Focalin vs. Adderall: What’s the Difference?

Attention deficit hyperactivity disorder, or ADHD, is estimated to affect 10 percent of children in the United States, which can make learning environments, social settings, and other situations a challenge.  There are numerous prescription medications available for the treatment of ADHD in children and adults, including Focalin and Adderall. When it comes to Focalin vs Adderall, what’s the difference?

Overview

Focalin and Adderall are central nervous system stimulant medications that are available in both generic and brand name forms. 

Adderall consists of two active ingredients, amphetamine and dextroamphetamine, while the active ingredient of Focalin is dexmethylphenidate hydrochloride. Central nervous system stimulants like Focalin and Adderall affect the activity of neurotransmitters in the brain that are associated with hyperactivity and impulsiveness, such as dopamine.

Focalin and Adderall are both categorized as Schedule II controlled substances by the U.S. Drug Enforcement Administration (DEA) due to their high potential for drug abuse and addiction. Schedule II is the highest level of control that can be given to a drug with medical applications.

Conditions Treated

Both Focalin and Adderall are used for the treatment of attention deficit hyperactivity disorder, commonly referred to as ADHD. Adderall is also approved by the FDA for the treatment of narcolepsy, a common sleep disorder. Focalin is sometimes used off-label for the treatment of narcolepsy, but the medication is not approved by the FDA for this purpose.

Attention Deficit Hyperactivity Disorder

ADHD is one of the most commonly diagnosed neurodevelopmental disorders in children in the United States.

While ADHD has existed for centuries, it has become increasingly common over the past several decades. Most people with ADHD are diagnosed with the condition during childhood, but some people may not be diagnosed until adulthood or may not experience symptoms until adulthood, a condition called adult-onset ADHD.  It is common for people with ADHD to experience symptoms from childhood into adulthood, some people find that their symptoms diminish or improve with age.  

The common medical definition of ADHD combines three disorders that were previously classified separately until recently. 

The classic presentation of ADHD is characterized by hyperactivity and impulsive behaviors. 

People who exhibit difficulty focusing or paying attention but who are not hyperactive were previously diagnosed with attention deficit disorder, or ADD, which is the second form of ADHD. 

The third form of ADHD is a combination of the hyperactive-impulsive presentation and the inattentive presentations of the disorder.

 It is common for a patient’s symptoms and presentation to change throughout their lifetime. Common signs and symptoms of ADHD include: 

  • Daydreaming
  • Difficult controlling impulsive behaviors
  • Squirming or fidgeting
  • Forgetting or losing things regularly
  • Difficulty resisting temptation
  • Talking excessively
  • Difficulty getting along with others
  • Hyperactivity
  • Making careless mistakes
  • Difficulty paying attention

Both Focalin and Adderall are approved for the treatment of ADHD and used as treatment options in adults and children. Adderall can be taken by children as young as three years of age, while Focalin should not be used in children under six years of age. 

Cost

Both Adderall and Focalin are available as both generic medications and brand name drugs. The cost of the medications is substantially reduced when the drugs are purchased in the generic forms.

When purchased as generic amphetamine and dextroamphetamine, both the immediate release and extended release versions of the drug are available at a monthly cost of ten dollars or less. By contrast, the brand name versions of Adderall cost approximately 262 dollars for a monthly prescription regardless of whether the immediate or extended-release version of the drug is purchased. The generic version of Adderall is covered by nearly all commercial insurance plans as well as Medicaid and Medicare.

Brand name Focalin XR, the extended-release form of the drug, is significantly more expensive than brand name Adderall. A one-month prescription of Focalin XR typically costs about 408 dollars. 

However, the immediate release brand name version of the medication, Focalin, is much less expensive than the immediate release version of brand name Adderall, at approximately 48 dollars for a one month prescription.  

The generic version of Focalin, dexmethylphenidate, can be obtained for less than 20 dollars for a monthly prescription. The generic and brand name versions of immediate release Focalin are often covered by commercial insurance, as is the generic version of Focalin XR. However, the brand name version of Focalin XR is often not covered. 

Side Effects

Both Adderall and Focalin are associated with numerous side effects, both in pediatric and adult patients, some of which can be serious and may require medical attention. The majority of patients who experience side effects of Adderall or Focalin will experience side effects when they first start using their medication or when their dose of the medication is increased. Some patients may notice that their side effects subside as their body adapts to their medication, while others experience side effects for as long as they use Adderall or Focalin. 

If you experience side effects that are prolonged or severe in nature, make sure to contact your doctor for medical advice, or seek medical attention immediately. 

