stop taking it.
These are benefits for anyone taking an ADHD medication, but especially for someone with a history of drug misuse.
Some research has found that Strattera doesn’t have as strong an effect on ADHD symptoms as ADHD stimulant medications. Therefore, Strattera is recommended instead of stimulants for children and adolescents only when stimulants cause too many side effects or aren’t effective.
That said, another study reported that Strattera is effective and well-tolerated. Its effects were similar to the effects of nearly all major stimulants. However, this study also found that Strattera wasn’t as effective as the time-release form of methylphenidate, which is the active ingredient in Ritalin.
If crash from your ADHD medication is a concern for you, Strattera might be a better option than a stimulant ADHD drug. It doesn’t cause a crash. It’s also less of a risk in other ways, such as dependence, withdrawal, and side effects.
However, some studies have found that it’s not as effective as certain stimulants.
To find out more about whether Strattera might be a good choice for you or your child, talk to your doctor. Be sure to ask any questions you may have, such as:
- Do you think Strattera or a different nonstimulant would be a good treatment option for me or my child?
- Do you think Strattera would be effective enough to treat my, or my child’s, ADHD symptoms?