Will Strattera (atomoxetine) help with weight loss?

Strattera (Atomoxetine) for Weight Loss

Strattera (atomoxetine) is not recommended for weight loss as it is not FDA-approved for this purpose and has limited evidence supporting weight loss effects.

Mechanism and Weight Effects

Atomoxetine is a selective norepinephrine reuptake inhibitor primarily approved for ADHD treatment. While some medications that affect norepinephrine can impact weight, atomoxetine's effects on weight are generally minimal:

• FDA labeling indicates that in short-term controlled studies (up to 9 weeks), atomoxetine-treated patients lost an average of only 0.4 kg compared to a gain of 1.5 kg in placebo-treated patients 1
• Long-term data shows that after initial weight loss, patients typically return to normal weight gain patterns 1
• Unlike stimulant medications that have more significant appetite suppression effects, atomoxetine's impact on weight is modest

FDA-Approved Weight Loss Medications

For effective weight management, guidelines recommend using medications specifically FDA-approved for weight loss:

• Phentermine (short-term use)
• Orlistat (Xenical, Alli)
• Phentermine/topiramate ER (Qsymia)
• Naltrexone/Bupropion (Contrave)
• GLP-1 receptor agonists (liraglutide, semaglutide) 2, 3

Effectiveness Comparison

When considering medications that might affect weight:

• Bupropion is the only antidepressant consistently associated with weight loss 2, 3
• FDA-approved weight loss medications typically produce 5-10% body weight loss 2
• Atomoxetine's weight effects are minimal and transient, with most patients returning to normal growth patterns after initial modest weight changes 1

Side Effect Profile of Atomoxetine

Atomoxetine has several side effects that make it unsuitable as a weight loss medication:

• Common side effects include dry mouth, insomnia, nausea, decreased appetite, constipation, dizziness, and fatigue 4, 5
• Cardiovascular effects include modest increases in heart rate and blood pressure 6
• Growth effects in children show initial slowing followed by rebound 1
• Potential for serious adverse events including liver injury and suicidal ideation 4

Appropriate Medication Selection for Weight Loss

For patients seeking weight loss, the American Gastroenterological Association and American Diabetes Association recommend:

1. FDA-approved weight loss medications as first-line pharmacotherapy 2, 3
2. Selecting medications based on:
   • BMI ≥27 kg/m² with obesity-associated comorbidities
   • Absence of contraindications
   • Potential for 5-10% weight loss with proper medication 2

Important Considerations

• Effective weight loss medication response is typically defined as ≥5% weight loss after 3 months 3
• Weight management medications should be continued beyond reaching weight loss goals to maintain benefits 3
• Discontinuation of weight management medications often results in weight regain 3
• Atomoxetine's primary purpose is ADHD treatment, not weight management 1, 4

If weight loss is the primary goal, patients should discuss FDA-approved weight loss medications with their healthcare provider rather than using medications like Strattera that are not indicated for this purpose.