Highlights
- Focalin, dexmethylphenidate, and Adderall, an amphetamine, are stimulant medications prescribed for ADHD treatment.
- Adderall and Focalin work in the same way and share several side effects and interactions but they also have differences, such as their composition and distinct adverse effects.
- Your medical history and a detailed examination will determine which of these medications is appropriate for you, and a healthcare provider may also recommend other options, including non-stimulants.
Living with attention deficit hyperactivity disorder (ADHD) can be overwhelming, and it is natural to want to learn as much as possible about the condition and its treatment options.
Focalin and Adderall are two names that often come up in this quest for ADHD knowledge. Although it is important to learn about these medications and their differences, ultimately, the decision about your treatment plan will be personalized, just for you, by your healthcare provider.
In the meantime, let’s answer your questions about these medications.
Are Focalin and Adderall the Same Thing?
Yes and no!
Yes, they are both:
- FDA-approved ADHD medications.
- In the same drug class as brain stimulants (central nervous system stimulants).
- Only available by prescription from a licensed medical provider.
- Classified as Schedule II controlled substances by the Drug Enforcement Administration (DEA) due to a risk of addiction in certain individuals.
Stimulants are usually the first-line choice for ADHD, should your doctor decide that medication is the next best step. In fact, they successfully
It makes sense to assume that because they are from the same class of medication, they have many similarities, which is correct; and we’ll discuss their differences later.
How They Work
Firstly, they work in the same way; Focalin, like Adderall, results in a higher concentration of the brain’s messengers (neurotransmitters), norepinephrine and dopamine, between the nerves. This helps manage the most common ADHD symptoms.
Dosing Similarities
Both
- Shorter-acting (4 to 6 hours) immediate-release (IR) tablets.
- Longer-acting (
up to 12 hours [6*] ) extended-release (XR) capsules.
Next, the basic dosing rules that your doctor will follow for Focalin and Adderall are similar if you are starting a stimulant for the first time:
- ‘Start low and go slow.’ This means starting on the lowest dose and increasing it weekly until ADHD symptoms are controlled.
- The first dose is taken in the morning when you wake up.
- They can be taken with or without food.
The tablet and capsule strengths and time between doses vary; we’ll discuss that later.
Drug Interactions They Share
Here, they have three similar drug interactions, which can be serious:
- Taking Focalin or Adderall is not allowed if you are taking a group of antidepressants called monoamine oxidase inhibitors because of the
risk of dangerously high blood pressure [7*] . - Also, other antidepressants that increase levels of the neurotransmitter serotonin (tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs)) have a risk of a
life-threatening reaction [8*] called serotonin syndrome. Therisk of this condition is higher [9*] when taking these antidepressants with Adderall. This is why telling your doctor about all the medication you are taking is extremely important. - All blood pressure medications, including beta-blockers, are affected; Focalin and Adderall cause them to not lower blood pressure well.
There are, however, interactions unique to each of these medications, also covered later, that your doctor will consider.
As with the drug interactions listed above, certain medical situations should be avoided when taking either Adderall or Focalin.
Warnings & Precautions That Are the Same
Because of their similar effect on your brain and body, taking Focalin or Adderall is not advised if you have:
- A risk of addiction and dependence
- An allergy to the medication itself
- Heart problems
- A high heart rate
- High blood pressure
- Poor blood circulation to the hands and feet
- Tics or Tourette syndrome
- Bipolar disorder with manic episodes
- Psychosis: seeing, hearing, or believing things that aren’t real
- A history of aggression
- High eye pressure
- A history of seizures
However, the risk for each medication in the above conditions is different; this is why, depending on your history, one might be a better option for you than the other. Your doctor will decide which is better for you or, possibly, whether stimulants are appropriate at all.
Their similar effects can also lead to shared side effects.
Shared Side Effects
Next, we will discuss unwanted reactions common to Adderall and Focalin. Later, we will discuss effects that are unique to each of them.
Most common effects:
- Dry mouth
- Decreased appetite and possible weight loss
- Nausea
- Anxiety
- Nervousness, agitation, or feeling jittery
- Poor sleep patterns
- Dizziness
- Irregular heartbeat
- High heart rate
- High blood pressure
- Sustained painful erections
Most potentially serious effects:
- Allergic reactions and skin rashes
- Pain and changes in temperature and color of fingers and toes
- Changes in vision or eye pain
So, now that you understand their similarities, we’ll proceed to the ‘no, they are not the same’ part.
What Are the Primary Differences? Focalin vs. Adderall
Let’s chat about why Focalin and Adderall aren’t the same thing.
Active Ingredients
The generic—or active—Adderall ingredients are mixed amphetamine salts, while the generic Focalin element is dexmethylphenidate, a family of methylphenidate drugs. Other commonly prescribed methylphenidate-based medications are Ritalin and Concerta."
Methylphenidate accounted for 80% of ADHD medication prescriptions in the late 1980s and 1990s, but these days, in the USA,
Because of these generic bases, people treated with Focalin (dexmethylphenidate) or Adderall (amphetamines) might have slightly different effects and interactions, and their dosing varies.
