Ritalin vs. Strattera for ADHD

Medically Reviewed by Shruthi N, MD on September 22, 2024
11 min read

Strattera and Ritalin are medicines that children and adults can take to manage symptoms of attention deficit hyperactivity disorder (ADHD). Both drugs improve focus and attention but in different ways.

Ritalin is the brand name of a stimulant drug called methylphenidate. Stimulants increase the levels of the chemicals dopamine and norepinephrine in your brain. They help you focus, stay organized, and pay attention. Up to 80% of people with ADHD who take stimulant drugs say their symptoms get better.

Strattera is the brand name of a non-stimulant drug called atomoxetine. It boosts levels of norepinephrine in your brain to help with attention, hyperactivity, and impulsive behavior.

For ADHD, Strattera often doesn't work as well as Ritalin and other stimulant drugs. But your doctor might prescribe it for certain reasons, such as if a stimulant medicine doesn’t help your symptoms enough or stimulants cause side effects you can’t handle.

Strattera doesn’t work as fast as Ritalin. But don’t stop taking it if you don’t feel better right away. You may need to take non-stimulant drugs for around 4-6 weeks before you see a big difference in your ADHD symptoms.

Your doctor can help you find the best ADHD treatment for you. It may take a few tries to get the medicine and dose right. If the first drug you take doesn't help enough or causes too many side effects, they can switch you to a different one.

Ritalin is a short-acting drug. Its effects last for about 3-4 hours. You’ll need to take at least one pill in the morning and one at lunchtime to manage your symptoms for an entire school or workday. Your doctor will let you know what dosing schedule is right for you.

Ritalin LA is an extended-release long-acting form of methylphenidate that lasts around 6-8 hours.

Strattera is a selective norepinephrine reuptake inhibitor (SNRI). Norepinephrine is a chemical your brain naturally makes. SNRIs keep more of this “neurotransmitter” circulating in your body, but these drugs take longer to work than stimulants. (Note: Strattera isn’t the same as SNRIs that refer to serotonin-norepinephrine reuptake inhibitors.)

While Strattera takes a while to kick in compared to Ritalin, the effects last longer once the drug builds up in your body. A daily dose of Strattera should work 24 hours as long as you take the drug around the same time every day.

The doctor will probably start you at the lowest dose and then slowly increase it until the drug starts to control your symptoms without causing too many side effects.

Ritalin tablets

Children age 6 and older

  • Starting dose: 5 milligrams twice a day (before breakfast and lunch)
  • Increase the dose by 5 to 10 milligrams each week, if needed
  • Highest dose: Daily doses above 60 milligrams are not recommended

Adults

  • Average dose: 20 to 30 milligrams two or three times a day
  • Lower dose: You may feel better with 10 to 15 milligrams a day
  • Higher dose: Some adults may need 40 to 60 milligrams every day

Adults and kids typically take Ritalin 30-45 minutes before a meal. Take your last dose before 6 p.m. if Ritalin makes it hard to sleep.

You can switch to Ritalin-SR extended-release tablets if you're taking 20 milligrams of Ritalin every 8 hours and you want to take only one pill that lasts longer.

Ritalin-LA

If you’re just starting methylphenidate:

  • Take 20 milligrams daily
  • Increase the dose by 10 milligrams each week, if needed
  • Maximum dose: 60 milligrams daily

If you already take Ritalin

  • The dosage is based on your current Ritalin dose

Don’t stop taking Ritalin suddenly, especially if you’ve taken a high dose for a long time. You could develop a physical dependence. Ask your doctor to help you lower the dose slowly. Also called tapering, this can lessen the chances you’ll have withdrawal symptoms.

Withdrawal symptoms of Ritalin may include:

  • Feeling uneasy
  • Depression
  • Fatigue
  • Vivid or bad dreams
  • Sleeping too little or too much
  • Increased hunger
  • Moving too slowly
  • Agitation

The recommended dosage depends on your weight and how long you've been taking Strattera. The doctor will start you at the lowest dose and then slowly increase it until the drug controls your symptoms while causing the fewest side effects.

Recommended dosages:

For children, teens, and adults who weigh up to 70 kilograms (154 pounds)

  • Starting daily dose: 0.5 milligrams per kilogram of body weight
  • Target daily dose: 1.2 milligrams per kilogram of body weight For

For children, teens, and adults who weigh 70 kilograms (154 pounds) or more

  • Starting dose: 40 milligrams per day
  • Target dose: 80 milligrams per day

The maximum dosage recommended is: 

  • 1.4 milligrams per kilogram for kids who weigh up to 70 kilograms
  • 100 milligrams for children and adults who weigh 70 kilograms or more

Both medications can cause side effects. They’re generally mild and tend to go away as your body gets used to the medicine. But some can be serious or more bothersome.

