The Difference Between Strattera and Adderall

Male medicine doctor hands hold jar of pills
istockphoto

Strattera and Adderall are medications prescribed to treat attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder characterized by difficulty regulating attention and controlling impulses and hyperactivity.

Both drugs improve attention span and decrease hyperactivity and impulsiveness; however, the medications are very different. The main difference is that Strattera is a non-stimulant, while Adderall is a psychostimulant medication.

How They Work

Adderall and Strattera are from different drug classes and work in distinct ways in the body.

Strattera

Strattera is a brand name for a drug that contains atomoxetine. It was approved by the U.S. Food and Drug Administration (FDA) in 2002 and became the first non-stimulant medication to receive approval for ADHD.

Strattera was also the first medication to be approved for treating adults with ADHD. It can be prescribed for people 6 years of age and older.

Strattera is a norepinephrine reuptake inhibitor, which means it allows the neurotransmitter norepinephrine to be available to the brain’s neurons for longer. It also raises the quantity of the neurotransmitter dopamine in the prefrontal cortex of the brain.

Adderall

Adderall is a brand name for the combination of drugs dextroamphetamine and amphetamine. It belongs to the amphetamine drug family. The FDA approved this medication in 1996.

In addition to ADHD, Adderall is also approved to treat narcolepsy. It can be prescribed to people ages 6 and up.

Adderall acts on the central nervous system by boosting the number of two specific neurotransmitters in the brain: dopamine and norepinephrine.

Increased dopamine and norepinephrine improves a person's ability to focus while decreasing hyperactivity and impulsive behavior.

Treatment Choices

ADHD medication is divided into two categories: first-line medications and second-line medications. Stimulant medications like Adderall are known to be the most effective treatment for ADHD. As such, they are considered first-line medication.

Non-stimulant medications like Strattera are second-line medications. While not as effective as stimulants, they can still be effective for ADHD symptoms.

Research has shown that compared to a placebo, Strattera reduced hyperactive, inattentive symptoms in adults. However, 40% of the research participants still reported significant ADHD symptoms.

Although stimulants are the most effective medication for ADHD, they don't work for everyone. People may also experience severe side effects when taking stimulants or have a medical condition that increases the risks of taking a stimulant (such as a history of addiction, a psychiatric condition like bipolar disorder, or a heart condition or sleep disorder).

In these cases, a non-stimulant medication like Strattera is an option. Strattera has also been found to help with conditions that often co-exist with ADHD like anxiety and oppositional defiant behavior (a pattern of aggression, disobedience, and a lack of respect for authority).

Forms, Dosages, and Efficacy

Strattera is available in an oral capsule that comes in seven doses ranging from 10 to 100 milligrams (mg). Generic versions of the drug are also available in the United States, Canada, and other countries.

Adderall IR (immediate-release) is available in tablets from 5 mg to 30 mg. Adderall XR (extended-release) is available in six doses, from 5 mg to 30 mg.

There are generics for Adderall (amphetamine salt combination), but people sometimes report these medications are not as effective as the brand name drug.

It can take four to eight weeks for Strattera to reach the maximum therapeutic effect. Once therapeutic levels have been reached, the effects of the medication last 24 hours.

In contrast, the effects of Adderall IR and Adderall XR can be felt as quickly as 30 minutes to one hour. The effects of Adderall IR start to wear off after four hours (and after 12 hours for Adderall XR).

You might discuss taking a break from Adderall (a "drug holiday" where you do not take the medication for a weekend or over a holiday). By contrast, Strattera needs to be taken every day.

Side Effects

For both medications, doctors usually start by prescribing a low dose and gradually increase it until the right therapeutic dose is found for a specific person. This usually means fewer side effects as the body adjusts to the medication.

Side effects of Strattera include:

  • Constipation
  • Dizziness
  • Dry mouth
  • Reduced appetite
  • Reduced libido (men may experience erectile dysfunction)
  • Sweating

Side effects of Adderall include:

  • Diarrhea
  • Dizziness
  • Dry mouth
  • Erectile dysfunction
  • Fever
  • Headache
  • Insomnia
  • Loss of appetite
  • Nausea
  • Nervousness
  • Sleep issues
  • Vomiting
  • Weight loss

Rare but serious side effects of Adderall include increased heart rate, high blood pressure, hallucinations, paranoia, shortness of breath, heart attack, and stroke.

Cardiac Concerns

Research has found that the likelihood of cardiac problems with the use of stimulant medications like Adderall is very low in healthy people. One study found that people taking stimulant medications for ADHD did not have an increased risk for cardiac events like heart attack, stroke, or sudden cardiac death.

In the past, patients had electrocardiography (EKG) screenings if a stimulant medication was prescribed. With new research findings, these screenings are no longer required unless you (or someone in your family) have a history of cardiac problems.

If you're taking stimulant medication and experience any severe or unusual signs or symptoms, contact your doctor immediately.

For Women

Both Adderall and Strattera are category-C drugs, which means they're considered unsafe to take during pregnancy or while breastfeeding. Talk to your doctor if you're pregnant or planning to become pregnant.

Risk of Abuse

Adderall is a schedule-II controlled substance. This means there's the potential for abuse and that extended use might cause dependence.

Adderall’s mode of action is to increase the activity of the dopamine, meaning it could be misused and inhaled or injected to create a high. Surges of dopamine cause the reinforcement of pleasurable but unhealthy behaviors like taking drugs, leading people to repeat the behavior again and again.

Studies show that people taking a prescription stimulant medication have a lower rate of substance abuse compared to those who were not taking the medication.

This could be because when ADHD is being treated safely and effectively, people with the condition are less likely to self-medicate and use non-prescription methods to manage their symptoms.

When stimulant medications are prescribed at appropriate doses and taken as prescribed, the risk of potential addiction is low. However, you should always store your medication safely and do not share your medication with other people.

As a non-stimulant medication, Strattera is not a controlled substance and doesn't carry the potential risk for abuse. It works by inhibiting norepinephrine uptake, rather than significantly affecting dopamine. It takes several weeks for the medication to take effect, making it difficult to abuse.

Black Box Warning

The FDA places a black box warning on some prescription drug labels to bring attention to possible serious or life-threatening risks that people need to be aware of.

Strattera has a black box warning for the possible increased risk of suicidal thoughts or actions in children, teens, and young adults. The parents and caregivers of kids taking Strattera are encouraged to monitor possible changes in the child's behavior and keep in close contact with the child’s doctor.

Adderall has two black box warnings. The first is to highlight the potential for abuse. The second is to warn about cardiac events.

If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Was this page helpful?
Article Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Alliance on Mental Illness. Atomoxetine (Strattera). 2019.

  2. Adler L, Tanaka Y, Williams D, et al. Executive Function in Adults With Attention-Deficit/Hyperactivity Disorder During Treatment With Atomoxetine in a Randomized, Placebo-Controlled Withdrawal Study. J Clin Psychopharmacol. 2014;34(4):461-466. doi:10.1097/JCP.0000000000000138

  3. National Alliance on Mental Illness. Amphetamine (Adderall). 2019.

  4. Schwartz S, Correll CU. Efficacy and Safety of Atomoxetine in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: Results From a Comprehensive Meta-Analysis and Metaregression. J Am Acad Child Adolesc Psychiatry. 2014;53(2):174-187. doi:10.1016/j.jaac.2013.11.005

Additional Reading