Attention-deficit/hyperactivity disorder is a neurologically based disorder that results from the deficiency of neurotransmitters in specific areas of the brain.
Medications can help decrease attention-deficit/hyperactivity disorder symptoms in children and adults.
These medications are designed to increase the ability of the ADHD patients to manage their impulses and activity level and pay attention.
Talking to your healthcare professional is the most recommended way to choose the right medication.
Stimulant Drugs
There are 3 forms of stimulants available:
- immediate-release (short-acting);
- intermediate-acting (last longer than short-acting versions);
- extended-release (intermediate-acting and long-acting).
Immediate-release medications are typically taken every 4 hours when required.
These drugs improve attention-deficit/hyperactivity disorder symptoms in about 70 percent of adults and 70 to 80 percent of children shortly after starting treatment.
Stimulant medications include:
- Vyvanse® (long-acting);
- Adderall XR® (long-acting);
- Adderall® (intermediate-acting);
- Ritalin SR® (intermediate-acting);
- Ritalin LA® (long-acting);
- Ritalin® (short-acting);
- Concerta® (long-acting);
- Methylin™ ER (intermediate-acting);
- Daytrana® (long-acting patch);
- Metadate® ER (intermediate-acting);
- Metadate CD® (long-acting);
- Focalin XR® (long-acting);
- Focalin® (short-acting);
- Dexedrine® Spansule® (intermediate-acting);
- Dexedrine® (short-acting).
Note – stimulants for attention-deficit/hyperactivity disorder can exacerbate or trigger symptoms of aggression, anxiety, hostility, paranoia, and depression.
Non-Stimulants
These drugs affect neurotransmitters, however, they don’t increase dopamine levels.
Common non-stimulants drugs include:
- Kapvay (extended release clonidine);
- Intuniv (extended release guanfacine);
- Strattera (atomoxetine).
Note – non-stimulant drugs are recommended when stimulants have caused intolerable side effects or haven’t worked.
Other Medications
Other medications are sometimes used for attention-deficit/hyperactivity disorder, like – antipsychotics and antidepressants.
Therapy
Besides medication, there are different therapies which can be effective in treating attention-deficit/hyperactivity disorder in children, teenagers, and adults. The range of non-medication therapies used for attention-deficit/hyperactivity disorder can include:
- family counseling;
- behavior modification;
- social training;
- anger management;
- cognitive therapy.
Here is a comparison between Evekeo and Adderall, two drugs that are used for the treatment of ADHD:
Evekeo
It is an immediate-release, short-acting stimulant medication which was approved by the US Food and Drug
Administration in 2014 for the treatment of attention-deficit/hyperactivity disorder symptoms.
Adderall
It is a brand name for a drug that contains dextroamphetamine and amphetamine.
It is available in two formulas:
- Adderall IR (immediate release);
- Adderall XR (extended release).
Uses
Evekeo is used for the following conditions:
- ADHD;
- narcolepsy;
- overweight and obesity.
Aderrall is used for the treatment of ADHD and narcolepsy.
Mechanism of Action, Duration, Half-Life
Evekeo works by increasing the release of dopamine and norepinephrine in extraneuronal space. It has a peak effect of 1.5 to 3.0 hours. The half-life of Evekeo ranges from 10 to 30 hours.
Adderall works by increasing the synaptic concentration of norepinephrine and dopamine. Adderall IR lasts for about 4 hours. Adderall XR is effective for 10 to 12 hours.
Its half-life is 11 hours in adolescents and 10 hours in adults.
Side Effects
Possible side effects of Evekeo include:
- high blood pressure;
- swelling of the face, lips, or tongue;
- breathing problems;
- itching or hives;
- diarrhea;
- skin rash;
- prolonged or painful erection;
- dry mouth;
- changes in emotions or moods;
- trouble sleeping;
- fingers or toes feel numb;
- stomach pain;
- loss of contact with reality;
- nausea;
- feeling faint or lightheaded;
- loss of appetite;
- heart palpitations;
- headache;
- loss of balance or coordination;
- fever;
- fast or irregular heartbeat;
- dizziness;
- uncontrollable head, neck, arm, mouth, or leg movements;
- trouble speaking or understanding;
- suicidal thoughts;
- changes in vision.
