From the Research
Atomoxetine can have an onset of action within 1-2 weeks of starting treatment, with some patients noticing initial improvements in attention and focus within the first week of treatment. The response to atomoxetine is incremental over a long period of time, with a greater than expected maintenance of response 1. According to a study published in the Journal of psychopharmacology, atomoxetine treatment in adults with ADHD was associated with small effect sizes after 4 weeks and moderate effect sizes by 6 months of treatment 2.
Key points to consider when initiating atomoxetine treatment include:
- The standard starting dose is usually 40mg daily for adults and weight-based for children (0.5mg/kg/day), with gradual titration up to a target dose of 80-100mg daily for adults or 1.2-1.4mg/kg/day for children, not exceeding 100mg total.
- Patients should continue the medication consistently even if benefits aren't immediately apparent, as premature discontinuation may prevent achieving optimal results.
- Side effects like nausea, decreased appetite, and fatigue often appear before therapeutic benefits and tend to diminish over time.
- Regular follow-up with a healthcare provider during the initial weeks is important to monitor response and adjust dosing as needed.
- Unlike stimulants, atomoxetine provides 24-hour symptom coverage when taken regularly, making it particularly beneficial for consistent ADHD symptom management throughout the day.
It's also important to note that some studies have investigated the use of biomarkers to predict response to atomoxetine, such as thalamocortical oscillatory activity using quantitative electroencephalography (qEEG) 3. However, the most recent and highest quality study suggests that atomoxetine's onset of action can be seen within 1-2 weeks, with continued improvement over time 2.