What is atomoxetine used for?
Atomoxetine is a non-stimulant medicine used to treat attention-deficit/hyperactivity disorder (ADHD) in children 6 years and older, adolescents, and adults. It is often used when stimulants cause too many side effects, do not work well enough, or are not a good fit, such as in people with a history of substance misuse or tics. It is not approved to treat major depressive disorder (MDD).
How long does atomoxetine take to work?
Atomoxetine does not work immediately. Some people notice small improvements in focus or impulsivity after 1 to 2 weeks, but full benefit often takes 4 to 8 weeks. Because of this slower onset, it’s important not to stop too soon if early changes are modest.
How is atomoxetine different from stimulant medications?
Stimulants (like methylphenidate or amphetamine) typically work within 30–60 minutes and have stronger average effects but can cause appetite loss, insomnia, and have abuse potential. Atomoxetine has no known abuse potential and is not a controlled substance. It works by increasing norepinephrine, not directly stimulating dopamine reward pathways, and it builds up gradually over weeks instead of giving an immediate effect.
What is the suicide warning with atomoxetine?
Short-term studies in children and adolescents found a small increase in suicidal thoughts (0.4% on atomoxetine vs 0% on placebo). No suicides occurred in those trials. Because of this, all children and teens starting atomoxetine should be watched closely by family and clinicians for new or worsening depression, irritability, agitation, or suicidal thoughts, especially in the first few weeks or when the dose changes.
What are the most common side effects?
Common side effects include nausea, stomach pain, decreased appetite, dry mouth, headache, trouble sleeping, feeling tired, increased sweating, and mild increases in heart rate or blood pressure. Adults may also notice sexual side effects such as erectile or ejaculatory problems. Many side effects are worst in the first month and then improve.
Can atomoxetine cause serious heart or liver problems?
Serious heart events and severe liver injury are rare but have been reported. Atomoxetine can raise heart rate and blood pressure and has been linked to rare cases of sudden death, heart attack, or stroke in people with underlying heart disease. It has also caused rare cases of severe liver injury and liver failure. Before starting, your clinician will ask about heart history and family history, and you should report any chest pain, fainting, dark urine, yellow eyes/skin, or severe fatigue immediately.
Does atomoxetine affect growth in children?
Atomoxetine can slow weight gain and height growth in some children and teens, especially during the first 1–2 years. Over longer follow-up (2–5 years), many children show partial or full catch-up, but not all. Weight, height, and appetite should be monitored regularly, and the treatment plan may be adjusted if significant growth delay occurs.
How should I take atomoxetine?
You usually take atomoxetine once or twice a day, with or without food, at about the same time each day. Swallow the capsule whole—do not crush, chew, or open it. If the capsule breaks and powder gets in your eyes, rinse them with water and seek medical advice. Do not change your dose or timing without talking to your prescriber.
What if I miss a dose?
If you miss a dose, take it as soon as you remember, unless it’s close to the time for your next dose. If it is close, skip the missed dose and return to your normal schedule. Do not take two doses at once to make up for a missed dose.
Can I drink alcohol while taking atomoxetine?
Alcohol can increase some side effects of atomoxetine, like dizziness, drowsiness, and impaired judgment. It may also make it harder to recognize mood changes. It is safest to avoid or minimize alcohol use and discuss your alcohol intake with your prescriber.
Is atomoxetine safe during pregnancy or breastfeeding?
We don’t yet have enough high-quality data to say atomoxetine is completely safe in pregnancy or breastfeeding, but so far no major birth defect signal has emerged. For pregnant or breastfeeding patients with mild ADHD, non-medication approaches are preferred. For more severe ADHD, continuing or starting medicine may be reasonable if the benefits outweigh potential risks. This decision should be made with your prescriber as part of shared decision-making, and the lowest effective dose should be used.
Can atomoxetine be used with stimulants?
Sometimes atomoxetine is combined with a stimulant in patients who have only a partial response to either medicine alone, but this increases the complexity of treatment and the risk of side effects, especially cardiovascular ones. Combination therapy should only be done under close supervision by a clinician experienced with ADHD medications.