From the Guidelines
Yes, atomoxetine should be tapered off when discontinuing treatment rather than stopped abruptly, as abrupt discontinuation may lead to potential discontinuation symptoms. A gradual taper over 1-2 weeks is generally recommended, though specific tapering schedules aren't as strictly defined as with some other medications. For example, if someone is taking 80mg daily, they might reduce to 40mg daily for one week before stopping completely. Tapering helps minimize potential discontinuation symptoms such as irritability, mood swings, lethargy, or sleep disturbances. These withdrawal effects occur because atomoxetine affects norepinephrine levels in the brain, and sudden changes can disrupt neurotransmitter balance. While atomoxetine doesn't cause the severe withdrawal syndromes seen with some medications, tapering is still considered best practice, especially for patients who have been on higher doses or long-term treatment 1. Always consult with the prescribing healthcare provider before making any changes to medication regimens, as individual factors may influence the optimal tapering approach. Some key points to consider when tapering atomoxetine include:
- Gradually reducing the dose over a period of time to minimize withdrawal symptoms
- Monitoring the patient for potential discontinuation symptoms such as irritability or mood swings
- Adjusting the tapering schedule as needed based on individual patient response
- Considering the patient's overall medical history and current health status when determining the optimal tapering approach 1. It's also important to note that the decision to taper off atomoxetine should be made in consultation with the prescribing healthcare provider, taking into account the individual patient's needs and circumstances.
From the FDA Drug Label
Atomoxetine capsules can be discontinued without being tapered. The answer is no, atomoxetine does not need to be tapered off 2.
From the Research
Tapering Off Atomoxetine
- The need to taper off atomoxetine is not explicitly stated in the provided studies, but it can be inferred from the information about discontinuation symptoms and the pharmacokinetics of the drug 3, 4.
- Atomoxetine discontinuation appeared to be well tolerated, with a low incidence of discontinuation-emergent adverse events 3.
- However, the study on clinical management of antidepressant discontinuation suggests that gradual tapering is necessary for all serotonin reuptake inhibitors, except fluoxetine, to minimize discontinuation symptoms 4.
- Although atomoxetine is not a serotonin reuptake inhibitor, it is a selective norepinephrine reuptake inhibitor, and its discontinuation symptoms may be similar to those of other antidepressants.
- The studies on the efficacy and safety of atomoxetine in adults and children with ADHD do not provide specific guidance on tapering off the drug 5, 6, 7.
- However, the study on the mechanism, clinical efficacy, safety, and dosage regimen of atomoxetine for ADHD therapy in children suggests that the drug can be administered either as a single daily dose or split into two evenly divided doses, and has a negligible risk of abuse or misuse 7.
- Based on the available information, it is likely that tapering off atomoxetine is not necessary, but it is always best to consult with a healthcare professional before stopping or changing any medication regimen.