Key takeaways:
Strattera (atomoxetine) and Ritalin (methylphenidate) are two medications used to treat attention-deficit hyperactivity disorder (ADHD).
Strattera and Ritalin work differently for ADHD. Strattera is a nonstimulant, with effects building up slowly over several weeks. Ritalin is a stimulant that starts working within an hour.
Ritalin is a traditional first-choice medication to treat ADHD in both children and adults. But Strattera may be a better option for certain people. Your healthcare team can help determine if either medication is a good option for you.
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Finding the right medication for attention-deficit hyperactivity disorder (ADHD) can take some trial and error. Strattera (atomoxetine) and Ritalin (methylphenidate) are two commonly prescribed options. But they work differently, have different side effects, and may not be equally effective for everyone.
If you’re wondering whether either of these ADHD medications could be a good option, here are six key differences between Strattera and Ritalin to consider.
1. Strattera and Ritalin work differently for ADHD
Both Strattera and Ritalin work in the brain to improve attention and focus, but they do this in different ways. Their actions involve the chemical messengers norepinephrine and dopamine, which play a role in attention, impulsivity, and motivation.
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Strattera is a nonstimulant medication. It works by keeping norepinephrine around longer, which can help improve attention and impulse control. It also modestly raises dopamine levels in certain areas of the brain.
Ritalin belongs to a group of medications called stimulants. It works by raising both dopamine and norepinephrine levels more directly and in broader areas of the brain. This may explain why Ritalin tends to be more effective for ADHD. But its effects on dopamine also contribute to a higher risk of dependency and misuse, causing it to be classified as a controlled substance.
2. Ritalin works faster than Strattera
A big difference between Strattera and Ritalin is how long they take to work. Ritalin begins working within an hour. Strattera, on the other hand, takes much longer.
Ritalin usually starts working within 30 to 60 minutes. But its effects don't last very long. Immediate-release (IR) versions of Ritalin work for up to about 4 hours. If you’re taking one of these medications, you might need to take it multiple times a day. An extended-release (ER) form that lasts longer is also available as the brand-name medication Ritalin LA.
Strattera’s effects build up slowly over several weeks. You might start to notice some improvements in your symptoms after the first week of taking it consistently. But more significant improvements can take 4 to 8 weeks. Strattera’s effects last up to 24 hours, so many people only need to take it once a day.
3. Ritalin offers more flexibility and dosage forms to choose from than Strattera
Another difference between Strattera and Ritalin is what dosage forms they come in. Strattera only comes as capsules that you have to swallow whole. Methylphenidate, the active ingredient in Ritalin, is available in many forms, which can give you more flexibility. These methylphenidate dosage forms include:
IR tablets
ER capsules and tablets (Concerta, Aptensio XR, Relexxii)
Chewable tablets (QuilliChew ER)
Orally disintegrating tablets (Cotempla XR ODT)
Liquid forms (Methylin, Quillivant XR)
Patches (Daytrana)
ADHD medication overview: Learn about the two main groups of ADHD medications — stimulants and nonstimulants.
What Strattera side effects should you watch out for? If you take Strattera (atomoxetine), here’s an overview of possible side effects you should know about and how to manage them.
Concerta vs. Ritalin: Learn what’s the same and what’s different about these two forms of methylphenidate.
This variety allows you to find exactly the right form for your specific needs and schedule.
4. Ritalin has different side effects and risks than Strattera
Strattera and Ritalin have a few overlapping side effects, such as headaches, abdominal pain, and trouble sleeping. But as a stimulant, Ritalin has unique risks to consider. For example, Ritalin carries a boxed warning (the FDA’s strongest medication warning) about an increased risk of dependency and misuse, which isn’t an issue with Strattera.
Here is an overview of notable side effects of Strattera and Ritalin.
| Strattera side effects | Ritalin side effects |
|---|---|
|
|
More rare but serious side effects linked to both Strattera and Ritalin include:
Cardiovascular effects, such as increases in blood pressure or heart rate, stroke, and heart attack
Slowed growth in children
Mental health effects, such as suicidal thoughts or behaviors, hallucinations, and aggression
Priapism (prolonged erections)
- StratteraAtomoxetine
- AtomoxetineGeneric Strattera
- RitalinMethylphenidate
If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text “HOME” to 741-741 to reach the Crisis Text Line.
