Atomoxetine (brand name Strattera) is a non-stimulant medication used for ADHD. It’s a selective norepinephrine reuptake inhibitor (NRI), not a stimulant like methylphenidate or amphetamines.
Key points
- Who it’s for
- Approved for ADHD in children 6 years and older, adolescents, and adults.
- Sometimes chosen when stimulants aren’t suitable (e.g., for tics, anxiety, substance-use concerns, or need for non-stimulant therapy).
- How it works
- Increases norepinephrine levels in parts of the brain (especially prefrontal cortex) to help improve attention and impulse control.
- How to take it
- Taken by mouth, can be with or without food, but try to be consistent.
- Dosing is age- and weight-dependent; you should follow your healthcare provider’s exact instructions. Typical guidelines:
- Children 6+ and adolescents (weight-based): Start about 0.5 mg/kg/day for 3 days, then increase to about 1.0 mg/kg/day (not to exceed 100 mg/day). Some guidelines use up to about 1.2 mg/kg/day if needed, still with a 100 mg/day maximum.
- Adults: Start 40 mg once daily, then after 3 days increase to 80 mg/day. If needed, can increase to 100 mg/day.
- It may take several weeks (often 2–4 weeks, sometimes longer) to see the full benefit.
- Common side effects
- Nausea or stomach upset, stomach pain
- Decreased appetite and weight loss
- Sleep disturbances (insomnia or vivid dreams)
- Dry mouth, dizziness, fatigue
- Mood changes (e.g., irritability)
- Important safety notes
- Blood pressure and heart rate can go up; monitor for symptoms like headache, chest pain, fainting, or unusually fast/slow heartbeats.
- Rare but serious liver injury has been reported; seek urgent care if you notice yellowing of the skin/eyes, dark urine, severe abdominal pain, or unusual fatigue.
- Can increase risk of suicidal thoughts/behaviors in some children and teens; close monitoring is important, especially when starting or changing dose.
- Not recommended with monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping an MAOI.
- Caution in people with glaucoma or pheochromocytoma; discuss other medical conditions with your provider.
- Dosing and monitoring
- Start doses are lower and increase gradually to minimize side effects.
- Regular follow-up with your clinician is important to track efficacy and tolerability.
- For kids, clinicians often monitor growth (height/weight) and blood pressure periodically.
- Pros vs. stimulants
- Benefits include no buildup of tolerance in the same way stimulants can, and no abuse potential in the same sense.
- May be less effective for some people than stimulant medications; some patients respond best to a stimulant, others to atomoxetine, and some to a combination.
If you’d like, tell me:
- Your or the patient’s age and weight
- Any other meds you’re taking
- Any past ADHD treatments and how they went
- Any health conditions (e.g., high blood pressure, liver issues)
- Whether you’re specifically looking for dosing guidance, side effects, interactions, or safety information
I can tailor the information to your situation and provide more precise dosing ranges and monitoring reminders.