From the Guidelines
It is not recommended to stop taking Strattera (atomoxetine) on weekends for ADHD treatment, as this can disrupt the steady-state levels of the medication and potentially reduce its effectiveness. Unlike stimulant medications, Strattera works by gradually building up consistent levels in your bloodstream over time, and it typically takes 4-6 weeks to reach full effectiveness 1. Taking "drug holidays" or skipping doses on weekends can cause fluctuations in symptom control, and Strattera has a half-life of about 5-24 hours, meaning that stopping for even a couple of days can significantly lower blood levels of the medication.
Some key points to consider when taking Strattera include:
- The usual starting dose is 40 mg po daily, with titration every 7-14 days to 60 then 80 mg/d, and a total maximum dose recommended as the lesser of 1.4 mg/kg/d or 100 mg/d 1
- Atomoxetine does not seem to be associated with major congenital malformations, including cardiac malformations, or other significant adverse obstetrical or developmental outcomes, although data are limited 1
- Non-stimulants like Atomoxetine have "around-the-clock" effects, but smaller effect size in comparison to stimulants, and may be a possible first-line option in comorbid substance use disorders, disruptive behavior disorders, tic/Tourette's disorder 1
Additionally, abruptly stopping Strattera can sometimes lead to withdrawal symptoms such as irritability, mood swings, or headaches. If you're concerned about side effects or want to adjust your treatment schedule, it's essential to consult with your healthcare provider first, as they might suggest alternative approaches like dosage adjustments or different medication options that better suit your needs while maintaining effective ADHD symptom management throughout the week 1.
From the Research
Stopping Strattera on Weekends
- There is no direct evidence to suggest that stopping Strattera (Atomoxetine) on weekends is safe or recommended 2, 3, 4, 5, 6.
- Atomoxetine is a selective norepinephrine reuptake inhibitor that is effective in treating Attention Deficit Hyperactivity Disorder (ADHD) in children and adults 2, 3, 4.
- The medication can be administered once or twice daily, and its efficacy has been demonstrated in short-term and long-term studies 2, 3, 5, 6.
- Discontinuation of atomoxetine has been shown to be well-tolerated, with a low incidence of discontinuation-emergent adverse events 2, 3.
- However, the studies do not provide information on the safety or efficacy of stopping atomoxetine on weekends specifically 2, 3, 4, 5, 6.
Potential Risks and Considerations
- Stopping atomoxetine on weekends may lead to a rebound effect, where symptoms worsen after discontinuation 6.
- The trajectory of response to atomoxetine is incremental over a long period, and stopping the medication on weekends may affect its efficacy 6.
- Patients should consult their healthcare provider before making any changes to their medication regimen, including stopping atomoxetine on weekends 2, 3, 4, 5, 6.
Clinical Implications
- Healthcare providers should educate patients on the potential risks and benefits of stopping atomoxetine on weekends 2, 3, 4, 5, 6.
- Patients should be monitored closely for any changes in symptoms or adverse events if they stop taking atomoxetine on weekends 2, 3, 4, 5, 6.
- Further studies are needed to determine the safety and efficacy of stopping atomoxetine on weekends in patients with ADHD 2, 3, 4, 5, 6.