The Pros and Cons of Strattera—A Nonstimulant medication for ADHD

Key takeaways:

Strattera is a non-stimulant medication that is used to treat ADHD in children and adults
Unlike its stimulant counterparts, Strattera has no risk of abuse, misuse, or dependence.
It will take 4 to 6 weeks to see the full effects of Strattera.
Strattera can cause changes in mental health, increase suicidal thoughts and ideations. If you or someone you know experiences a worrisome change in behavior, please contact your doctor or seek emergency medical care.

A national survey in 2016 estimates that 6.1 million children in the United States have been diagnosed with attention deficit hyperactivity disorder (ADHD). ADHD is a common neurodevelopmental disorder that is often diagnosed in childhood but can last well into adulthood. People with ADHD can be overactive with difficulty focusing. Being unable to control impulsive behaviors is another hallmark of ADHD. Children and adolescents with ADHD do not grow out of these behaviors without treatment. The symptoms can worsen over time, resulting in poor performance at school, work, low self-esteem, and unstable relationships. Please continue reading to learn about different ADHD treatments. Find out the key differences between stimulant and non-stimulant medications for ADHD. We'll also talk about the pros and cons of non-stimulant medications for attention deficit hyperactivity disorder.

What is the treatment for attention deficit hyperactivity disorder (ADHD)?

Several central nervous system (CNS) stimulant medications have been approved by the FDA (Food and Drug Administration) to treat ADHD. Examples of these stimulant medications include Adderall®, Concerta®, Ritalin®, Focalin®, and Vyvanse®. These medicines are usually the first line of treatment for ADHD. However, they may not be the best fit for everyone. Just like any other medication, stimulant medications may cause harmful side effects. Keep in mind that CNS stimulants do not cure ADHD, they work by reducing ADHD symptoms, and because of medication differences, some people respond better to certain medications than others.

Another treatment option for ADHD in adults, children, and adolescents is non-stimulant medications. Strattera® (atomoxetine) was the first non-stimulant medication approved by the U.S. Food and Drug Administration (FDA) to treat ADHD in adults and children over the age of six. In general, this class of medication is considered less effective than stimulant medications. For this reason, they are often considered the second- or third-line of treatment for ADHD. Meaning, they are offered to patients who have not responded to stimulant medications, have severe side effects, or prefer to use a non-stimulant agent for their ADHD.

Pros and Cons of Non-Stimulant ADHD Medications

Pros

Effectiveness

A non-stimulant ADHD medication can effectively control and treat ADHD symptoms in many adults, children, and teens. Strattera is classified as a norepinephrine reuptake inhibitor; it works by increasing the amount of norepinephrine in the central nervous system. Norepinephrine is a brain chemical that helps to increase attention span and focus while reducing hyperactivity and impulsive behaviors. Strattera is longer-acting compared to certain stimulants such as Ritalin. Its effects can last for 24 hours or more, making it a good choice for children and adults who prefer a longer-acting agent.

Side Effects

Strattera does not cause many common side effects caused by psychostimulants, such as insomnia, dependence, or withdrawal. Also, this non-stimulant medication has some anti-depressive effects. Therefore, it may be a better choice in people with symptoms of ADHD as well as depression. Strattera is also sometimes a better choice for children with Tourette's syndrome because, unlike stimulants, it does not aggravate tics. Lastly, a possible side effect of Strattera is urinary retention, which can be an advantage for children who have enuresis (problems with bedwetting).

Risk of abuse and dependency

A key advantage of a non-stimulant ADHD drug like Strattera is that it is not a controlled substance. This is because it has a lower potential for abuse and dependence compared to stimulant medications. Since Strattera is not a schedule II controlled substance, you can receive a prescription of Strattera for more than a 30 day supply. In contrast, stimulants are subject to strict federal regulations on how these drugs are prescribed and dispensed. A doctor must issue a prescription every month for the medication to be dispensed by the pharmacy. The prescription for a non-stimulant ADHD medication such as Strattera can be called into the pharmacy for more than a 30-day supply at a time.

Cons

Efficacy

Non-stimulant medications are approved by the FDA to treat ADHD symptoms. However, they are generally considered less effective than the stimulant medications used to treat symptoms of ADHD. Another disadvantage is that Strattera takes 3-4 weeks of continued use to become fully effective. As a result, some patients give up before one month because it doesn't seem to work. If an individual needs ADHD medication only occasionally, for example, to improve focus and attention for a short period, taking Strattera may not be the best option (stimulant medications would be the better choice in this case).

Side Effects

Strattera can have side effects similar to some antidepressants, including decreased appetite, nausea, vomiting, upset stomach, stomach pain, constipation, weight loss, dry mouth, headache, dizziness, daytime sleepiness or sluggishness, and mood swings. This non-stimulant ADHD medication can also cause high blood pressure, increased heart rate, and other serious heart problems in people with a history of heart disease.

Risk of Suicidal Thoughts

Strattera can increase the risk of suicidal thoughts. Therefore, children and teens taking this medicine need to be monitored for suicidal thinking and ideations.

Is Strattera the only non-stimulant ADHD medication?

Strattera was the first non-stimulant that was FDA approved. However, other non-stimulants can be used to treat ADHD as well. These include guanfacine, clonidine, and certain antidepressants.

In adults and children with both ADHD symptoms and depression, antidepressant medications called tricyclic antidepressants have been found to be useful. Another type of antidepressant called monoamine oxidase inhibitors is also occasionally used. However, these drugs can cause unpleasant and sometimes intolerable side effects, such as weight gain, blurred vision, upset stomach, drowsiness, dizziness, and low blood pressure.

Why is atomoxetine not a stimulant?

Atomoxetine is the active ingredient in the non-stimulant ADHD medication, sold under the brand name Strattera. This drug is a selective norepinephrine reuptake inhibitor. As the name suggests, it works on the reuptake of norepinephrine. Therefore, it is not a stimulant. Also, unlike stimulants that are commonly used to treat ADHD, Strattera (atomoxetine) is not a controlled substance because it has a low risk of abuse, misuse, and addiction.

Does Strattera change your personality?

Strattera works by changing the way the brain absorbs a chemical called norepinephrine. Norepinephrine affects a person's overall mood. Therefore, Strattera can affect a person's mood and personality. Like other antidepressants, this non-stimulant ADHD medication has been linked to an increased risk of suicidal thinking and behaviors in children and adolescents. Parents need to be vigilant for any worrying change in mood, behavior, or personality if their child has been prescribed Strattera.

What is the best ADHD medication with the least side effects?

In addition to therapy and counseling, medications are a generally safe and effective treatment for attention deficit hyperactivity disorder. Doctors can choose from a range of drugs, including stimulant and non-stimulant ADHD medicines. However, these medications do not affect everyone in the same way. One medication might work better for one person than another. The same goes for the side effect profile—an ADHD medication may cause severe side effects in an individual but be quite well tolerated by another patient. That's why it's important to be medically reviewed and get your doctor's advice, diagnosis, or treatment recommendations.

For the best results, you should discuss with your doctor different treatment options, including your personal preferences and expectations. Your doctor should be able to guide you to the ADHD treatment that is right for you, along with the dose that controls your ADHD symptoms while causing minimal to no side effects. Keep in mind that you or your child may need a combination of medication, skills training, and behavioral therapies for the most effective ADHD treatment.

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