Ritalin side effects

The most common side effects from Ritalin include:

Less often, you may have serious side effects such as:

  • Mood swings or changes to your personality
  • Thoughts about hurting yourself or others
  • Seeing or hearing things that aren’t there
  • Uncontrollable facial movements (tics)

It's rare, but Ritalin is also linked to serious heart problems, mental health issues, circulation problems in your fingers and toes, and erections that last longer than usual and may be painful.

Ritalin could also raise your chances of stroke and heart attack. Don’t take it if you have a serious heart problem, especially not without weighing the pros and cons with your doctor first.

Some studies show that stimulant medications can slow growth in children or result in slightly shorter height when they grow up. But not all researchers have found these results, and when effects are observed, they are usually minimal. 

Tell your doctor if you’re concerned about the long-term effects of Ritalin on your child’s growth and development. 

Very rarely, you could have a serious allergic reaction to methylphenidate. Call 911 right away if you or a loved one take Ritalin and:

  • You have trouble breathing
  • Your throat feels tight
  • Your lips, mouth, or tongue swell
  • Your loved one faints or doesn’t respond

Strattera side effects

The most common side effects from Strattera in children and adolescents include:

  • Nausea and vomiting
  • Sleepiness
  • General tiredness (fatigue)
  • Trouble sleeping at night
  • Reduced appetite
  • Belly pain

In rare cases, children and teens who take Strattera may have suicidal thoughts or behaviors. The doctor should monitor your child closely while they take this drug.

Strattera may change your child’s mood in other ways. Watch for signs of:

  • Anxiety
  • Agitation
  • Panic attacks
  • Irritability
  • Hostility 
  • Aggressiveness
  • Extreme high or low moods

The most common side effects of Strattera in adults include:

Other side effects of Strattera may include: 

  • Menstrual cramps
  • Low libido
  • Difficulty having an orgasm or ejaculating
  • Increased sweating
  • Irritability
  • Skin rash
  • Dizziness

Sometimes, Strattera is linked to liver or heart problems, mania symptoms, or erections that last longer than usual and may hurt. You or your child shouldn't take Strattera if you have a severe heart problem.

If you’re allergic to Strattera, the drug can cause:

Call 911 right away if you take Strattera and you can’t breathe or your lips, tongue, mouth, or throat swell. Rarely, you could have a serious allergic reaction to the medication that needs fast treatment.

Concerns during pregnancy and breastfeeding

Ritalin. In general, Ritalin isn’t recommended during pregnancy. But there may be reasons for you to stay on it. Your doctor will go over the pros and cons of taking methylphenidate and how the drug may affect your baby.

Ritalin can get into your breast milk in small amounts. But you should tell your doctor if your baby shows signs of irritability or trouble sleeping while you’re breastfeeding. These could be signs that your baby is getting side effects from the medication.

High doses of Ritalin and other stimulants may lessen how much breast milk you make.

Strattera. You may be able to take atomoxetine safely during pregnancy. There’s ongoing research into how Strattera may affect babies before they’re born, but there’s no evidence that the drug causes birth defects, miscarriage, or other bad health outcomes for you or your baby.

Strattera likely gets in your breast milk, but there’s no research on how the drug may affect your baby during breastfeeding.

Your doctor will help you weigh the pros and cons of taking Strattera while pregnant or breastfeeding to decide if it’s the best way to control your ADHD symptoms.

Both Ritalin and Strattera can interact with other drugs. So, it’s important to talk to your doctor about all the medication you take, including supplements. They’ll let you know what’s safe to take with your ADHD treatment. 

Ritalin drug interactions

If you take Ritalin, it’s really important that you tell your doctor if you:

Take blood pressure drugs. Your blood pressure medicine may not work as well when you take Ritalin. 

Are going to have surgery. Your blood pressure and heart rate may spike during surgery if you mix Ritalin with common kinds of anesthesia. 

Take risperidone. You may have more uncontrolled body movements (extrapyramidal symptoms, or EPS) if you take both drugs and need to raise or lower your dose of either.

It’s best not to mix alcohol with methylphenidate. That’s because drinking can increase the effects of Ritalin and raise your odds of side effects.

