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Nov 16, 2023

Focalin vs. Adderall: Which Is More Effective?

A necessary step in the process of managing the symptoms associated with

A necessary step in the process of managing the symptoms associated with attention deficit hyperactivity syndrome (ADHD) is choosing a prescription medication that works safely and effectively.

To assist you in this process, your healthcare provider may prescribe one of two medications approved by the Food and Drug Administration (FDA): Focalin (dexmethylphenidate) or Adderall (amphetamine/dextroamphetamine).

Focalin and adderall are central nervous system (CNS) stimulants, drugs that increase dopamine and norepinephrine levels in the brain and improve wakefulness, impulse control, and attention to detail.

While primarily seen as similar, these two medications differ regarding their active ingredients, requirements for prescription, approved indications (uses), and potential for side effects, amongst other differences.

For example, you may seek a drug regime for a diagnosis of narcolepsy, for which only Adderall is FDA-approved.

Moving forward, this article will compare and contrast Focalin and Adderall, examining what primary features they share and what differentiates them.

ADHD affects millions of children in the United States and many adults.

People with ADHD experience symptoms that interfere with their ability to perform school, work, and other daily activities, including:

ADHD is generally treated with various methods, including prescription medication, therapy, and educational or behavioral intervention.

Narcolepsy is a chronic (long-lasting) condition that affects the brain's ability to control sleep-wake cycles.

Narcolepsy is broken up into type 1 and type 2: Type 1 narcolepsy involves cataplexy (episodes of muscle weakness triggered by emotions). In comparison, type 2 is the presence of daytime sleepiness without cataplexy.

To combat narcolepsy, CNS stimulants or other drugs, such as antidepressants, are used to keep an individual awake. A healthcare provider may also recommend dietary and behavioral changes to supplement an ongoing drug regimen.

The following outlines notable similarities and differences between Focalin and Adderall.

The active ingredient in Focalin is called dexmethylphenidate. It is chemically similar to methylphenidate, the ingredient in Ritalin.

In comparison, the active ingredient in Adderall is called amphetamine/dextroamphetamine or mixed amphetamine salts.

Both medications are classified as CNS stimulants.

How CNS stimulants work has yet to be wholly understood, but they are thought to stimulate activity in the CNS, increasing levels of dopamine and norepinephrine.

Dopamine and norepinephrine are neurotransmitters that send messages between nerve cells.

Increasing dopamine and norepinephrine helps improve focus and concentration and reduces impulsivity.

Note, however, that drugs used to manage ADHD-related symptoms include non-stimulant medications.

The FDA has approved Focalin and Adderall for the following uses:

For people who can take a CNS stimulant like Focalin or Adderall, they may wonder, which is better?

One meta-analysis comparing many studies on various stimulants for short-term ADHD treatment concluded the following:

Regarding efficacy and safety, the researchers found methylphenidate drugs (such as Focalin) better suited to children and adolescents and amphetamines (such as Adderall) better suited to adults.

Nonetheless, the best drug for you (or your child) can only be determined by the healthcare provider, who will consider various individual factors to decide which medication is most appropriate when used in combination with other interventions such as therapy.

Focalin and Adderall are not safe for everyone.

People who should not take Focalin or Adderall include:

Also, pregnant or breastfeeding people should consult their healthcare provider before beginning treatment with Focalin or Adderall.

Like many drugs, Focalin and Adderall possess the potential for adverse effects. Notably, both stimulants carry a black box warning, the strongest warning required by the FDA.

Moreover, Focalin and Adderall are classified by the Drug Enforcement Administration (DEA) as Schedule II controlled substances.

Misuse of Focalin or Adderall can cause addiction, overdose, heart attack, stroke, or sudden death.

Common side effects of Focalin include:

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening, or you think you have a medical emergency.

Serious side effects of Focalin and their symptoms can include the following:

Common side effects of Adderall include:

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening, or you think you have a medical emergency.

Serious side effects of Adderall and their symptoms can include the following:

Finally, know that CNS stimulants can affect growth in children. Therefore, adolescents who take stimulants will be closely monitored for development.

Focalin (IR) is an oral tablet with 2.5 milligrams (mg), 5 mg, and 10 mg strengths.

Focalin (ER) is available in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg doses.

Focalin is available in both brand-name and generic formulations.

You can take Focalin with or without food but do not stop taking Focalin suddenly. When you stop taking Focalin, the healthcare provider will instruct you on how to slowly and safely taper off the drug.

Adderall IR is an oral tablet with 5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg tablets.

Adderall XR is available in dosage strengths of 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg capsules.

Like Focalin, Adderall is also available in brand-name and generic formulations.

Swallow the IR tablets and ER capsules whole (don't chew or crush them). If swallowing the ER capsule isn't possible, you can open it and sprinkle the contents onto a teaspoon of applesauce.

Tell your healthcare provider about all your medicines, including prescription and over-the-counter (OTC) drugs and vitamins or supplements.

While taking Focalin or Adderall, do not start any new medications without approval from your healthcare provider.

Because these drugs are in the same drug class, they have similar drug interactions. Some drug interactions include but are not limited to:

This is a partial list of drug interactions.

Other drug interactions may occur with Focalin or Adderall. Consult your healthcare provider for more information about drug interactions and how they may affect you.

Choosing the proper medication, regardless of condition or severity, can be challenging, especially if the drug is for a child or other loved one.

Focalin and Adderall are effective in their approved indications. However, it's important to remember that while both are orally administered CNS stimulants used for wakefulness and focus, both drugs have the potential for adverse effects and addictive properties.

Like all drugs, Focalin and Adderall should only be taken under the direction and supervision of a healthcare provider.

Like all prescription drug regimens, speak to your healthcare provider about which drug is right based on your or your child's medical history and current symptoms.

Misuse of stimulants can cause heart attack, stroke, and sudden death. People who overuse or misuse stimulants over time may also experience trouble sleeping, irritability, personality changes, and psychotic symptoms.

The cost depends on the formulation (brand or generic), dosage, and quantity. Choosing the generic alternative, in most cases, will be significantly less expensive than opting for the brand-name drug.

Ask your pharmacist to help you calculate the cost of your prescription.

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Centers for Disease Control and Prevention (CDC). Data and Statistics About ADHD.

National Institute of Neurological Disorders and Stroke. Narcolepsy.

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DailyMed. Label: Ritalin- methylphenidate hydrochloride tablet.

MedlinePlus. Dextroamphetamine and amphetamine.

National Cancer Institute. Definition of a CNS stimulant.

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DailyMed. Label: Focalin- dexmethylphenidate hydrochloride tablet.

DailyMed. Label: Adderall- dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate tablet.

DailyMed. Label: Adderall XR- dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate and amphetamine aspartate capsule, extended release.

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Prescribers’ Digital Reference: Dexmethylphenidate hydrochloride - drug summary.

Prescribers’ Digital Reference: Amphetamine aspartate monohydrate/amphetamine sulfate/dextroamphetamine saccharate/dextroamphetamine sulfate - drug summary.

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By Karen Berger, PharmDKaren Berger, PharmD, is a community pharmacist and medical writer/reviewer.