Atomoxetine
Strattera
Selective Norepinephrine Reuptake InhibitorGeneric availableTDM data
The precise mechanism by which atomoxetine produces its therapeutic effects in Attention–Deficit/Hyperactivity Disorder (ADHD) is unknown, but is thought to be related to selective inhibition of the pre–synaptic norepinephrine transporter, as determined in ex vivo uptake and neurotransmitter depletion studies.
Compare Atomoxetine →FDA-Approved Indications
- ADHD (adults; pediatric 6+)
Common Off-Label Uses
- Anxiety disorders with ADHD
- Binge eating disorder
What Sets This Drug Apart
- Only FDA-approved non-stimulant NRI for ADHD; NOT scheduled and has no known abuse potential — key advantage over all stimulants
- Requires 2-4 weeks for full therapeutic effect (vs same-day onset with stimulants); lower overall efficacy than stimulants per NMA data
- Boxed warning for suicidal ideation in children/adolescents — class-antidepressant-like signal that stimulants do not carry
- CYP2D6 substrate with significant pharmacogenomic implications: poor metabolizers have ~10x higher exposure; dose adjustment required
- 24-hour coverage from once-daily dosing makes it useful for patients with early-morning or evening ADHD symptoms that stimulants miss
- May be preferred when comorbid anxiety, tic disorders, or substance use disorders make stimulants less suitable
Boxed Warning
SUICIDAL IDEATION IN CHILDREN AND ADOLESCENTS