Strattera vs. Vyvanse: Similarities, differences, and how to choose (2023)

The Food and Drugs Administration have approved Strattera and Vyvanse to treat attention deficit hyperactivity disorder in children and adults.

Strattera (atomoxetine) and Vyvanse (lisdexamfetamine) have different mechanisms of action to treat attention deficit hyperactivity disorder (ADHD). Strattera is a nonstimulant drug while Vyvanse is a stimulant. There are some differences in their side effects, dosages, risks, and drug interactions.

This article looks at the similarities and differences between Strattera and Vyvanse to help people make decisions about treatment for ADHD.

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Atomoxetine, the active ingredient in Strattera, is the best known nonstimulant medication to treat ADHD.

Strattera is technically an antidepressant drug, which doctors classify as a selective norepinephrine reuptake inhibitor (SNRI). Doctors prescribe other SNRI medications to treat depression, but they only prescribe Strattera to treat ADHD.

Strattera works by changing the way a person’s brain uses norepinephrine, which is a neurotransmitter, or brain chemical. Norepinephrine affects a person’s ability to pay attention. Strattera acts on this system to help improve a person’s attention span.

Although nonstimulant medications, such as Strattera, are effective for treating ADHD, they do not work as well as stimulant drugs. They are, however, a better choice for people who do not tolerate stimulants well or have problems with anxiety, which stimulants can adversely affect.

Vyvanse is a stimulant medication belonging to the amphetamine subgroup. Like Strattera, Vyvanse also affects how the brain uses neurotransmitters.

Vyvanse and other amphetamines block the reuptake of norepinephrine and dopamine in the brain. Dopamine is a neurotransmitter connected to mood, attention, and motivation.

Researchers believe low levels of dopamine and the symptoms of ADHD are linked. Therefore, Vyvanse can help improve the way the brain uses dopamine to assist with symptoms related to attention or motivation.

People also take Vyvanse for the treatment of binge eating disorder in adults.

(Video) ADHD Medication - Stimulants vs. Nonstimulants

Doctors classify Vyvanse and other stimulant medications for ADHD as Schedule II drugs, meaning they have a high potential for abuse.

Adults and children aged 6 years or older can take Strattera or Vyvanse to help manage the symptoms of ADHD.

Typically, a doctor will start a person on the lowest dose of medication and gradually increase the dosage as appropriate. Factors such as age and weight will influence the dose a person takes.

People can take both medications with or without food. Taking Vyvanse in the morning will help a person avoid insomnia at night.

Strattera and Vyvanse both come in capsule form. Vyvanse also comes in chewable tablets.


Strattera capsules come in the following doses:

  • 10 mg
  • 18 mg
  • 25 mg
  • 40 mg
  • 60 mg
  • 80 mg
  • 100 mg

The dosage varies depending on a person’s body weight and age.

Children who weigh less than 70 kilograms (kg) should start Strattera at a dose of 0.5 milligrams per kilogram of body weight (mg/kg) and increase this to a target total daily dose of 1.2 mg/kg per day.

Children and adolescents should not take more than 1.4 mg/kg or 100 mg (whichever is less).

Children who weigh more than 70 kg and adults can start at a dose of 40 mg per day and increase this to a target dose of 80 mg per day. After 2–4 weeks, people can increase to 100 mg daily if they have not achieved an ideal response. This dose is the maximum daily dose.

People should swallow the capsules whole rather than breaking them apart.

Typically, people do not need to taper Strattera before discontinuing.


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Vyvanse capsules come in the following doses:

  • 10 mg
  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg
  • 70 mg

Vyvanse chewable tablets come in the following doses:

(Video) Stimulants Vs Nonstimulants Understanding ADHD Medications

  • 10 mg
  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg

People aged 6 and over can start taking 30 mg of Vyvanse daily. A doctor may increase the dosage by 10 or 20 mg every week to achieve the desired response. The maximum daily dose is 70 mg daily. The recommended dose is 30–70 mg.

People who take Vyvanse for binge eating disorder also start on an initial dose of 30 mg. They can increase this by 20 mg a week up to a maximum of 70 mg. The recommended dose is 30–70 mg.

People can swallow Vyvanse capsules whole or open the capsule and mix the powder with yogurt, juice, or water.

Vyvanse chewable tablets contain a dosage that is equivalent to the capsule. A person should chew the tablet thoroughly before swallowing.