Possible side effects of Adderall include:
- diarrhea;
- nervousness;
- loss of appetite;
- restlessness;
- weight loss;
- difficulty falling asleep;
- fast or pounding heartbeat;
- uncontrollable shaking of a part of the body;
- excessive tiredness;
- headache;
- faintness;
- changes in sex drive;
- seizures;
- dry mouth;
- believing things that are not true;
- stomach pain;
- hallucinating;
- nausea;
- hostile behavior;
- vomiting;
- hoarseness;
- constipation;
- difficulty breathing or swallowing;
- shortness of breath;
- swelling of the eyes, tongue, face, or throat;
- chest pain;
- hives;
- slow or difficult speech;
- blistering or peeling skin;
- dizziness;
- fever;
- numbness of an arm or leg;
- changes in vision or blurred vision;
- feeling unusually suspicious of others;
- verbal tics.
Dosage
Evekeo
For the treatment of attention-deficit hyperactivity disorder:
- Children 3 to 5 years – 2.5 mg PO once per day in the morning. An additional 1 to 2 doses may be given at 4 to 6-hour intervals if required. Maximum dosage is 40 mg per day.
- Children and Adolescents 6 to 17 years – 5 mg PO once or two times per day initially. An additional 1 to 2 doses may be given at 4 to 6-hour intervals if required. Maximum dosage is 40 mg per day.
- Adults – the initial dose is 5 or 10 mg PO daily upon awakening. The daily dose may be raised in increments of 5 to 10 mg at weekly intervals until optimal response is obtained. Maximum dosage is 60 mg per day.
Adderall
Both Adderall IR and Adderall XR are available in tablets ranging from 5mg to 30mg.
For the treatment of attention-deficit hyperactivity disorder:
- Children from 3 to 5 years of age – the initial dose is 2.5 mg per day. The dosage may be increased with 2.5 mg every seven days until a good response is obtained.
- Children 6 years of age and older – the initial dose is 5 mg once or two times per day. The dosage may be increased with 5 mg every seven days until a good response is obtained. Maximum dosage is 40 mg per day.
Warnings & Precautions
Patients with a history of substance addiction or abuse should inform their healthcare professional before using Evekeo.
Also, other patients who should not take this medication include those who have:
- taken an antidepressant called a monoamine oxidase inhibitor within the past 2 weeks;
- agitation;
- thyroid problems;
- tension;
- allergies to any of the ingredients in this medication;
- moderate to severe high blood pressure;
- hardening of the arteries (atherosclerosis);
- heart problems.
Adderall is not intended for use in children who exhibit symptoms which indicate primary psychiatric disorders or exhibit symptoms that are secondary to environmental factors. Also, this drug should not be used by people with a history of:
- Tourette syndrome;
- agitation;
- severe anxiety;
- glaucoma.
Drug Interactions
Evekeo may interact in a negative way with the following medications:
- Zoloft (sertraline);
- bupropion (a medication primarily used as a smoking cessation aid and as an antidepressant);
- Trintellix (vortioxetine);
- Lexapro (escitalopram);
- Fetzima (levomilnacipran).
Adderall may interact in a negative way with the following medications:
- Cymbalta (duloxetine);
- Zoloft (an antidepressant medication of the selective serotonin reuptake inhibitor class);
- Lexapro (escitalopram);
- Wellbutrin (bupropion);
- Tramadol;
- Prozac (fluoxetine);
- omeprazole.
Alcohol
These ADHD medications should not be mixed with alcohol since adverse cardiac side effects are even more likely to occur.
Is It Safe During Pregnancy or Breastfeeding?
These ADHD medications should be used during pregnancy only if the possible benefits outweigh the potential risk to the fetus.
Also, during breastfeeding, these stimulants may pass into breast milk and cause side effects in a nursing infant.
Bottom Line – Evekeo vs Adderall
Evekeo (amphetamine) is an amphetamine-based stimulant medication US FDA approved for the treatment of ADHD in patients ages 3 and older.
Less commonly, the drug is prescribed to treat obesity and narcolepsy.
Adderall (amphetamine and dextroamphetamine) is a stimulant medication containing the drugs which come in two basic forms: standard and an extended release product.
It is used to treat ADHD and narcolepsy.
Sources https://www.ncbi.nlm.nih.gov/pubmed/25692608 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1524735/ https://www.sas.upenn.edu/~mfarah/pdfs/Creativity-Psychopharm.pdf http://pediatrics.aappublications.org/content/110/2/258?download=true https://hub.jhu.edu/2016/02/16/adderall-abuse-rising-young-adults/