Stimulant Focalin vs. Nonstimulant Strattera

Stimulants commonly known as psychostimulants are used in the treatment of the Attention-Deficit Hyperactivity Disorder (ADHD). Another category of drugs used in the treatment of ADHD is known as nonstimulant. Unlike stimulants, the nonstimulants do not cause dependence and are not prone to abuse. Also, nonstimulants have been preferred to stimulant medication for the treatment of ADHD as they do not cause sleeplessness, agitation and loss of appetite. Nonstimulant medication has been proven to have smoother and longer-lasting effects as compared to the stimulants ones. Strattera (atomoxetine) is the only nonstimulant drug that is approved for the treatment of ADHD by the United States Food and Drug Administration (FDA). Both types of medications do not cure ADHD. Instead, they reduce the ADHD symptoms such as impulsivity and hyperactivity. This study will focus on short-term and long-term effects of stimulant focalin and nonstimulant Strattera on both children and adults.

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Comparison of stimulant Focalin (dexmethylphenidate) and nonstimulant Strattera (atomoxetine)

On the stimulant category, Focalin is the first-choice medication for the treatment of ADHD. It is available as a generic drug. As a stimulant, Focalin has adverse side effects such as insomnia. Conversely, Strattera is the first choice medication in the category of nonstimulant medications that are used for the treatment of ADHD. It has advantages over the focalin as it is nonstimulant thus does not have many side effects. Both Focalin and Strattera are taken as pills (Focalin, 2016).

Focalin Strattera

Type Psychostimulant Norepinephrine Reuptake Inhibitor (NRI)

Format IR Immediate release (IR) or Extended release (XR) Long-acting (LA)

Approved uses ADHD ADHD

Dosage IR: 2.5 mg/5 mg/10 mg or XR: 5 mg/10 mg/15 mg/20 mg/25 mg/30 mg/35 mg/40 mg 10mg/8mg/25mg/40mg/

60mg/80mg/100mg

Ingredients Dexmethylphenidate Atomoxetine

Generic version Yes No

Manufacturer Novartis Pharmaceuticals Eli Lilly & Company

Mechanism of action It works by inhibiting reuptake of norepinephrine dopamine reuptake inhibitor (NDRI) catecholamine and catecholamines. It increases extracellular levels by inhibiting norepinephrine and dopamine transporters. It works by inhibiting reuptake of norepinephrine. It also works as NMDA receptor antagonist with minimal affinity for kappa and mu opioids receptors as a partial agonist. Additionally, it draws a minor degree of serotonin reuptake inhibition and slightly affects dopamine.

Half life 2 to 4.5 hours 24 hours

Legal status Schedule II (US) Prescription-only (Rx)

Date approved IR approved on November 2001

XR approved on May 2005 November 26th, 2002

Side effects It causes Dizziness, Stomach aches, Nervousness, Weight loss, Insomnia and loss of Appetite It causes Dry mouth, Loss of appetite, Nausea, constipation, sleepiness, dizziness, sexual dysfunction, insomnia, weight loss, stomach aches

Investigational uses Treatment-resistant depression and Narcolepsy Pediatric bedwetting, weight loss, binge eating disorder, treatment-resistant depression

Effects duration IR = 4 to 6 hours

XR = 12 hours LA = 24 hours

Common Risk factors of Stimulant focalin and nonstimulant strattera

Some risk factors have been associated with taking Focalin. It is risky to use monoamine oxidase inhibitor (MAOI) 14 days prior to use of Focalin. For the people with a rich history of abuse of the drug psychotic episodes, heart problems, and bipolar disorder, it is risky to use Focalin as it can cause adverse effects (Compare Focalin vs. Strattera, 2016). On the other hand, some risk factors have been linked the use of Strattera. This medication has adverse effects for children under the age of 18. Additionally, people with a history of bipolar disorder, psychotic disorder and heart problem may experience adverse health effects from using Strattera. Also, it is not recommended for children to start taking Strattera prior to puberty stage.

Strattera of Strattera for patients taking MAOI

The use of MAOI two weeks prior to taking Strattera or two weeks after discontinuing the Strattera exposes the patients to fatal medical reactions. It can cause serious myoclonus, hyperthermia, automatic instability and rigidity with the possibility of rapid mental fluctuations.