Strattera and Vyvanse appear to have similar side effect profiles. Although Strattera may also lead to side effects of sexual dysfunction.

Common side effects of Strattera include:

  • abdominal pain
  • nausea
  • vomiting
  • fatigue
  • irritability
  • weight loss
  • poor appetite
  • headache
  • sleepiness
  • dizziness
  • rash
  • heart racing
  • dry mouth
  • constipation
  • chills
  • numbness and tingling
  • insomnia
  • trouble urinating
  • erectile dysfunction or ejaculation disorder
  • increased sweating or hot flashes

Common side effects of Vyvanse include:

  • decreased appetite
  • difficulty sleeping
  • abdominal pain
  • irritability
  • vomiting
  • weight loss
  • nausea
  • dry mouth
  • dizziness
  • rash
  • heart racing
  • tremor
  • diarrhea
  • anxiety
  • agitation
  • increased sweating
  • shortness of breath

There are some risks a person should be aware of when considering Strattera or Vyvanse.

Since Vyvanse contains a stimulant, it carries a high risk of abuse and dependence.

Both Strattera and Vyvanse have the potential to cause sudden cardiac death and raise blood pressure or heart rate. People who have known underlying heart problems should avoid these medications.

Both Strattera and Vyvanse can induce psychotic symptoms, including hallucinations or mania in children and adolescents, even in those without a known history of psychotic disorder.

Additionally, Strattera has links to an increased risk of suicidal thoughts in children and adolescents. A doctor should monitor people who begin taking Strattera or Vyvanse for changes in behavior.


Strattera and Vyvanse may interfere with growth and weight in children, and therefore, a doctor should monitor the child’s growth.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Strattera and Vyvanse may interact with certain medications. A person should always tell their doctor about all of the other medicines they take, including over-the-counter (OTC) medicines, supplements, and herbal remedies.

Strattera and Vyvanse may interact with other medications used for depression, including monoamine oxidase reuptake inhibitors (MAOIs), serotonergic drugs, and tricyclic antidepressants (TCAs).

Some medications, including quinidine and ritonavir, can affect the metabolism of Strattera or Vyvanse, resulting in higher levels of the drug in the body.

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(Video) 💊 My Strattera (Atomoxetine) Experience 🤔

Both medications are effective in improving the symptoms of ADHD.

Stimulants like Vyvanse are the most common drug for treating ADHD. However, nonstimulant medications such as Strattera may be a better option for some people, especially those who are not able to tolerate stimulants.

A person should talk to their doctor about the benefits, risks, and side effects of taking different ADHD medications. The doctor will develop an individualized treatment plan to fit what is best for that person.

Strattera and Vyvanse are medications that treat the symptoms of ADHD. Vyvanse contains amphetamine, which is a stimulant. Strattera does not contain a stimulant. Children over the age of 6, as well as adults, can take these medications.

The two medications have different mechanisms of action to treat ADHD. They also carry individual risks and side effects.

People should discuss with their doctor to determine the most appropriate treatment for ADHD symptoms.


Is it safe to take Strattera and Vyvanse together?


Strattera and Vyvanse do not have a direct drug interaction, but it is not common to take both together. However, there are some situations when someone might be taking both. Strattera has a delayed onset of action, and a person might take Vyvanse to help bridge or treat their ADHD symptoms while the Strattera takes effect. Once the Strattera has time to start working, the person would stop using Vyvanse and continue only taking the Strattera.

Dena Westphalen, PharmD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

(Video) Vyvanse vs Adderall


How is Strattera different from Vyvanse? ›

Strattera (atomoxetine) and Vyvanse (lisdexamfetamine) have different mechanisms of action to treat attention deficit hyperactivity disorder (ADHD). Strattera is a nonstimulant drug while Vyvanse is a stimulant. There are some differences in their side effects, dosages, risks, and drug interactions.

How do I know which ADHD medication is right for me? ›

Talk with your doctor to decide which works best for your routine, and to figure out the best time of day to take your medication. Your doctor can't know ahead of time which drug will work best for you. They'll probably start you out with a low dose and see if it helps ease your symptoms.

What is the number 1 ADHD medication? ›

ADHD specialists recommend methylphenidates as the first-choice medication for treating children and adolescents, and amphetamines as the first-choice medication for adults.

