An increasing number of people are being diagnosed with ADHD. It is uncertain if that is due to a rise in the number of people who have the disorder or if the rate has always been at roughly the level that it is today but is simply being tested for much more often than was the case in the past. Regardless, more people nowadays are seeking an effective form of treatment for ADHD so that they can more effectively navigate the world: in school, at work, socially and otherwise.
Two of the primary medications that have been prescribed for ADHD are Focalin and Adderall. Although there are some significant similarities between these two central nervous system stimulants, it is important to consider the differences as one may ultimately be much more effective for you than the other, depending on your body and the overall situation that is being treated.
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ADHD is an acronym that means attention deficit hyperactivity disorder. Those who experience this tend to suffer from extensive periods of inattentiveness, hyperactivity and impulsiveness.
Do take into account that when children’s actions are being assessed by their parents, it is normal and expected for them to experience some of these symptoms, particularly when they are younger. But if those symptoms are particularly significant or do not appear to improve as they age, then you might want to consult a professional to determine if they have ADHD.
It is also important to note that many individuals first receive an ADHD diagnosis as an adult despite having experienced it since childhood and that these symptoms do often continue past childhood. Also of note is that men and boys tend to be diagnosed more often than women and girls are, but it is uncertain if that is because males tend to experience ADHD more often or if females more effectively hide the symptoms.
Those who have been diagnosed with ADHD should ensure that they receive the most effective treatment for managing their symptoms. In many cases, that is where Focalin and Adderall come in.
Focalin at a Glance
Focalin is the brand name of this treatment method. It is actually dexmethylphenidate and is derived from methylphenidate, which is more commonly known by its brand name of Ritalin. Focalin, which is essentially twice as strong as Ritalin, has been approved for use since 2001.
It is prescribed in tablets containing 2.5, 5 or 10 mg that are designed for immediate release or in extended-release capsules that can vary in size from 5 to 40 mg (5, 10, 15, 20, 25, 30, 35 and 40). Users are usually 6 years of age or older.
Focalin is typically used to treat ADHD while it can also be used as an off-label medication for treating narcolepsy.
Many say that Focalin use results in less nervousness as compared to consuming Adderall, but, of course, your experience may differ.
Adderall at a Glance
Adderall is also a brand name, and it also consists of dextroamphetamine but a lesser amount of it, about 75%. The other 25% is levoamphetamine. A more common way that its contents are described is that Adderall has mixed amphetamine salts. It was initially approved for use in 1996.
This stimulant is prescribed in immediate-release tablets or extended-release capsules that range in size from 5 to 30 mg (5, 10, 15, 20 and 30 in both cases with 12.5 also available for IR and 25 also available for ER). Children as young as 3 are prescribed it for the treatment of ADHD.
Adderall has been approved by the FDA to treat both ADHD and narcolepsy while some prescribe it off-label for the treatment of anxiety and depression.
IR Tablets Versus ER Capsules
The immediate-release (IR) tablets that are available for both Focalin and Adderall tend to have a 4-6 hour duration of effect while extended-release (ER) capsules for both usually provide sustained effects for up to 12 hours.
The capsules should not be chewed or crushed and consumed in that way although, if they are difficult to swallow as is, an option would be to open them and combine the contents with something sweet, such as applesauce, and taken that way. If doing the latter, make sure to consume the entire tablet’s content in a short time period – e.g. one swallow.
Performance and Efficacy
Both Focalin and Adderall increase the levels of neurotransmitters, which help nerve cells communicate with each other, in the user’s brain. This helps users be able to focus more efficiently on details, control their impulses and, for those suffering from narcolepsy, stay awake. The main difference between the two is that Focalin more so focuses on how the brain uses dopamine while Adderall does so with serotonin.
As far as their efficacy goes, in a general sense, Focalin is more effective in children while Adderall is more affective in adults. However, do keep in mind that that is just a general statement as individual factors will determine which is best for a specific person as numerous adults have experienced improvement while taking Focalin while the same can be said for children and Adderall.
Side Effects and Risks
First, if you have heart disease or rhythm issues, glaucoma, Tourette’s syndrome or severe anxiety, you should not take either Focalin or Adderall.
