Strattera vs. Adderall: 8 Differences Between These ADHD Medications

There are two main groups of medications for attention-deficit hyperactivity disorder (ADHD): stimulants and nonstimulants. They differ in how they work, how often you take them, and potential risks and side effects.

Stimulants like Adderall (mixed amphetamine salts) are considered first-choice medications for ADHD. But nonstimulants like Strattera (atomoxetine) can be a good option for certain people. Here, we’ll review Strattera versus Adderall, including eight differences between them.

1. Adderall and Strattera work in different ways for ADHD

Adderall and Strattera work differently for ADHD. Both medications primarily affect two brain chemicals: norepinephrine and dopamine. Boosting these chemicals can help improve ADHD symptoms, such as difficulty focusing and impulsivity. But Adderall and Strattera do this differently.

As a stimulant medication, Adderall increases norepinephrine and dopamine in multiple ways. This includes triggering their release and keeping them around in the brain for longer, leading to fast-acting symptom relief. And unlike Strattera, Adderall increases dopamine in multiple parts of the brain, including the “reward center” that makes it more likely to be habit-forming.

Strattera, a nonstimulant, doesn’t directly trigger the release of these chemicals. It works more gradually by preventing norepinephrine from being cleared away. This effect also indirectly increases dopamine levels in the brain, but not in the area that reinforces habit-forming behaviors like Adderall.

2. Adderall works faster than Strattera

Another key difference between Adderall and Strattera is the time it takes for them to work. 

Adderall works within an hour for most people. This is true for both the immediate-release (IR) and extended-release (XR) forms. Strattera takes longer to start working. You may feel effects within a week, but it can take a month or two to see its full effects.

3. Adderall and Strattera are approved for different age groups

Adderall and Strattera are also approved for different age groups. Both are used to treat ADHD in adults. But in general, Adderall is approved for younger age groups than Strattera.

Adderall IR is approved for adults and children ages 3 and older. Adderall XR is approved for adults and children ages 6 years and older. Strattera, on the other hand, is approved to treat ADHD in adults and children ages 6 and older.

EXPERT PICKS: WHAT TO READ NEXT

• ADHD medication overview. Two main groups of ADHD medications — stimulants and nonstimulants — are available to treat this condition.

• Adderall IR vs. Adderall XR: Learn about the short- and long-acting forms of Adderall, including how long they last, how they’re taken, and whether it’s OK to combine them.

• What Strattera side effects should you watch for? If you take Strattera, it helps to know about its side effects.

• What are Adderall’s side effects? Adderall can have side effects, some common and some rare.

4. Adderall offers more dosage forms and flexibility than Strattera

When comparing Adderall and Strattera, another factor is their dosage forms and how often they need to be taken. Strattera is available only as an IR capsule. Adderall comes in both IR tablets and XR capsules, allowing for more flexibility in how it’s taken.

Strattera is typically taken in the morning, with its effects lasting throughout the day. You’ll usually need to take it only once a day. But some people may divide their total daily dose into a morning dose and a second dose later in the day.

Adderall IR lasts 4 to 6 hours, so it may need to be taken up to 3 times a day. Some people prefer this option since they can adjust when they take each dose based on their needs. 

Adderall XR, on the other hand, lasts up to 12 hours. It can be a good choice for those who want a full day of treatment with a single morning dose.

5. Adderall has a higher potential for dependence and misuse

Unlike Strattera, Adderall is a controlled substance, meaning that it has a risk of dependence and misuse. This is because it increases dopamine levels in the reward center of the brain. Taking Adderall in ways other than prescribed can increase these risks.

Strattera isn’t a controlled substance, and it’s not known to cause dependence or misuse. So if you have a history of substance use disorder, your prescriber may recommend Strattera over a stimulant like Adderall.

6. Adderall and Strattera have different side effects

Adderall and Strattera share some common side effects. But they also have different risks based on how they work in the body. Most side effects are typically mild. Serious side effects are rare but possible. To lower your risk of side effects, take Strattera or Adderall exactly as prescribed.

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7. Adderall has more drug interactions

Both Adderall and Strattera can interact with other medications. But Adderall has more known drug interactions than Strattera. The list includes medications, supplements, and even vitamin C.

Adderall interactions often involve substances that increase serotonin levels. When they’re taken with Adderall, this can raise the risk of a serious condition called serotonin syndrome. Examples of these medications and supplements include:

• Antidepressants, such as fluoxetine (Prozac) and duloxetine (Cymbalta)

• Triptan migraine medications, such as sumatriptan (Imitrex)

• Opioid pain medications, such as tramadol (ConZip) and fentanyl

• Supplements, such as St. John’s wort

Strattera has fewer known interactions, but it can still interact with some medications. This includes some antidepressants, such as fluoxetine, which can increase Strattera levels in the body.

Be sure to share a list of your medications and supplements with your care team. This helps them check for potential interactions and adjust your treatment plan if needed.

8. Adderall is typically recommended over Strattera

Stimulants like Adderall are generally more effective than nonstimulants like Strattera for treating ADHD. This makes them first-choice medications for both children and adults. For adults, XR stimulants, such as Adderall XR, are often preferred.

But Strattera may be a better option in certain situations, such as:

• If Adderall causes intolerable side effects: Strattera may be less likely to cause stimulant-related side effects, such as insomnia.

• If there’s a history of substance misuse: Strattera isn’t a controlled substance and has no known risk of dependence. For this reason, it’s preferred for people with a history of substance use disorder.

• If drug interactions are a concern: Adderall has more drug interactions than Strattera. Other medications you’re taking may influence which option is safer for you.

Who should avoid Adderall or Strattera?

Some people may be told to avoid Adderall or Strattera because of a higher risk of serious side effects, including those with:

• Heart conditions: Both medications can raise blood pressure and heart rate. This can be risky for people with heart disease or structural heart problems.

• Recent MAOI use: Avoid Adderall and Strattera if you’re taking or have taken a monoamine oxidase inhibitor (MAOI) in the past 2 weeks. Wait until at least 2 weeks after your last MAOI dose to prevent dangerous interactions.

• Narrow-angle glaucoma or pheochromocytoma: Strattera can worsen symptoms of these conditions.

• History of substance use disorder: Adderall has a higher potential for dependence and misuse and may not be suitable.

Why trust our experts?

Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

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