Strattera and Vyvanse are FDA-approved drugs used to treat attention deficit hyperactivity disorder (ADHD). However, these prescription medications are not the same. Strattera is a selective norepinephrine reuptake inhibitor (SNRI). Vyvanse is a stimulant. These drugs work in distinct ways, and they carry separate risks of side effects.
Strattera is the brand name for the drug atomoxetine hydrochloride. Though many SNRIs are used to treat depression, Strattera is only used for ADHD. It works by changing the way your brain absorbs the chemical norepinephrine as well as how that chemical acts in your body. Norepinephrine affects your overall mood. By changing how it works in your body, Strattera may be able to:
- decrease hyperactivity
- improve attention span
- reduce impulsive behaviors
Vyvanse is a brand name for the drug lisdexamfetamine dimesylate. It’s an amphetamine. Like Strattera, Vyvanse also alters brain chemicals. However, it targets dopamine as well as norepinephrine. It’s thought that this drug helps keep more dopamine in the brain and helps stimulate the release of norepinephrine. As a result, more of these chemicals are available to stimulate the brain, which helps increase attention and focus.
Because Vyvanse doesn’t become active until it’s in your digestive system, its potential for misuse may be less than that of other stimulants that act as soon as they’re in your body.
Both Strattera and Vyvanse can be used in people who are 6 years and older to treat ADHD. For either drug, your doctor will start you on the lowest dose, then increase your dosage as needed. Dosage for both drugs varies based on factors such as age and weight.
Either drug comes as an oral capsule and in the following strengths:
Strattera is an immediate-release drug. It begins to work quickly after you take it, but your dose may need to be adjusted after a minimum of 3 days of use for a period of 2 to 4 weeks to reach a total daily dose of 1.4 milligrams per kilogram of body weight (mg/kg), or up to a maximum daily total of 100 mg — whichever is less. You can take it once or twice per day, depending on your prescribed dosage.
If you take it once per day, you should take it in the morning. If you take it twice per day, take it in the morning and again in the late afternoon or early evening. You should take the last dose before 6 p.m. so that it doesn’t interfere with sleep. To maintain the best results, Strattera should be taken regularly. If you skip or miss a dose, take it as soon as possible, but do not exceed the total daily dose prescribed to you in a 24-hour period.
Vyvanse is a long-acting drug. It enters your body in an inactive form. As you digest the drug, your body slowly converts it into its active form. Then it starts working. You take Vyvanse once per day. Taking it in the morning gives the most benefits during waking hours.
Both Strattera and Vyvanse can cause side effects. The side effects that both drugs can cause are:
- abdominal pain
- aggressive behavior
- decreased appetite
- decreased sex drive
- dry mouth
- excessive sweating
- increased blood pressure
- increased heart rate
- vision changes, such as blurry vision, double vision, and pupil dilation (enlarged pupils)
- weight loss
Uniquely, Strattera may also cause erectile dysfunction and thoughts of suicide, especially in children and teens. Vyvanse may also cause difficulty breathing.
Many people can use Strattera or Vyvanse. However, some people have other conditions that could be affected if they use one of these drugs.
You may be at increased risk of side effects from Strattera if you have:
- high blood pressure
- liver disease
- history of depression
The following conditions may also increase your risk of side effects from either drug:
- drug or alcohol abuse
- heart disease
- irregular heart rate
- overactive thyroid gland (hyperthyroidism)
Both drugs may cause serious cardiovascular events, including sudden death, in people with pre-existing heart abnormalities.
You and your doctor should consider possible drug interactions when you take any kind of medication. In some cases, a doctor might prescribe more than one drug for ADHD. Both Strattera and Vyvanse may interact with certain kinds of antidepressants, including monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants.
Some of these drugs may require dosage adjustments and some should not be used with Strattera. That’s why it’s important for you to tell your doctor about all drugs you use, including over-the-counter drugs, herbal remedies, vitamins, and supplements.
Stimulants such as Vyvanse are the most common form of ADHD treatment. They often work in the body quickly so that the medication may relieve symptoms faster. However, this doesn’t mean that stimulants are your only option. Strattera is one example of an ADHD medication that doesn’t fall under the common class of stimulant-type drugs.
Ultimately, you and your doctor can decide which of these two ADHD medications might work best for you. It’s important to remember that there is no cure for ADHD. However, you can get some symptom relief with consistent treatment.