Atomoxetine (Strattera) for attention deficit hyperactivity disorder

Examples

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Brand Name	Generic Name
Strattera	atomoxetine

How It Works

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Atomoxetine (Strattera) strengthens the chemical signals between brain cells and also increases certain brain chemicals, called neurotransmitters, to improve concentration. It is not a stimulant.

Why It Is Used

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Atomoxetine is used to treat attention deficit hyperactivity disorder (ADHD) in children, teens, and adults.

It is sometimes recommended instead of stimulant medications, such as amphetamine (examples include Dexedrine or Adderall) and methylphenidate (examples include Ritalin, Concerta, Metadate CD, or Focalin) for people who have bothersome side effects from those medications.

For example, about 10% to 35% of people with ADHD also have tics, such as spasms of the muscles of the face (facial tic), clearing the throat, sniffing, and excessive blinking. Stimulant medications for ADHD may make tics worse. Recent research found that atomoxetine did not make tics worse.¹

How Well It Works

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Several studies have shown atomoxetine to effectively control the symptoms of ADHD in children and adults.²

Atomoxetine does not start working as quickly as stimulant medications. Reports suggest that full effects are often not seen until the person has been taking atomoxetine regularly for at least 3 or 4 weeks.

Side Effects

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Possible side effects include:

• Decreased appetite.
• Upset stomach.
• Nausea or vomiting.
• Dizziness.
• Tiredness.
• Mood swings.

Growth is sometimes slowed in children taking atomoxetine, but it is not known if this delay is permanent.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory on Strattera. It suggests that parents and other caregivers closely watch for warning signs of suicide in children and teens taking this medicine.³ The FDA does not recommend that people stop using this medicine, but to watch for warning signs of suicide in those using it.

It is important for parents to be honest with their child about the possible risks and benefits of the medicine. Talk to your child about whether he or she is having any suicidal thoughts. Tell your child to come to you if he or she has suicidal thoughts in the future.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Atomoxetine can be taken once or twice a day.

Atomoxetine may be an alternative for those people who have bothersome side effects from stimulants, such as nervousness, irritability, or tics.

Atomoxetine is more convenient than stimulant medications because you can obtain prescription refills over the phone.

Unlike stimulant medications, atomoxetine does not have the potential for abuse.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Allen AJ, et al. (2005). Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology, 65(12): 1941–1949.

2. Greydanus DE, et al. (2003). Attention-deficit/hyperactivity disorder in children and adolescents: Interventions for a complex costly clinical conundrum. Pediatric Clinics of North America, 50(5): 1049–1092.

3. U.S. Food and Drug Administration (2005). FDA issues public health advisory on Strattera (atomoxetine) for attention deficit disorder. FDA News P05-65. Available online: http://www.fda.gov/bbs/topics/NEWS/2005/NEW01237.html.

Credits

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Author	Jeannette Curtis
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Mina Dulcan, MD - Child and Adolescent Psychiatry
Last Updated	April 17, 2008