Strattera (atomoxetine) is a selective norepinephrine reuptake inhibitor (SNRI) approved by the FDA for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children, adolescents, and adults. As the first non-stimulant medication specifically developed for ADHD management, it offers a distinct pharmacological profile, providing a valuable option for patients who cannot tolerate or have contraindications to stimulant-based therapies. Its mechanism of action focuses on increasing norepinephrine in the prefrontal cortex, a key area for attention and executive function, leading to improved symptom control without the potential for abuse or dependence associated with stimulants.

Features

• Active Ingredient: Atomoxetine hydrochloride
• Drug Class: Selective Norepinephrine Reuptake Inhibitor (SNRI)
• Available Forms: Capsules (10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg)
• Prescription Status: Requires a prescription; not a controlled substance
• Onset of Action: Full therapeutic effects may take 2–4 weeks to manifest
• Duration: Provides 24-hour symptom coverage with once or twice-daily dosing

Benefits

• Reduces core ADHD symptoms, including inattention, hyperactivity, and impulsivity, through norepinephrine modulation.
• Offers a non-controlled substance alternative, eliminating concerns about abuse, diversion, or dependency.
• Provides all-day symptom management with a single daily dose, supporting consistent performance at school, work, and home.
• Suitable for patients with comorbid anxiety or tic disorders, where stimulants may be less ideal.
• May improve executive functioning, emotional regulation, and overall quality of life.
• Can be taken with or without food, offering flexibility in daily routine.

Common use

Strattera is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in patients aged 6 years and older. It is used to reduce symptoms such as difficulty sustaining attention, organizational challenges, excessive talking, fidgeting, and impulsive decision-making. It is often prescribed when stimulant medications are ineffective, poorly tolerated, or contraindicated due to substance use history, cardiovascular risk, or coexisting conditions like anxiety disorders. It is not approved for use in children under 6 years of age.

Dosage and direction

Dosage must be individualized based on age, weight, and clinical response. For children and adolescents up to 70 kg body weight, the initial dose is approximately 0.5 mg/kg/day, which may be increased after a minimum of 3 days to a target daily dose of approximately 1.2 mg/kg. For patients over 70 kg (adults and heavier adolescents), the starting dose is 40 mg daily, which may be increased after a minimum of 3 days to a target dose of 80 mg daily. The maximum recommended daily dose is 100 mg. Strattera may be administered as a single daily dose in the morning or divided into two doses (morning and late afternoon/early evening). Capsules should be swallowed whole and not opened, chewed, or crushed.

Precautions

Patients should be monitored for the emergence of suicidal ideation, especially during the initial months of treatment or after dosage changes. Blood pressure and heart rate should be checked regularly due to potential increases. Use with caution in patients with hypertension, tachycardia, cardiovascular disease, or cerebrovascular disorders. May cause severe liver injury in rare cases; discontinue if jaundice or laboratory evidence of liver injury appears. May affect urinary outflow; use caution in patients with urinary retention. Angle-closure glaucoma has been reported. May cause somnolence or fatigue; advise patients to avoid driving or operating machinery until they know how Strattera affects them.

Contraindications

Hypersensitivity to atomoxetine or any component of the formulation. Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to risk of serotonin syndrome. Narrow-angle glaucoma. Severe cardiovascular disorders that could be exacerbated by increases in blood pressure or heart rate.

Possible side effect

Common side effects include: nausea, vomiting, dyspepsia, decreased appetite, weight loss, fatigue, drowsiness, dizziness, mood swings, irritability, and insomnia. Less common but serious side effects may include: suicidal thoughts (especially in children and adolescents), severe liver injury, priapism (prolonged and painful erection), Raynaud’s phenomenon, orthostatic hypotension, syncope, tachycardia, hypertension, allergic reactions (e.g., angioedema, rash), and urinary retention. Patients should report any unusual or severe symptoms to their healthcare provider promptly.

Drug interaction

Concomitant use with MAOIs is contraindicated. May interact with drugs that inhibit CYP2D6 (e.g., paroxetine, fluoxetine, quinidine), potentially increasing atomoxetine levels. Use with albuterol or other beta2-adrenergic agonists may potentiate cardiovascular effects. Caution with drugs that affect blood pressure. Potential pharmacodynamic interaction with other norepinephrine-affecting agents.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose may include drowsiness, agitation, hyperactivity, abnormal behavior, gastrointestinal symptoms, tachycardia, hypertension, and mydriasis. There is no specific antidote; provide supportive care and monitor cardiac and vital signs. Gastric lavage or activated charcoal may be considered if ingestion was recent. Contact a poison control center for latest guidance.

Storage

Store at room temperature (20–25°C or 68–77°F); excursions permitted between 15–30°C (59–86°F). Keep in a tightly closed container away from light, moisture, and heat. Keep out of reach of children and pets.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

Clinical trials and post-marketing studies demonstrate Strattera’s efficacy in reducing ADHD symptoms across age groups, with particular benefit noted in patients who cannot use stimulants. Many patients and clinicians report improved focus, reduced impulsivity, and better daily functioning. Common criticisms include slower onset of action compared to stimulants and a higher incidence of gastrointestinal side effects. Adherence to dosing and patience during the titration period are frequently emphasized for optimal outcomes.