What is Atomoxetine?

Atomoxetine (brand name: Strattera) is a prescription medication approved for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children (age 6 and older), adolescents, and adults. It is a non-stimulant and is not considered habit-forming or addictive. 

How Does Atomoxetine Work? 

Atomoxetine increases levels of norepinephrine, a neurotransmitter involved in attention, impulse control, and mood regulation. This helps improve focus, attention, and self-control in people with ADHD. 

Approved and Off-Label Uses 

• FDA-Approved Use:

  • Treatment of ADHD in children (age 6+), adolescents, and adults. 

• Off-Label Uses:

  • Atomoxetine may be used off-label for certain conditions such as treatment-resistant depression, anxiety disorders (especially in patients with ADHD), and binge eating disorder. Off-label use should be based on clinical judgment and available evidence. 

How to Take Atomoxetine 

• Take atomoxetine once daily or split into two doses (morning and late afternoon/early evening). 

• May be taken with or without food. 

• Swallow capsules whole; do not open, crush, or chew. The contents can irritate the eyes and mucous membranes. 

Common Side Effects: 

• Upset stomach, nausea, vomiting 

• Decreased appetite, weight loss 

• Sleepiness or trouble sleeping 

• Dry mouth 

• Dizziness 

• Mood changes (irritability, mood swings) 

• Increased heart rate or blood pressure 

Serious Side Effects (Contact your healthcare provider immediately if these occur): 

• Yellowing of the skin or eyes, dark urine, itching, or flu-like symptoms (possible liver problems) 

• Chest pain, shortness of breath, fainting, or irregular heartbeat 

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• New or worsening mood changes, depression, or thoughts of suicide 

• Unusual aggression or hostility 

• Painful or prolonged erections (priapism) 

• Difficulty urinating 

Special Considerations 

• Pregnancy & Breastfeeding: The safety of atomoxetine during pregnancy and breastfeeding is not fully established. 

• Children: Approved for children age 6 and older. Monitor growth (height and weight) during treatment, as some children may experience slowed growth, which often normalizes over time. 

• Older Adults: Limited data are available. Use caution, especially in those with cardiovascular conditions. 

• Heart & Blood Pressure: Atomoxetine can increase heart rate and blood pressure. Monitor these parameters before and during treatment, especially in patients with a history of heart disease, high blood pressure, or stroke. 

• Liver: Rarely, atomoxetine can cause serious liver injury. Monitor for symptoms such as yellowing of the skin/eyes or dark urine. 

• Mental Health: Atomoxetine may increase the risk of suicidal thoughts, particularly in children and adolescents. Monitor for new or worsening mood or behavior changes. 

Monitoring & Drug Interactions 

• Blood pressure and heart rate should be checked regularly. 

• Growth (height and weight) should be monitored in children. 

• Liver function tests may be indicated if symptoms of liver dysfunction develop. 

• Atomoxetine is metabolized by the liver enzyme CYP2D6. Certain medications (e.g., fluoxetine, paroxetine, some heart medications) can affect atomoxetine levels. 

• Do not use atomoxetine with monoamine oxidase inhibitors (MAOIs) or within 2 weeks of stopping an MAOI. 

• Use caution with other medications that affect heart rate or blood pressure. 

Additional Information 

• If you miss a dose, take it as soon as you remember. Do not take more than the prescribed amount in one day. 

• Store at room temperature, away from moisture and heat. 

• Keep out of reach of children.