Adderall

Common side effects of Adderall that normally do not require medical attention include:

  • Dry mouth
  • Stomach pain and stomach upset
  • Weight loss
  • Anxiety
  • Lack or loss of strength

Common serious side effects of Adderall that require immediate medical attention include:

  • Fast, pounding, or irregular heartbeat or pulse/ heart problems
  • Lower back or side pain
  • Difficult, burning, or painful urination
  • Bloody or cloudy urine
  • Bladder pain
  • Frequent urge to urinate

Less common side effects of Adderall that require immediate medical attention include:

  • Headache
  • Diarrhea
  • Chills
  • Shivering
  • Joint pain
  • Vomiting
  • Fever
  • Muscle aches and pains
  • Hoarseness
  • Trouble sleeping
  • Nausea
  • Runny nose
  • Allergic reactions
  • Unusual tiredness or weakness
  • Loss of appetite
  • Sore throat
  • Cough
  • Sweating

Focalin

Common side effects of Focalin vary depending on whether the medication is taken by children or adults. Common side effects reported in children between the ages of 6 and 17 years of age include:

  • Dyspepsia (indigestion)
  • Headache
  • Decreased appetite
  • Anxiety

Common side effects reported in adults include:

  • Dry mouth
  • Headache
  • Pharyngolaryngeal pain (pain in the back of the mouth or the throat)
  • Dyspepsia (indigestion)
  • Anxiety

Serious side effects associated with the use of Focalin include:

  • Priapism (painful or prolonged erections) in both adults and children
  • Unexplained wounds on the fingers or toes
  • High blood pressure or increased heart rate
  • Circulation problems in the fingers or toes, including the development of peripheral vasculopathy or Raynaud’s phenomenon
  • Slowing of growth (height or weight) in children using Focalin

Patients who experience any of the serious side effects associated with Focalin should seek medical attention from a healthcare professional immediately. 

Warnings for Use

Focalin and Adderall are both classified as Schedule II controlled substances because they are associated with a high risk of abuse and addiction. Each drug contains a black box warning due to the potential for abuse and addiction. 

Both drugs are frequently abused by people who do not have a prescription for the medication but who want to improve their focus or concentration for a specific event.  When taken on a regular basis or over a long period of time without a medical need, it is common for people to develop a physical or psychological dependence on Adderall and Focalin.  

Symptoms of dependence may include:

  • Sweating
  • Nausea
  • Anxiety
  • Depression 
  • Nightmares
  • Body aches
  • Vomiting 
  • Muscle weakness

Withdrawal

People who become dependent on Focalin or Adderall can experience withdrawal symptoms when the use of the medication is stopped or reduced dramatically in a short period of time. 

Patients who have been taking Focalin or Adderall for a period of more than two weeks should seek the guidance of a medical professional when reducing their dose of the drug or stopping use of the medication. 

Withdrawal symptoms associated with the discontinuation of Adderall and Focalin can include:

  • Changes in mood
  • Sweating
  • Cravings
  • Anxiety
  • Shaking
  • Fatigue
  • Agitation
  • Sleep disturbances
  • Increased appetite
  • Depression
  • Strange dreams

Medical Concerns

Adderall and Focalin both have the potential to cause serious damage to the heart and cardiovascular system. Adderall comes with a black box warning from the FDA warning of these potential risks. 

Long term Adderall or Focalin abuse can result in the following health conditions: 

  • Hyperactivity
  • Heart disease
  • Insomnia
  • Tremors
  • Constipation
  • Weight loss
  • Feeling jittery or on edge
  • Trouble breathing/shortness of breath
  • Headaches
  • Abdominal pain
  • Dizziness
  • Heart palpitations
  • Dry mouth

Make sure to give your doctor a complete medical history during your consultation, as some medical conditions can make it dangerous to take Focalin or Adderall. 

Disclaimer that you should not take Adderall or Focalin for ADHD treatment if you:

  • Take a type of antidepressants called MAOIs
  • Have anxiety or tension
  • Have glaucoma
  • Are easily agitated
  • Are extremely sensitive to the effects of the medication

Summary

Focalin and Adderall are central nervous system stimulants that are used for the treatment of ADHD. Both medications are available in generic and name brand forms and in both short-acting or immediate-release and long-acting or extended-release (Adderall XR) formulations. 

Focalin is approved for the mental health treatment of ADHD in children as young as six and adults, while Adderall is approved for the treatment of ADHD in children as young as three and adults and for the treatment of narcolepsy in adults. Adderall or focalin can be crushed into applesauce for children who have difficulty swallowing pills. 

The brand name forms of each ADHD medication can be expensive, but you can receive significant cost savings regardless of your insured status by using a pharmacy discount card from USA Rx.

Sources:
https://www.addictioncenter.com/stimulants/adderall/ 
https://americanaddictioncenters.org/adderall/long-term-effects 
https://www.cdc.gov/ncbddd/adhd/data.html 
https://www.webmd.com/drugs/2/drug-22256/focalin-oral/details 
https://www.novartis.us/sites/www.novartis.us/files/focalinXR.pdf

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