Can Strattera Be Stopped Without Tapering?
Yes, Strattera (atomoxetine) can be discontinued without tapering according to the FDA-approved prescribing information. 1
FDA-Approved Discontinuation Protocol
The official FDA drug label explicitly states: "Atomoxetine capsules can be discontinued without being tapered." 1 This is a unique characteristic of atomoxetine that distinguishes it from many other psychiatric medications.
Clinical Evidence Supporting Abrupt Discontinuation
- Research in over 3,000 children and adolescents found no evidence of symptoms rebound and no evidence of an acute discontinuation syndrome when stopping atomoxetine treatment. 2
- The mechanism of action (selective norepinephrine reuptake inhibition) does not produce the same neuroadaptations that require tapering with other psychiatric medications. 2
Post-Discontinuation Monitoring Requirements
While tapering is not required, the American Academy of Child and Adolescent Psychiatry recommends establishing a monitoring plan after stopping atomoxetine because:
- ADHD symptoms may return gradually over weeks to months after discontinuation, not immediately. 3
- Schedule follow-up appointments to assess for symptom recurrence and determine if retreatment is necessary. 3
- This delayed return of symptoms is distinct from withdrawal syndromes seen with other medications.
Key Distinction from Other Psychiatric Medications
Atomoxetine's discontinuation profile differs markedly from:
- Antidepressants (SSRIs/SNRIs): Require gradual tapering over weeks to months to prevent discontinuation syndrome with symptoms like dizziness, nausea, flu-like symptoms, and mood disturbances. 4, 5
- Alpha-2 agonists (guanfacine, clonidine): Must always be tapered to avoid rebound hypertension. 3
- Other psychotropics: Most require gradual tapering to avoid withdrawal or rebound symptoms. 3
Common Pitfall to Avoid
Do not confuse the gradual return of ADHD symptoms (which occurs over weeks to months) with an acute withdrawal syndrome requiring tapering. 3 The former reflects the underlying condition re-emerging, not a medication withdrawal effect. 2