Which stimulant is most similar to Vyvanse? ›

Ritalin (methylphenidate)

Ritalin is a central nervous system stimulant just like Vyvanse. Like Concerta the generic name for Ritalin is methylphenidate. Ritalin is used for the treatment of ADHD and has an additional indication for narcolepsy that Vyvanse does not have.

Does Strattera work like Vyvanse? ›

Strattera and Vyvanse are FDA-approved drugs used to treat attention deficit hyperactivity disorder (ADHD). However, these prescription medications are not the same. Strattera is a selective norepinephrine reuptake inhibitor (SNRI). Vyvanse is a stimulant.

Does Strattera improve mood? ›

Strattera appears to have some antidepressant properties and can help those who have symptoms of depression as well as symptoms of ADHD. When taking stimulant medications, those with depressive symptoms may need to add a second medication.

What is the new ADHD medication? ›

Discover Qelbree. The first non-stimulant approved for ADHD in over a decade.

What is best long acting stimulant for ADHD? ›

For many adults with ADHD, the most convenient and best choice for their treatment will be an extended-release stimulant, like Adderall, Vyvanse, or Concerta. The ease of once-daily dosing and the lower risk of addiction or misuse makes extended-release stimulants a good fit for a lot of my patients.

How do I know if my ADHD medication needs adjusting? ›

The following are some common signs that ADHD medication should be adjusted: irritability or increased hyperactivity when the medication is in a child's system. consistent weight loss or problems with appetite.

What are the top 3 ADHD medications? ›

The most popular ADHD medications among ADDitude readers include (in alphabetical order): Adderall XR (amphetamine) Concerta (methylphenidate) Dexedrine (amphetamine)

Which ADHD medication is best for focus? ›

Adderall (dextroamphetamine, amphetamine)

Adderall is a combination of dextroamphetamine and amphetamine. This central nervous system (CNS) stimulant helps improve concentration and reduce impulsivity.

Is Vyvanse the best ADHD drug? ›

Earlier studies that compared other stimulant drugs with the active ingredient in Vyvanse found that it's about equally effective. A 2013 analysis of children and teens found the active ingredient in Vyvanse to be much more effective at relieving ADHD symptoms than the active ingredient in Ritalin.

What is the best substitute for Vyvanse? ›

The following are some of the most common alternatives to Vyvanse.
  1. Adderall XR (dextroamphetamine and amphetamine, also called amphetamine salts) ...
  2. Concerta (methylphenidate extended-release) ...
  3. Intuniv (guanfacine extended-release) ...
  4. Ritalin (methylphenidate) ...
  5. Strattera (atomoxetine)

What is a good replacement for Vyvanse? ›

Fortunately, there are several prescription alternatives to Vyvanse. This drug is a stimulant belonging to the amphetamine category of ADHD medications. Other amphetamines used to treat ADHD include: Adderall.

Does Vyvanse increase dopamine or serotonin? ›

A: Vyvanse works by slowly increasing the levels of dopamine and norepinephrine in your brain. Norepinephrine is a neurotransmitter that increases attention and alertness. Dopamine is a natural substance that increases pleasure and helps you focus.

Does Strattera help with motivation? ›

Strattera is a non-stimulant drug used to treat symptoms of ADHD in adults and children over the age of 6. It is thought to work by increasing norepinephrine levels in the brain, which are associated with awareness, motivation, learning, memory, and ability to focus.

What does it feel like to take Strattera? ›

Strattera can cause very significant abdominal pain, nausea and drowsiness, especially when starting the medication. Strattera tends to offset the effect of the stimulant starting to work and then wearing off. At times, it still should be taken more than once a day.

Does Strattera help anxiety? ›

Strattera (Atomoxetine) is a prescription antidepressant that belongs to the SNRI class. It is approved by the FDA to treat attention deficit hyperactivity disorder. However, it can be used off-label to treat a number of anxiety disorders as well. Strattera has not shown to be effective for treating depression.

What should I avoid while taking Strattera? ›

Avoid drinking alcohol or using illegal drugs while you are taking this medication. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

Does Strattera help you focus? ›

Strattera and Ritalin are prescription medications used to treat attention deficit hyperactivity disorder (ADHD). They help decrease hyperactivity and increase focus.

Who should not take Strattera? ›

You should not take Strattera if you have: taken, or plan to take an antidepressant monoamine oxidase inhibitor or MAOI within 14 days. untreated narrow-angle glaucoma. an allergy to atomoxetine or any other ingredients in Strattera.

