From the Guidelines
I strongly advise against taking atomoxetine and naltrexone together without consulting a healthcare provider first, as there is limited information available on the safety and efficacy of this combination. While there is no major known interaction between atomoxetine (Strattera) and naltrexone (Vivitrol, ReVia), these medications work on different neurotransmitter systems and are prescribed for different conditions. Atomoxetine is primarily used for ADHD and works by affecting norepinephrine levels, while naltrexone is an opioid antagonist used for alcohol and opioid dependence.
Both medications can have side effects that might overlap, such as nausea, headache, dizziness, or sleep disturbances, which could potentially be additive when taken together. According to a study published in the journal Pediatrics 1, atomoxetine can cause initial somnolence and gastrointestinal tract symptoms, particularly if the dosage is increased too rapidly. On the other hand, naltrexone has been associated with adverse effects such as nausea, headache, and dizziness, as reported in a study published in the BMJ 1.
Your doctor needs to evaluate your specific medical history, the reasons you're taking each medication, and any other medications you might be using to ensure this combination is safe for you. Dosage adjustments might be necessary when taking both medications, and monitoring for side effects would be important, especially when first starting this combination. Additionally, a study published in the Mayo Clinic Proceedings 1 highlights the importance of considering potential drug-drug interactions when using naltrexone, particularly with opioids, as it can reduce the efficacy of the analgesic or precipitate a withdrawal reaction.
It is also worth noting that naltrexone-bupropion ER, a combination medication that includes naltrexone, has been shown to have potential benefits for weight loss and smoking cessation, as reported in a study published in Gastroenterology 1. However, this combination should be used with caution, particularly in patients with a history of seizures or epilepsy, and should be avoided in patients with uncontrolled hypertension or those taking monoamine oxidase inhibitors.
In summary, while there is limited information available on the safety and efficacy of taking atomoxetine and naltrexone together, it is crucial to consult with a healthcare provider before starting this combination to ensure safe and effective treatment.
From the Research
Atomoxetine and Naltrexone Interaction
- There are no direct studies on the interaction between atomoxetine and naltrexone in the provided evidence 2, 3, 4, 5, 6.
- Atomoxetine is a selective norepinephrine reuptake inhibitor used to treat attention-deficit/hyperactivity disorder (ADHD) 2, 3, 4, 6.
- Naltrexone is an opioid receptor antagonist used to treat opioid addiction and other conditions.
- The lack of direct evidence on the interaction between atomoxetine and naltrexone makes it difficult to determine their safety when taken together.
Pharmacokinetics and Potential Interactions
- Atomoxetine is metabolized by the cytochrome P450 2D6 (CYP2D6) enzyme 2, 6.
- Naltrexone may interact with other medications that are metabolized by the CYP2D6 enzyme, but its specific interaction with atomoxetine is unknown.
- Patients taking atomoxetine and naltrexone together should be monitored for potential adverse effects, such as changes in heart rate, blood pressure, or liver function 3.
Clinical Considerations
- Atomoxetine has been shown to be effective and generally well-tolerated in the treatment of ADHD, with a negligible risk of abuse or misuse 2, 3, 4, 6.
- The presence of comorbidities, such as anxiety or depression, does not appear to affect the efficacy of atomoxetine in treating ADHD symptoms 4.
- However, the potential interaction between atomoxetine and naltrexone should be considered when treating patients with comorbidities or those taking multiple medications.