Strattera vs Vyvanse: Exploring the Key Differences!

Strattera vs Vyvanse discusses the key differences and similarities between the two commonly used medications to treat ADHD.

When we talk about the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD), the balancing act of neurotransmitters such as dopamine and norepinephrine is crucial.

Medications like Vyvanse and Strattera each take a different approach to correct these imbalances, which are central to ADHD symptoms.

This article will explore their key differences and similarities, providing insight into how each drug works to modulate neurotransmitter activity and manage the disorder.

The Role of Neurotransmitters in ADHD

Neurotransmitters are chemical messengers that transmit signals between neurons. In ADHD, the levels and functioning of certain neurotransmitters, such as dopamine and norepinephrine, may be altered.

These neurotransmitters are crucial in regulating attention, movement, and emotional responses.

The two important neurotransmitters that play key roles in the development of ADHD are:

• Norepinephrine, and 
• Dopamine

Strattera and Vyvanse are two medications that increase the levels of norepinephrine in the brain. However, Vyvanse also increases the levels of dopamine in the brain.

Let us now deep dive into the nuances of Vyvanse and Strattera, dissecting their pharmacological profiles to understand their potential in ADHD management.

Pharmacological Profile of Strattera vs Vyvanse:

Strattera is the brand name of “Atomoxetine Hydrochloride“. It belongs to the class of drugs called SNRIs (selective norepinephrine reuptake inhibitors).

Unlike other SNRIs such as Duloxetine and Venlafaxine, Strattea is not used to treat Depression. It is the only SNRI indicated for the treatment of ADHD.

Strattera, by blocking, the reuptake of Norepinephrine in the brain, helps improve attention spans, reduce impulsiveness, and reduce hyperactivity.

Vyvanse is the brand name of “lisdexamfetamine dimesylate“. It is a precursor of the stimulant drug, Amphetamine.

Vyvanse increases the levels of norepinephrine as well as dopamine. It causes the release of dopamine which in turn stimulates the release of norepinephrine.

Norepinephrine keeps the brain active and improves focus and attention span.

Compared to amphetamine, which is very addictive, the addictive potential of Vyvanse is low as it is in the inactive form. It is activated in the GI tract and has a low addictive potential.

Summarizing the mechanism of action of Strattera vs Vyvanse:

Vyvanse is a stimulant that functions by increasing the levels of dopamine and norepinephrine in the brain, which helps to improve focus and alertness.

In contrast, Strattera is a non-stimulant that prevents the reabsorption of norepinephrine, which can be better for those who cannot take amphetamine-based medications or who are at risk of addiction or suicidal thoughts.

Which drug has a faster onset of action: Strattera or Vyvanse?

Strattera belongs to the adrenergic uptake inhibitors for ADHD, which specifically target norepinephrine pathways to mitigate symptoms of ADHD.

This class of medication is known for its gradual onset of action, which may result in a smoother effect throughout the day.

Vyvanse, as a CNS stimulant, directly stimulates the release of dopamine and norepinephrine, leading to more immediate symptom relief.

Its stimulant nature, however, may contribute to a higher risk of dependency compared to non-stimulant alternatives like Strattera.

How to take Strattera and Vyvanse?

Strattera (Atomoxetine hydrochloride) has a half-life of 5 hours [Ref]. It is to be taken once daily in the morning or twice daily (in the morning and afternoon).

Vyvanse (lisdexamfetamine dimesylate) has a half-life of less than one hour. However, its active compound dextroamphetamine has a half-life of about 12 hours. It is taken once daily in the morning [Ref]. 

Both Strattera and Vyvanse are available in oral capsule formulations in different strengths as given in the table below:

Vyvanse’s additional availability as a chewable tablet offers an alternative for those who have difficulties swallowing capsules.

Can you take Strattera and Vyvanse together?

The combined use of Strattera and Vyvanse is not recommended. In refractory cases, your doctor may recommend combining two drugs from different classes.

Case reports of Strattera and Stimulant drugs have been published [Ref]. The following combinations were reported to be safe and effective in children and adolescents who were refractory to a single drug alone:

• Atomoxetine and Methylphenidate (Immediate-release) in an 8-year-old boy
• Atomoxetine (Strattera) and Adderall XR in a 17-year-old girl
• Atomoxetine (Strattera) and OSM Methylphenidate in a 14-year-old boy
• Adderall XR and Strattera in a 6-year-old boy

Combining Strattera and Vyvanse together may result in more severe adverse reactions primarily headache, dizziness, and hypertension.

It is not recommended to use Strattera and Vyvanse together unless your doctor prescribes them.

How to switch from Vyvanse to Strattera?

Neurostimulators such as Vyvanse and methylphenidate may be switched to Strattera and vice versa depending on the patient’s response to treatment.

During the transition phase from one drug to another, both may be combined together without added concerns of hypertension, seizures, or other side effects [Ref].

It is best to start Vyvanse at a low dose and titrate it upwards to the recommended dose and slowly taper Strattera.

The transition can be abrupt in patients who do not have significant symptoms. However, it may be as slow as 6 to 8 weeks to prevent rebound symptoms and side effects.

How effective is Strattera vs Vyvanse?

Several randomized controlled trials have evaluated the efficacies of both Strattera and Vyvanse.

Strattera is considered less effective than amphetamine-based therapies such as Vyvanse.

In a comprehensive network meta-analysis, Strattera and Vyvanse were found superior to placebo in children and adults in the management of ADHD [Ref].

Strattera was found to be less effective in children than in adults. Amphetamines including Vyvanse were the most potent drugs for ADHD at all ages.

Vyvanse demonstrated superior efficacy in reducing ADHD symptoms compared to placebo, significantly impacting core symptoms such as impulsivity, hyperactivity, and lack of focus.

Strattera’s effectiveness, as reported by users on Drugs.com, is more modest, with an average rating of 5.2 out of 10 from a total of 511 ratings. 

Contrary to Strattera, users rated Vyvanse 7.4 out of 10 from a total of 922 reviews

Strattera vs Vyvanse Side Effects and Interactions:

Both medications have potential side effects, with Strattera showing a slightly higher rate of negative effects, as reported by users on Drugs.com.

A total of 322 drugs are known to interact with Strattera and 340 with Vyvanse, making it crucial to consult healthcare providers about current medications.

Here are some common side effects of Vyvanse and Strattera:

How costly is Strattera vs Vyvanse:

The cost of these medications without insurance can be significant, with Strattera averaging $461.87 for 30 capsules, 40 mg each, and Vyvanse costing $1,305.80 for 100 capsules, 30 mg each.

For some individuals, finding a discount Vyvanse or Strattera can make this valuable treatment more accessible.

Substance Control and Pregnancy Category

Strattera is not classified as a controlled substance and has no abuse potential, whereas Vyvanse is a Schedule II controlled substance, indicating a high potential for abuse.

Both drugs are categorized under Pregnancy Category C, where risks cannot be ruled out.

Lifestyle Considerations

Strattera has no known food or alcohol interactions, which can be a significant factor for some individuals. However, mixing Vyvanse with alcohol can increase the risk of cardiovascular side effects.

Conclusion

The choice between Vyvanse and Strattera should be made in consultation with a healthcare provider, considering factors like the individual’s health history, the potential for addiction, and the likelihood of adverse reactions.

Both medications offer benefits for ADHD treatment, but their differences could significantly impact their suitability for different individuals.

It’s essential to weigh these factors carefully to make an informed decision about ADHD management.