Tapering Off Strattera (Atomoxetine) 100mg After 8 Years
Atomoxetine can be discontinued without tapering, according to the FDA label, which explicitly states that "Atomoxetine capsules can be discontinued without being tapered." 1
Key Principle: No Taper Required
- The FDA-approved prescribing information for atomoxetine clearly indicates that tapering is not necessary when discontinuing the medication. 1
- Unlike SSRIs, benzodiazepines, or opioids that require gradual dose reductions to prevent withdrawal syndromes, atomoxetine does not produce physical dependence requiring a taper schedule. 1
What to Expect Upon Discontinuation
- Atomoxetine has a relatively short half-life (5.2 hours in extensive metabolizers and 21.6 hours in poor metabolizers), meaning the drug clears from your system within days. 2
- Modest increases in heart rate and blood pressure that may have occurred during treatment gradually decrease on cessation without requiring a taper. 3, 4
- Atomoxetine is not associated with abuse, diversion, or withdrawal syndromes that characterize controlled substances, which is why it does not require tapering. 3, 4
Monitoring After Discontinuation
- Watch for return of ADHD symptoms (inattention, hyperactivity, impulsivity) rather than withdrawal symptoms, as these represent the underlying condition rather than medication discontinuation effects. 3, 4
- Blood pressure and heart rate should normalize within days to weeks after stopping, but can be monitored if there were cardiovascular concerns during treatment. 3, 4
Important Caveats
- If you are taking other medications metabolized by CYP2D6 (such as certain antidepressants), stopping atomoxetine will not affect their levels, as atomoxetine does not inhibit or induce CYP enzyme activity. 2
- The absence of required tapering does not mean you should stop without medical consultation—discuss your decision with your prescriber to ensure appropriate monitoring for ADHD symptom recurrence and to consider alternative management strategies if needed. 1
Clinical Context
- The FDA's explicit statement that atomoxetine "can be discontinued without being tapered" stands in stark contrast to medications like SSRIs (which require hyperbolic tapering to very low doses), benzodiazepines (which require 10% monthly reductions), or opioids (which require slow tapers over months). 1, 5, 6
- After 8 years of use, you can stop the 100mg dose immediately without the gradual dose reductions required for other psychiatric medications. 1