What is the safest ADHD medication for adults? ›

The nonstimulants atomoxetine, guanfacine, and bupropion are considered best choices for individuals in substance abuse treatment programs. Nonstimulants are also a desirable choice for people who have had adverse effects on stimulant medications.

What are the 2 major drugs used in ADHD? ›

Medications for ADHD

There are only two stimulant medications, methylphenidate (the active ingredient in Ritalin, Concerta and other formulations) and amphetamine (the active ingredient in Adderall, Vyvanse and other formulations).

Which ADHD medication is best for inattentive type? ›

The two types that are most commonly used are amphetamine and methylphenidate. Mixed amphetamine salts are marketed under the brand name Adderall®. Methylphenidate is sold under the brand names Ritalin®, Concerta®, Metadate® and others.

Which ADHD medication is best for impulsivity? ›

High blood pressure medicines are another choice. These drugs can help control impulsivity and hyperactivity symptoms.
This type of medication includes:
  • Atomoxetine (Strattera).
  • Clonidine ER (Kapvay)
  • Guanfacine ER (Intuniv)
  • Viloxazine (Qelbree)
9 Mar 2021

What type of behavior therapy is the most effective for ADHD? ›

Cognitive behavioral therapy (CBT) is essentially brain training for ADHD. It is a short-term, goal-oriented form of psychotherapy that aims to change negative patterns of thinking and reframe the way a patient feels about herself and her symptoms of ADHD.

How long does it take for Strattera to work for ADHD? ›

Strattera takes from one to four weeks to work. The dose determined by trial and error using a process called titration that measures benefits against side effects. After four weeks, the dose can be increased. Capsules are available in 10, 18, 25, 40 and 60 mg strengths.

How do you know if ADHD meds are too low? ›

Initial Dose

Too little response: The medication isn't sufficiently controlling your ADHD symptoms such as inattention, impulsivity, and hyperactivity. Intolerable side effects: The medication may be working, but the side effects are severe and/or intolerable. 3.

What time of day are ADHD symptoms most common? ›

This study determined that children with ADHD face greater difficulties in daily functioning compared with community sample children, that these difficulties are time-dependent, and that these difficulties were particularly experienced in the evening.

What happens if your ADHD medication is too high? ›

When the dosage is too high, stimulants can cause children or even adults to seem “spacey” or “zombie-like,” or to be uncharacteristically tearful or irritable (a condition known as emotional lability). In general, the best way to rein in these side effects is simply to lower the dosage.

Does Strattera cause weight gain? ›

Effects on Growth

Subsequently, weight gain rebounds and at about 3 years of treatment, patients treated with Strattera have gained 17.9 kg on average, 0.5 kg more than predicted by their baseline data.

Is Vyvanse a Tier 3 drug? ›

Prior to being removed from the Essential Formulary, Vyvanse was a Tier 3 medication. A coverage exception can be granted in the rare circumstance that a member's specific clinical situation makes the alternatives inappropriate for their health. More information concerning these requests can be found here.

Which of the 3 types of ADHD is the most frequent? ›

What are the different types of ADHD? Three major types of ADHD include the following: ADHD, combined type. This, the most common type of ADHD, is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility.

What are 3 treatments for ADHD? ›

Based on the best available evidence, effective strategies include treating ADHD with medication, parent-delivered behavior therapy, and teacher-delivered behavior therapy.

Why do doctors prefer Vyvanse? ›

Because Vyvanse is an extended-release version and has a slightly longer duration of medicinal effects, this could be a consideration for some physicians. Both medications have different interactions with other types of medications and substances.

What makes Vyvanse less effective? ›

As with other acidifying medications, vitamin C can cause Vyvanse to be less effective than expected. The opposite is true for medications like sodium bicarbonate (found in Zegerid) and acetazolamide, which decrease the acidity of your urine.

Does Vyvanse help with anxiety? ›

Often, trouble with attention causes anxiety. So if medication works to reduce symptoms, it may reduce anxiety. But Vyvanse is not an anxiety medication. And stimulant medications can sometimes increase anxiety in a small percentage of kids who take them.

Does Vyvanse increase or decrease serotonin? ›

Vyvanse interacts with antidepressant drugs that increase the level of serotonin in the body. Too much serotonin increases the risk of a serious Vyvanse side effect called serotonin syndrome, which can be life-threatening.