Approved Uses
You have already read that both Adderall and Focalin are registered for use in ADHD.
In addition, Adderall can be used to treat narcolepsy, a disorder that presents with
In addition, even though both medications are registered in adults and children,
Differences in Dosing
You don’t need to worry too much about this section, as your healthcare professional will take control of your dosing; read it if you are interested in how the correct dose is achieved.
Recommended Adult Dosages: Focalin
Focalin tablets [13*] (IR): 2.5 mg, 5 mg, and 10 mg. A typical starting dose is 2.5 mg twice daily. The maximum dose is 10 mg twice a day.Focalin XR capsules [14*] : 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, and 40 mg. A typical initial dose is 10 mg once daily in the morning. The maximum dose is 40 mg.
Recommended Adult Dosages: Adderall
Adderall tablets [15*] (IR): 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg and 30 mg. A typical starting dose is 5 mg once or twice a day. The maximum dose is 40 mg a day.Adderall XR capsules [16*] : 5 mg, 10 mg, 15 mg, 20 mg, 25 mg and 30 mg. A typical initial dose is 20 mg once daily in the morning. The maximum dose is 40 mg.
Typical dosages are provided for informational purposes only. Please consult your healthcare provider and follow their instructions.
Immediate-release Adderall (Adderall IR tablets) has been in short supply in recent years (2022 until the time of writing), so many patients followed their medical providers’ recommendation to switch to extended-release formulation (Adderall XR capsules).
Another treatment option that MDs considered due to the lack of available immediate-release Adderall was switching patients to Focalin or other methylphenidate-based medicines. To work out the dosage of Focalin equivalent to Adderall, they use a recommended dosage conversion tool and individual health specifics to prevent a symptom relapse.
What other differences are there?
Side Effects and Drug Interactions Unique to Each Medication
Earlier, we discussed the shared unwanted effects and drug interactions to watch out for; here, you will learn about situations specific to Focalin and Adderall.
Common Side Effects
Unique side effects of Adderall:
- Aggression
- Impotence
- Urine infections
Unique Focalin side effects:
- Sore throat
- Sore stomach
- Fever
Usually, side effects of all stimulants are annoying and not tolerated well, even if they are mild; this means that the medication needs to be stopped or changed, as most side effects don’t disappear with time.
Drug Interactions
There is a higher risk of life-threatening serotonin syndrome when Adderall is taken with SSRIs, SNRIs, tricyclic antidepressants, or the following medications:
- Triptans used to treat migraines
- Buspirone, an anxiety medication
- Opiate painkillers such as tramadol and fentanyl
- Tryptophan supplements
- St. John’s Wort
Other interactions of Adderall:
- Tricyclic antidepressants: Adderall increases the risk of serious and sudden heart effects.
- Antacids and urinary alkalizers: Any medication that stops a ‘burn’ increases the Adderall effect.
- Proton pump inhibitors (PPIs): These medications used for inflamed stomachs, stomach ulcers, and heartburn decrease the effect of Adderall.
- Lithium: This mood stabilizer decreases the effect of Adderall.
- Haloperidol: This antipsychotic decreases the effect of Adderall.
Focalin interacts with the following:
- Certain anesthetics: Increase the risk of a sudden surge in heart rate and blood pressure.
- Risperidone: Focalin increases the risk of stiffness, tremors, and restlessness.
Although these are the more common interactions and effects, they are not the only possibilities; you should always tell your doctor what medication you are taking, whether long-term or even cold or flu, because they might clash.
Also, if you ever experience unusual symptoms after starting a new medication, speak to your doctor.
Comparing Efficacy: Is It True That Focalin Is More Powerful Than Adderall?
So, which medication works better?
It is a myth that Focalin is stronger than Adderall. The simple answer is that what works for one person might not be as effective for you. When choosing an ADHD medication, your healthcare provider will focus on which one is best for you, taking into account the many factors we have discussed in this article.
Focalin Compared to Adderall: A Quick Reference TableFocalin Compared to Adderall: A Quick Reference Table
Adderall | Focalin | |
Class of medication |
|
|
Active generic ingredients | Mixed amphetamine salts | Dexmethylphenidate |
Used for |
|
|
Types and how long do they work |
|
|
Typical initial and maximum doses for adults with ADHD | Adderall tablets
| Focalin tablets:
|
Adderall XR capsules
| Focalin XR capsules
| |
Medications to avoid |
|
|
Medications to use with caution |
|
|
Warnings |
| |
Shared unwanted effects | Most common effects
Most potentially serious effects
| |
Unique unwanted effects |
|
|
Summing Up: Which Is Right for You?
Ultimately, your doctor will make this decision.
Usually, behavioral therapy and self-help techniques will be recommended early in an ADHD treatment plan, and there are many factors that your healthcare provider will consider before prescribing any medication for an ADHD diagnosis.
As a result, during the consultation, they will take a thorough medical and family history to ensure Focalin or Adderall is safe to consider. Next, they might request information about your heart and blood pressure.
You have to start somewhere, so book your consultation today and take the first step toward personalized ADHD treatment.
