From the Guidelines
Strattera (atomoxetine) is generally allowed for commercial drivers under Department of Transportation (DOT) regulations. Unlike stimulant medications used for ADHD, Strattera is not a controlled substance and does not typically cause the side effects that would impair driving ability, as noted in the study by 1. However, drivers should still follow proper protocols when using this medication. The driver should inform their DOT medical examiner about taking Strattera during their physical examination. The examiner will evaluate if the medication is effectively controlling the driver's ADHD symptoms without causing side effects that might impair safe driving. Some key points to consider when using Strattera for commercial drivers with ADHD include:
- The medication's mechanism of action, which increases norepinephrine levels in the brain rather than acting as a stimulant, making it compatible with safety-sensitive transportation positions 1
- The potential for adverse effects, such as nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence, which are common in child and adolescent clinical trials 1
- The need for documentation from the prescribing physician stating that the driver is stable on the medication without significant side effects
- The medical examiner's evaluation of the driver's safety to operate commercial vehicles while taking Strattera, which may result in certification for up to 12 months if deemed safe. It is essential to prioritize the driver's safety and the safety of others on the road, and Strattera may be a suitable option for commercial drivers with ADHD who are carefully monitored and managed by their healthcare provider, as suggested by the study 1.
From the Research
Strattera and DOT Regulations
- Strattera, also known as atomoxetine, is a non-stimulant medication used to treat attention-deficit/hyperactivity disorder (ADHD) 2, 3, 4.
- The US Department of Transportation (DOT) has regulations regarding the use of certain medications by individuals in safety-sensitive positions, such as commercial drivers.
- According to the studies, atomoxetine is not a controlled substance in the US, which may affect its use in DOT-regulated positions 2, 3.
- However, there is no direct information in the provided studies regarding the specific use of Strattera in DOT-regulated positions.
Safety and Efficacy of Strattera
- Strattera has been shown to be effective in reducing ADHD symptoms in both children and adults 2, 3, 4.
- The medication has a relatively safe profile, with common adverse events including headache, abdominal pain, and nausea 2, 3, 5.
- However, Strattera may have a poor benefit-risk balance for the treatment of adults with ADHD, according to a meta-analysis and meta-regression study 6.
Use of Strattera in Adults
- Strattera has been approved for the treatment of ADHD in adults, and has been shown to be effective in reducing symptoms 3, 4.
- The medication may be used off-label for other conditions, such as mood disorders and cognitive dysfunction, but its safety and efficacy in these contexts are not well established 5.
- Adults taking Strattera should be monitored for changes in blood pressure and other potential adverse events 5.