What does Vyvanse do to the brain long term? ›

By taking more than the recommended dose, users can experience a range of serious, negative impacts on their health in the long run. For example, misuse of central nervous system stimulants such as Vyvanse can hasten the development of tolerance, physiological dependence, and addiction.

Why does Vyvanse give me energy? ›

Too much dopamine and norepinephrine, a chemical similar to adrenaline, overexcites the brain and causes high energy, inattention, nervousness, agitation, excitability, or euphoria. If a person with normal levels of dopamine and norepinephrine is experiencing anxiety, Vyvanse will probably worsen the anxiety.

Does Vyvanse affect memory? ›

Can memory loss occur with Vyvanse? Probably not. Memory loss wasn't reported in clinical studies of Vyvanse. Keep in mind that forgetfulness and poor memory are symptoms of attention deficit hyperactivity disorder (ADHD), which Vyvanse is approved to treat.

Does Vyvanse affect motivation? ›

When you first start taking Vyvanse, you might experience a boost in energy, motivation and positivity. However, these effects don't typically last, says Dr. Lieberman.

Is Strattera better than stimulants? ›

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.

Is Strattera safer than stimulants? ›

Unlike stimulant drugs, Strattera is not a controlled substance. Therefore, people are less likely to abuse or become dependent on it. In addition, Strattera doesn't cause many of the potential side effects linked to psychostimulants, such as sleeplessness.

Does Strattera work as well as Adderall for ADHD? ›

Strattera contains atomoxetine whereas Adderall contains a mixture of amphetamine salts (MAS). Both Strattera and Adderall are effective for ADHD; however, Strattera is not a stimulant which means it is not likely to be abused or cause dependence, tolerance, or withdrawal symptoms on discontinuation.

Does Strattera work for everyone with ADHD? ›

It boosts levels of norepinephrine in your brain to help with attention, hyperactivity, and impulsive behavior. Strattera often doesn't work as well for ADHD as Ritalin and other stimulant drugs. Your doctor might prescribe it only if a stimulant medicine doesn't help your symptoms.

Does Strattera make you gain weight? ›

Effects on Growth

Subsequently, weight gain rebounds and at about 3 years of treatment, patients treated with Strattera have gained 17.9 kg on average, 0.5 kg more than predicted by their baseline data.

What does Strattera make you feel like? ›

Nausea, vomiting, abdominal pain, decreased appetite, constipation, headache, dry mouth, tiredness, and sleepiness are the most commonly reported side effects. Strattera has been associated with an increased risk of suicidal thoughts or behavior in children and adolescents with ADHD.

Does Strattera help with focus? ›

Does Strattera help you focus? Yes. Strattera can help treat ADHD symptoms. By increasing the amount of norepinephrine, Strattera can help with attention span and focus and reduce impulsive and hyperactive behavior.

How do I know if Strattera is working? ›

How do I tell if stimulant drugs are working?
  1. increased heart rate or blood pressure.
  2. decreased appetite.
  3. trouble falling or staying asleep.
  4. irritability, as the medicine wears off.
  5. nausea or vomiting.
  6. headaches.
  7. mood swings.

Is Strattera used for inattentive ADHD? ›

In addition to treating key ADHD symptoms like inattentiveness, Strattera has been found to improve quality of life and decrease emotional instability among both children and adults with ADHD.

Does Strattera work instantly? ›

Strattera takes from one to four weeks to work. The dose determined by trial and error using a process called titration that measures benefits against side effects. After four weeks, the dose can be increased.

How long does it take for Strattera to kick in? ›

How long does it usually take for Strattera to work? Some people report small changes in hyperactivity and impulse control within two weeks, but it may take 4 to 8 weeks for the drug to achieve maximum effectiveness.

Can Strattera cause anger? ›

The mild side effects of Strattera can be similar to those of stimulants and can include nervousness, trouble sleeping, and irritability.


1. Some ADHD medicines may be linked to psychosis, study finds
(CBS News)
2. ADHD Medication Choices
(My Doctor - Kaiser Permanente)
3. ADHD: We Finally Know Which Drugs to Use | Morning Report
4. Adult ADD + ADHD - Adderall + Vyvanse + Ritalin - How Are the Medications Different?
(Scott Shapiro, MD)
5. ADHD Medication Options
(UC Davis MIND Institute)
6. Dr Russell Barkley on ADHD Meds and how they all work differently from each other
(Adhd Videos)
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