5. Strattera and Ritalin have different interactions
Stattera and Ritalin share a few of the same interactions. But they also have unique interactions to know about.
Common medications that interact with Strattera include:
Monoamine oxidase inhibitors (MAOIs): This combination can lead to serious side effects. Examples include fever and blood pressure changes.
Some antidepressants: Certain antidepressants can cause Strattera to build up in your body, leading to unwanted side effects. Examples include fluoxetine (Prozac) and paroxetine (Paxil).
Albuterol: Both Strattera and albuterol can increase your heart rate and blood pressure.
Blood pressure medications: Strattera may increase blood pressure, making these medications less effective.
Ritalin can interact with various medications as well, such as:
MAOIs: Taking Ritalin with an MAOI can lead to dangerously high blood pressure.
Blood pressure medications: Ritalin can also make these medications less effective by raising blood pressure.
Albuterol: Ritalin can worsen blood pressure and heart rate increases from albuterol.
Certain anesthetics: Combining Ritalin with some anesthetics can raise the risk of high blood pressure and increased heart rate during surgery.
Risperidone: The risk of extrapyramidal symptoms is higher when taking risperidone (Risperdal) with Ritalin.
These aren’t all of the medications that can interact with Strattera and Ritalin. To avoid or manage potential interactions, make sure to tell your healthcare professional about all of the medications, supplements, and vitamins you take before starting either Strattera or Ritalin.
6. Ritalin is typically (but not always) a first-choice treatment for ADHD
Research shows that stimulant medications like Ritalin work better for most people with ADHD. Up to 80% of children with ADHD who take stimulants like Ritalin see improvements in their symptoms. Plus, it works faster than Strattera. These are a few reasons why Ritalin is typically a first-choice treatment for ADHD.
Strattera may not work as well as Ritalin for most people with ADHD, and it usually takes longer to work. However, there are certain situations in which Strattera might be a better choice:
If stimulant-related side effects are bothersome: If you've tried Ritalin or other stimulants and had too many side effects, Strattera could be a good alternative.
If stimulants aren’t working well: If stimulant medications just don't seem to help your ADHD symptoms, Strattera might be worth trying.
If there’s a history of substance use disorder: Strattera isn't habit-forming. So it might be a safer choice if you or someone in your family has a history of substance use disorder.
How to choose the best option for you
Choosing between Strattera and Ritalin is a decision that should be made with your healthcare team. Here is a summary of the differences between them.
| Strattera | Ritalin | |
|---|---|---|
| Category | Nonstimulant | Stimulant |
| Onset of symptom relief | Gradually over several weeks | Within an hour of taking it |
| Dosage form(s) | Oral capsules that must be swallowed whole |
|
| Risks to consider |
|
|
| Place in therapy | May be a better fit in certain situations, such as when there’s a history of substance use disorder and/or stimulant intolerance | First-choice medication for many adults and children with ADHD |
The bottom line
Strattera (atomoxetine) and Ritalin (methylphenidate) are both medications for attention-deficit hyperactivity disorder (ADHD), but they're not the same.
Ritalin usually works faster and better for most people, and there are more ways to take it. But it has unique risks and may need to be taken more often during the day. Strattera takes longer to work, but you may only need to take it once daily. Strattera may be a better choice if you can't take stimulants like Ritalin or if you have a history of a substance use disorder.
Your healthcare team can help you figure out which option may be best for you. They’ll consider how quickly you need relief, how often you can take medication, and your health history.
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References
Centers for Disease Control and Prevention. (2024). Treatment of ADHD.
Gottlieb, S. (2001). Methylphenidate works by increasing dopamine levels. BMJ.
Kimko, H. C., et al. (1999). Pharmacokinetics and clinical effectiveness of methylphenidate. Clinical Pharmacokinetics.
Schulz, K. P., et al. (2012). Common and unique therapeutic mechanisms of stimulant and nonstimulant treatments for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry.
Verghese, C., et al. (2024). Methylphenidate. StatPearls.
Wietecha, L. A., et al. (2016). Atomoxetine increased effect over time in adults with attention‐deficit/hyperactivity disorder treated for up to 6 months: Pooled analysis of two double‐blind, placebo‐controlled, randomized trials. CNS Neuroscience & Therapeutics.
