Atomoxetine

Products

Atomoxetine is commercially available in capsule form and as a drinkable solution (Strattera, generics). It was approved in many countries in 2009.

Structure and properties

Atomoxetine (C17H21NO, Mr = 255.4 g/mol) is present in drugs as atomoxetine hydrochloride. It is structurally closely related to the SSRI fluoxetine (Fluctine, Prozac, generics), which was also developed at Lilly.

Effects

Atomoxetine (ATC N06BA09) produces significant improvement in the core symptoms of impulsivity, hyperactivity, and attention deficit in ADHD. The effects are due to selective inhibition of the presynaptic norepinephrine transporter NET. This increases norepinephrine concentrations in the central nervous system. The mean half-life is 3.6 hours.

Indications

For the treatment of attention deficit hyperactivity disorder (ADHD).

Dosage

According to the drug label. The capsules and drinking solution are usually taken once daily in the morning and independently of meals.

Abuse

Atomoxetine, unlike methylphenidate, is not an amphetamine derivative and has no euphoric or stimulant effects. Abuse is therefore unlikely.

Contraindications

  • Hypersensitivity
  • Combination with MAO inhibitors
  • Narrow-angle glaucoma
  • Pheochromocytoma
  • Severe cardiovascular disease
  • Children under 6 years

Full precautions can be found in the drug label.

Interactions

Atomoxetine is biotransformed by CYP2D6 and has a high potential for drug-drug interactions.

Adverse effects

The most common potential adverse effects in children and adolescents include abdominal discomfort, vomiting, nausea, an increase in heart rate, an increase in blood pressure, headache, drowsiness, and decreased appetite.