From the Guidelines
Strattera, also known as atomoxetine, is a non-stimulant medication primarily used to treat attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults by increasing levels of norepinephrine in the brain. According to the most recent study 1, atomoxetine works by binding to the norepinephrine transporter, thereby increasing synaptic noradrenaline and dopamine in the prefrontal cortex.
Key Characteristics of Strattera
- It is orally administered and primarily metabolized through the cytochrome P450 2D6 (CYP2D6) pathway 1.
- The medication is available in capsules containing 10,18,25,40,60,80, or 100 mg of atomoxetine hydrochloride, as well as in an oral solution (4 mg/ml) 1.
- Titration follows a sequential, weight-based approach, with a maximum recommended dosage of 1.4 mg/kg/day or 100 mg/day, whichever is lower 1.
Important Considerations
- Analyses of twelve placebo-controlled trials in children and adolescents showed a greater risk of suicidal ideation during treatment with atomoxetine, leading to special warnings by federal agencies and regulatory bodies 1.
- Common adverse effects of atomoxetine include nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence 1.
- Approximately 7% of the population are poor metabolizers of atomoxetine, which may lead to increased adverse effects due to significantly higher plasma levels and longer half-lives 1.
From the FDA Drug Label
Atomoxetine hydrochloride is a selective norepinephrine reuptake inhibitor medicine. It is used for the treatment of attention deficit and hyperactivity disorder (ADHD). Atomoxetine hydrochloride may help increase attention and decrease impulsiveness and hyperactivity in patients with ADHD
Strattera is another name for the medication atomoxetine, which is a selective norepinephrine reuptake inhibitor used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) 2 2.
From the Research
What is Strattera
- Strattera, also known as atomoxetine, is a selective norepinephrine reuptake inhibitor that is not classified as a stimulant 3.
- It is indicated for use in patients with attention-deficit hyperactivity disorder (ADHD) 3, 4, 5.
- Atomoxetine is effective and generally well tolerated, with a negligible risk of abuse or misuse, and is not a controlled substance in the US 3, 5.
Mechanism of Action
- The mechanism of action of atomoxetine is unclear, but is thought to be related to its selective inhibition of presynaptic norepinephrine reuptake in the prefrontal cortex 3.
- Atomoxetine has a high affinity and selectivity for norepinephrine transporters, but little or no affinity for various neurotransmitter receptors 3.
Efficacy
- Atomoxetine is effective in the short-term and long-term treatment of ADHD in children and adolescents 3, 4.
- It is also effective in adults with ADHD, with improvements in ADHD symptoms and quality of life 5.
- Combined therapy with methylphenidate and atomoxetine may enhance the effectiveness of monotherapy in some patients 6.
Safety and Tolerability
- Atomoxetine is generally well tolerated, with common adverse events including headache, abdominal pain, decreased appetite, vomiting, somnolence, and nausea 3, 4.
- It may be associated with an increased risk of suicidal ideation, seizures, arterial hypotension, tachycardia, and hepatic disorders 7.
- Atomoxetine carries a risk of multiple drug interactions due to its metabolism by the cytochrome P450 isoenzyme 2D6 and its inhibitory effect on noradrenaline reuptake 7.