Effects of Stimulant focalin and nonstimulant Strattera

Sex

Both Focalin and Strattera have been shown to affect erection in men. Reports indicate that, upon the use of Focalin or Strattera, men can experience an erection that can last for more than four hours. Although there are rare such cases, the effects can be adverse if not treated early enough as it can cause impotence in men. The long-term effects of Focalin and Strattera in men include permanent damage to the penis, if not treated on time. Men are advised to seek immediate medical assistant is such a situation arise (Compare Focalin vs. Strattera, 2016).

Weight loss

Use of focalin medication in the treatment of ADHD causes weight loss due to the suppression of appetite. Like other stimulants, long-term use can affect childrens weight and height especially those between the age of 7 and 10. Similar effects on height and weight loss in children are experienced upon the long-term use of nonstimulant Strattera (Compare Focalin vs. Strattera, 2016). However, Strattera affects the height and weight of children who may have started Strattera medication prior to puberty stage. For children in focalin or Strattera medication, doctors are advised to monitor their growth constantly.

Use during pregnancy

There has been no adequate study conducted to investigate the impacts of the use of Focalin in the medication of ADHD for the expectant women. However, few studies conducted on animals indicate that high dosage of Focalin can result in cardiac defects. Although no harm has been reported among the pregnant women, care should be taken since there is no adequate information indicating the harm Focalin can cause to the foetus.

Similar to the case of Focalin, there are no reliable findings on the impacts of Strattera on expectant mothers. The few reported cases on three expectant mothers indicated healthy newborns for two women and a loss of the infant for one woman. While performed on pregnant rats, studies indicated that pregnant rats injected with 25mg/kg daily showed reduced pup survival. When used at 40mg/kg, there was reduced fetal weight and ossification. Similar research was conducted in rabbits with 100mg/kg injected daily. The findings indicated that the offspring had abnormalities in their blood vessels and indicated minimal viability (Humphreys, Garcia-Bournissen, Ito & Koren, 2007). Prior to its usage during pregnancy, women should discuss its prescription with approved medical assistants.

Advantages and disadvantages of using Strattera and Focalin in the treatment of ADHD

Focalin has the advantage over the Strattera in that it can be used alongside other medication strategies such as non-drug therapies and counseling in the treatment of ADHD. Also, Focalin has an extra advantage as it occurs in two forms. The immediate-release form of Focalin can be used twice in a day while the extended-release form can only be used once in a day. Focalin is made in a manner to suite both adults and children who do not like to swallow capsules. It can be opened and the powder sprinkled in water to make it easy for them to use the drug. On the contrary, Strattera has advantages over the nonstimulant Focalin as it is not a controlled drug like the stimulant Focalin. It is one of the few medications and the only one that has been approved so far by the US Food and Drug Association (FDA) for the treatment of ADHD. It is taken once in a day and can be used alongside other treatment procedures such as counseling or non-drug therapies.

Disadvantages of stimulant Focalin and nonstimulant Strattera in treatment of ADHD

In the treatment of ADHD, Focalin can only be taken early in the morning or afternoon, failure to which it results in adverse health effects such as insomnia. Focalin has a limitation in its use in the treatment of ADHD as it is a controlled drug hence it to be locked up to avoid the possibilities of abuse. On the contrary, strattera is taken as an alternative drug for the treatment of ADHD. Doctors usually try other types of medication and use Strattera when it is the only option left. It is expensive as compared to focalin since it is not available as a brand name medication.

In summary, the two types of medication, stimulant Focalin and nonstimulant Strattera are imperative in the treatment of ADHD. Strattera has reduced impacts of abuse and addiction, unlike the focalin. Prior to deciding the medication to use, the patient should consult the approved physician for appropriate guidance.

References

Humphreys, C., Garcia-Bournissen, F., Ito, S., & Koren, G. (2007). Exposure to attention deficit hyperactivity disorder medications during pregnancy. Canadian Family Physician, 53(7), 11531155.

Compare Focalin vs. Strattera - Iodine.com. (2016). Iodine.com. Retrieved 3 May 2016, from http://www.iodine.com/compare/focalin-vs-stratteraFocalin vs. Adderall: Comparison. (2016). Mentalhealthdaily.com. Retrieved 3 May 2016, from http://mentalhealthdaily.com/2015/06/02/focalin-vs-adderall-comparison/