Strattera vs. Qelbree

See how Strattera and Qelbree compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Strattera and Qelbree are both non-stimulant ADHD medications that are not controlled substances, but they work through different mechanisms involving norepinephrine and, for Qelbree, serotonin.

  • Strattera reaches its full daily dose within about a week, while Qelbree takes up to five weeks to titrate to its highest maintenance dose.

  • Generic atomoxetine is available for Strattera at a lower cost, while Qelbree currently has no generic version.

Strattera vs. Qelbree Drug Summary

Strattera

Strattera (atomoxetine) is a selective norepinephrine reuptake inhibitor approved to treat ADHD in patients age 6 and older. It comes as an oral capsule taken once daily or split into two doses, with dosing based on body weight in children and a fixed dose in adults. Since the brand-name product was discontinued in 2024, it is now available only as generic atomoxetine.

Qelbree

Qelbree (viloxazine) is a selective norepinephrine reuptake inhibitor approved to treat ADHD in adults and children age 6 and older. It is taken as a once-daily extended-release capsule that can be swallowed whole or opened and sprinkled on food. Qelbree was approved in 2021 and uses a mechanism that also affects serotonin activity.

Strattera vs. Qelbree Side Effects

Strattera

Most common
nausea (up to 26%)
decreased appetite (up to 25%)
dry mouth (up to 21%)
abdominal pain (up to 18%)

Qelbree

Most common
nausea (up to 5%)
decreased appetite (up to 5%)
somnolence (up to 16%)
fatigue (up to 12%)

Strattera vs. Qelbree Dosage

Strattera

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.5 mg/kg/day Days 1-3
Maximum dose 100 mg once daily Week 5 onward
Dose changes 4 increases As tolerated

Qelbree

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 100 mg once daily Week 1
Maximum dose 600 mg once daily Week 5 onward
Dose changes 4 increases Every week

Strattera vs. Qelbree Indications

Strattera

Strattera is FDA-approved for ADHD in children, adolescents, and adults age 6 and up. It is not approved to treat narcolepsy or depression, even though some clinicians have explored it off-label for these conditions. Its approval has been in place since 2002, giving it a long history of clinical use.

  • Treats ADHD in patients age 6 and older

  • Not approved for narcolepsy (off-label only)

  • Not approved for depression (off-label only)

  • Non-stimulant option available since 2002

  • Not a controlled substance

Qelbree

Qelbree is FDA-approved for ADHD in adults and children age 6 and older. It is not approved for bipolar disorder or major depressive disorder, though its serotonin-related activity has drawn research interest in these areas. It has been available since 2021, making it a newer option in the non-stimulant category.

  • Treats ADHD in adults and children age 6+

  • Not approved for bipolar disorder (off-label only)

  • Not approved for major depressive disorder (off-label only)

  • Newer non-stimulant option approved in 2021

  • Not a controlled substance

Strattera vs. Qelbree Pros and Cons

Strattera

Strattera has more than two decades of clinical use and is now available as a lower-cost generic. Its side effect profile is well-characterized, though it carries specific contraindications around eye and adrenal gland conditions and a cardiac warning for people with structural heart abnormalities.

Pros

  • Available as lower-cost generic atomoxetine

  • Weight-based dosing allows precise titration in children

  • More than 20 years of clinical safety data

  • Can be split into two daily doses for tolerability

Cons

  • Higher reported rates of nausea and appetite loss

  • Contraindicated in narrow angle glaucoma and pheochromocytoma

  • Capsules should not be opened before swallowing

  • Carries a specific warning for structural heart abnormalities

Qelbree

Qelbree offers a novel mechanism that also affects serotonin activity and a sprinkle-on-food option for people who have trouble swallowing capsules. As a newer drug with no generic version, it has a longer titration schedule and less long-term safety data than Strattera.

Pros

  • Capsules can be opened and sprinkled on food

  • Novel mechanism affecting both norepinephrine and serotonin

  • No specific structural heart abnormality warning

  • Flexible dosing with or without food

Cons

  • No generic version currently available

  • Longer titration schedule, up to five weeks to max dose

  • Less long-term safety data as a newer drug (2021)

  • Not recommended with CYP1A2 drugs like theophylline

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