As for everyone else, keep in mind that both of these treatment methods come with black box warnings, indicating that they have been deemed by the FDA to need to be treated with special care and that serious consideration was made by it to making them both 100% illegal. In fact, they are both Schedule II controlled substances, meaning that they carry a high potential for dependence and abuse.
Also, tolerance will likely develop, meaning that increasing amounts become necessary to experience similar results, and withdrawal symptoms are possible when use is discontinued. The latter can include extreme fatigue and depression. Because of the distinct possibility of withdrawal symptoms, it is important to not cease use suddenly. Consult medical advice on how to do so safely and gradually.
Besides addiction and overdose, the most severe side effects that are possible for users of either include stroke, heart attack and death.
Otherwise, Focalin-specific side effects include insomnia, nausea, dizziness and headaches. Those taking this should also keep an eye out for some of its much less common but more serious side effects, which include an irregular heartbeat, loss of vision, unintentional muscle movements and behavior changes.
Adderall-specific side effects also include insomnia and nausea as well as dry mouth and a fever. More serious side effects that some have experienced after taking Adderall have also included an irregular heartbeat, unintentional muscle movements and behavioral changes in addition to trouble speaking, seizures, chest pain, shortness of breath, severe headaches and blood flow issues.
As expected, those taking higher dosages are more likely to experience side effects.
Drug Interactions and Contraindications
One of the ways that users can have negative experiences with Focalin and Adderall is through drug interactions as this treatment method combined with other drugs that you are taking can cause especially severe side effects. The ways that this can happen are numerous, but here are a few examples.
Taking Focalin or Adderall with a blood pressure medication can increase the chances of high blood pressure, arrhythmia and heart palpitations occurring. Either combined with antidepressants can increase the chances of side effects occurring. Antipsychotics combined with Focalin or Adderall may result in the latter treatment method not being as efficient as it otherwise would be.
Other possible drug interaction issues can result from combining use of either with monoamine oxidase inhibitors, seizure medications or acid reducers.
One specific group of people who should be wary of taking either Focalin or Adderall even if drug interactions are not issues are those who currently have high blood pressure or a similar heart-related condition. If that describes you, make sure to communicate those specific details to a health professional before you are prescribed either.
Cost and Flexibility
Of course, the cost to take Focalin or Adderall depends on a number of factors, including if you will have health insurance handle some or all of the cost. That said, consider ballpark figures of $25 for 30 2.5-mg tablets of the generic form of Focalin (dexmethylphenidate) and $10 for 30 5-mg tablets of the generic form of Adderall (amphetamine salts) while noting that many have experienced lower prices for Adderall for those sizes of tablets.
Since both Focalin and Adderall are Schedule II substances, it is important to keep in mind that possessing and using either without a prescription is illegal. So is the selling or giving of your prescribed tablets or capsules to others to use.
Another Option: Behavioral Therapy
Many experience success with managing ADHD with the help of behavioral therapy, some with this as a sole treatment method and others with it alongside medication, such as Focalin and Adderall. Behavioral therapy generally involves helping you control ADHD-related symptoms and manage tasks more effectively and productively.
You may want to consider taking advantage of behavioral therapy before asking for a prescription to Focalin or Adderall, particularly since it is a more effective long-term treatment method since both of the latter options do tend to result in tolerance over time.
Keep in mind how important it is to combine researching Focalin and Adderall on your own with a consultation with a healthcare professional to determine what the best medication choice is for you. That is because so many factors come into play when deciding which one should be prescribed, such as any prescriptions that you are taking for something else, your health status and your specific ADHD symptoms.
Also of note is that many only respond to one or the other, sometimes for reasons that are not readily apparent, so if you are prescribed one and do not experience any improvement, consider asking for a prescription of the other and transitioning to that.
Regardless of which one you are using, keep an eye on any side effects that you may experience, particularly the more serious ones that you should seek medical attention for. That said, also keep in mind the benefits of taking one of these to treat your ADHD and how it might be able to benefit your life in numerous ways.
If you have ADHD and a substance use disorder, consider reaching out to us at Live Free Recovery for treatment. One of our specialties is helping those with co-occurring disorders recover in a specialized manner that, in this case, takes into account how ADHD affects the substance use disorder and how the substance use disorder affects ADHD.