Is Strattera better than Ritalin?

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Medical Answer:

From the studies available (and there are not many) the efficacy of Strattera (atomoxetine) is significantly less than Ritalin or other methylphenidate drugs like Concerta or Daytrana and amphetamines like Adderall and Dexedrine.

There is certainly significant evidence from at least a dozen clinical trials that Strattera can help ADHD but, depending on the study, between 20-30% of participants discontinued treatment and as little as 20% had a statistically significant response. There is also significant concern about Strattera's side effects, particularly the increased risk in suicidal ideation among people 24 and under.

During development of Strattera, the drug was intended to be an antidepressant however clinical trials indicated Strattera is not effective in treating depression but it did produce some positive results for ADHD. Strattera's side effect profile, including increased risk of suicidal ideation, is very similar to the drugs it is most related to, antidepressants.

A significant amount of anecdotal evidence, backed up by a few studies, indicates that Strattera is more effective in people who fail to respond to two-three stimulants (eg., Adderall, Ritalin, and Dexedrine). People who may have been first prescribed Strattera and found it to be ineffective normally responded to stimulants.

In addition, stimulant medications are still considered to be first-line medications by most physicians and medical associations. In fact recent studies indicate that stimulant treatment is by far the most effective and safe treatment of ADHD. Surprisingly there is also more evidence indicating that therapy and behaviour modification has minimal efficacy and may be appropriate for people with very mild ADHD however more severe forms almost always require medication and often do not respond better to medication and therapy.

I must also note that it is important not to judge a medication based upon a single personal experience or anecdotal story. Unfortunately side effects do occur with any drug and it may be serious, even lethal in rare cases however one story is not clinically significant. All drugs have risks and benefits and it is important to talk with you doctor about the best medication for you. It is also important to understand the different drugs including their active ingredient and side effects.


Do not discontinue, start, or change the dose of any drug without talking with your doctor.
Personal anecdotes about Strattera:

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From my daughter's experience, the answer is NO. Strattera had more side effects and the side effects were extreme. They included tiredness, irritability, anger, and extreme mood swings. Strattera discontinuation syndrome was horrible. When she took Ritalin, while she needed it more frequently (a few times a day), she was more focused in school and we didn't see the extreme mood swings that we did with Strattera and we did not experience horrible withdrawal effects.

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For me, personally, YES.
For several years, I had been taking Cylert, but was concerned about the liver function checks that I had to go through taking that medication. Ritalin is not an alternative for me; I have bad side effects from long-term use, including mild amphetamine-like psychosis and disabling migraine headaches.
Last year, they found a type-3 Bosniak Cyst in my right kidney. The kidney had to be removed.
For seven months after my hospital discharge my ADHD went unmedicated I didn't see any way around learning to live without the medication. Needless to say, this was a BAD IDEA; after convalescence, upon return to work, my job performance ratings went straight down the ol' toilet!
I've been on Strattera for 6 weeks now, and I'm REALLY pleased. My family certainly notices the difference, and I can see a difference for the better in my performance at work!
Side effects...well, I now do have some difficulty urinating; but it's usually only a few moments pause before I begin; I notice that the urinary flow is not as rapid as it once was, and that it takes me longer to urinate, but that seems relatively minor. Sometimes I still "feel" like I have to urinate after I've urinated. This usually stops after a few minutes.
I have noticed a mild bit of sexual dysfunction, but that seems to be wearing off. I haven't noted any others, no extreme constipation, no nauseau (unless one of the pills accidently breaks in your mouth-- man! Does it taste NASTY!), no difficulty operating heavy machinery.
For me, Strattera seems to be a good fit. I do have some concern about the difficulty urinating, because I now have only one kidney, but my overall performance is better with this than with any other medication I've tried for ADD, all of which were amphetamine or methylphenidate based.

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My step son's mother put him on Strattera about 4 months ago and he has become cruel to animals and his friends. He is very hyper, can't concentrate,and has developed other new problems that he didn't have before he was on the medication. I don't want to try and put anything in anyones head, but medication is not always the answer.

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I think it really depends on the individual. For me, the answer is no, because of the side effects.
Ritalin causes my mood swings to be a little worse at times, but when I could afford Concerta, the time release version, it wasn't as bad. Ritalin and Concerta help me concentrate, make me less impulsive, and evens out my energy level throughout the day.
Strattera makes me very tired, more depressed and angry, and caused severe pain and discomfort in my "male parts". It helped me a little with impulsiveness, but did not help me in the other areas.

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My mother (62) and myself (31) started on Strattera simultaneously about four weeks ago. We had just recently been diagnosed, and not been on any medication for ADHD previously. Within the first week my mother started speak more coherently. During the second week, I had to organize and oversee several important projects at work, and for once I wasn't an anxious mess. Also, I was hearing what people were saying without falling out or interupting. WOW! Somewhere during the third week, I began to have thorough thoughts. That is to say, I could think through an issue without being highjacked by other stuff in my head. I have to say I was amazed at the level of intellectual thought that was going on! Felt like I could really conquer the world with my brain functioning like this. My side effects, a sort of "drugged" feeling that dissipated over time. My mother, unfortunately, had to go off as she was tired and sweat profusely in what resembled hot flashes (even though she has long since passed menopause). My doctor switched me to Ritalin, since he feels more sure it is totally safe, and after a great first week (I have never been so sweet and nice in my life, lots of energy and no drugged feeling), I started to have mild anxiety. Ritalin seems to provoke my anxiety, and wears off during the day, which I think is terribly unfortunate since I would like to think clearly around the clock.

First answer by Walresa. Last edit by DiLuca. Contributor trust: 26 [recommend contributorrecommended]. Question popularity: 152 [recommend question].