From the Research
A patient might take both sertraline and Strattera (atomoxetine) when they have co-occurring depression and ADHD, as this combination can address both conditions simultaneously and improve overall quality of life. Sertraline is an SSRI antidepressant that treats depression, anxiety, and other mood disorders by increasing serotonin levels in the brain, while Strattera is a non-stimulant medication that treats ADHD by increasing norepinephrine levels to improve attention and reduce impulsivity. The typical adult dose for sertraline ranges from 50-200mg daily, while Strattera is usually started at 40mg daily and may be increased to 80-100mg daily 1.
Key Considerations
- Both medications work through different neurotransmitter systems, making them compatible for concurrent use in many cases.
- However, this combination should only be used under close medical supervision, as both medications can affect blood pressure and heart rate, and there is a small risk of serotonin syndrome, as reported in a case study where atomoxetine alone induced serotonin syndrome 2.
- Patients should report any unusual side effects like agitation, rapid heart rate, high fever, or confusion immediately to their healthcare provider.
- The clinical effectiveness of sertraline in primary care has been studied, and it has been found to be effective in reducing anxiety symptoms, improving mental health-related quality of life, and self-reported improvements in mental health, although its effectiveness in reducing depressive symptoms within 6 weeks is uncertain 1.
Important Evidence
- A study published in 2005 found that atomoxetine monotherapy was effective in treating ADHD and improving anxiety and depressive symptoms in pediatric patients with ADHD and comorbid symptoms of depression or anxiety 3.
- Another study published in 2019 found that sertraline was unlikely to reduce depressive symptoms within 6 weeks in primary care, but it improved anxiety, quality of life, and self-rated mental health 1.
- A case report published in 2022 highlighted the risk of serotonin syndrome induced by an overdose of atomoxetine alone in a patient with ADHD 2.
Recommendations
- The combination of sertraline and atomoxetine should be used with caution and under close medical supervision, considering the potential risks and benefits, and the patient's individual needs and medical history.
- Patients should be closely monitored for any signs of serotonin syndrome, and the dosage of both medications should be adjusted accordingly.
- The patient's response to treatment should be regularly assessed, and the treatment plan should be adjusted as needed to optimize outcomes and minimize risks.