Strattera drug interactions

If you take Strattera, use caution with:

  • CYP2D6 inhibitors 
  • Blood pressure drugs
  • Albuterol
  • Any drug that may raise your blood pressure or affect your heart rate

Strattera doesn’t seem to affect alcohol levels in your blood. 

Do not take Ritalin or Strattera with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping MAOIs. This can cause dangerously high blood pressure. 

Very high blood pressure can raise your odds of health problems such as: 

  • Stroke
  • Heart attack
  • Heart valve problems
  • Eye problems 
  • Seizures in pregnant people with high blood pressure (preeclampsia)

How much these drugs cost depends on your health insurance coverage and your local pharmacy. In general, the longer-acting forms cost more than the shorter-acting forms. Higher doses are more expensive than lower doses. Generic versions often cost less than brand-name versions.

Ritalin is a controlled substance. That means the government thinks there’s a strong chance that some people may abuse or misuse it and develop an addiction.

In general, stimulant drugs such as Ritalin raise dopamine levels in your brain. That’s a chemical that triggers feelings of pleasure and makes you want to take the drug again. If you use Ritalin for the feel-good effects, you may start to take more and more of the drug to get the same feeling.

If you take high doses of Ritalin and develop a physical or psychological dependence, you may get withdrawal symptoms such as depression, tiredness, and trouble sleeping when you suddenly stop taking the drug. 

It’s important to note that you can develop a physical dependence on a drug and have withdrawal symptoms even if you’re not addicted to it. Addiction means you have strong cravings for a drug and you can’t control your substance use.

If you have ADHD, you’re more likely to have substance use problems compared to people without ADHD. But there’s no evidence that long-term stimulant treatment will raise your odds of developing an alcohol or substance use disorder.

Strattera is not a controlled substance and doesn't affect dopamine levels the same way as stimulant drugs. There’s no evidence that people are likely to misuse it. And it doesn't seem to cause dependence or withdrawal symptoms when you stop taking it.

 RitalinStrattera
What is the generic name?Methylphenidate hydrochlorideAtomoxetine hydrochloride
Is a generic version available?YesYes
What does it treat?ADHD and narcolepsyADHD
What forms does it come in?Immediate-release oral tablet Extended-release oral tablet Extended-release oral capsuleOral capsule
What strengths does it come in?Immediate-release tablet: 5 milligrams, 10 milligrams, 20 milligrams 

Extended-release tablet: 20 milligrams 

Extended-release capsules: 10 milligrams, 20 milligrams, 30 milligrams, 40 milligrams
10 milligrams
18 milligrams
25 milligrams
40 milligrams
60 milligrams
80 milligrams
100 milligrams
What's the typical length of treatment?Long-termLong-term
How do I store it?Between 68 F and 77 F in a light-resistant containerAt a controlled room temperature of 77 F
Is this a controlled substance?YesNo
Is there a risk of withdrawal with this drug?YesNo
Does this drug have potential for misuse?YesNo

Ritalin and Strattera are drugs used to treat ADHD in children and adults. You can only get them with a prescription from your doctor. 

Ritalin (methylphenidate) is a stimulant. These are the most common kinds of drugs used to manage ADHD. Strattera (atomoxetine) is a non-stimulant medication that controls ADHD symptoms in a different way. Ask your doctor about the pros and cons of both.

Is Strattera better than Ritalin?

It depends. In general, Strattera doesn’t work as well for controlling ADHD symptoms as Ritalin or other stimulants. But it may be the right choice for you if you don’t respond to Ritalin or stimulants cause side effects you can’t tolerate.

Is Strattera better than stimulants for ADHD?

In general, non-stimulant drugs such as Strattera don’t work better for ADHD symptoms than stimulant drugs. But that doesn’t mean it won’t work well for your symptoms. Your doctor will help you weigh the pros and cons of all your treatment options.

What is the most effective non-stimulant for ADHD?

Strattera is one of the most commonly used non-stimulant drugs used to treat ADHD. Other non-stimulant choices may include viloxazine (Qelbree), clonidine (Catapres, Kapvay), and guanfacine (Tenex, Intuniv). 

What's the strongest ADHD medication?

Amphetamines such as Adderall (dextroamphetamine) and Vyvanse (lisdexamfetamine) tend to have stronger effects than Ritalin. They may also last a little longer. But just because they’re stronger doesn’t mean they’re better for controlling your ADHD symptoms.