Atomoxetine
Non-stimulant prescription ADHD drug: a selective norepinephrine reuptake inhibitor.
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Pharmacology
Contents
WHAT IS ATOMOXETINE?
Detailed overview
Atomoxetine (Strattera) is the first non-stimulant ADHD medication approved by the FDA and EMA, acting as a selective inhibitor of the norepinephrine transporter (NET). By raising synaptic norepinephrine it indirectly boosts dopamine in the prefrontal cortex, improving attention and impulse control, while it does not raise dopamine in reward regions, so it has essentially no abuse potential. Unlike methylphenidate and amphetamine it is a non-controlled substance, but its effect builds gradually over weeks rather than acting immediately. It is a prescription-only medicine that should be taken under medical supervision.
Mechanism
Selective norepinephrine reuptake inhibitor (NRI)
Half-life
~5 hours (longer in poor metabolizers)
Legal status
Prescription medicine (non-controlled)
Receptor profile
- Norepinephrine transporter (NET)Strong
- Prefrontal dopamine (via NET, indirect)Moderate
- ADHD symptoms (attention, impulsivity)Moderate
Safety
Side effects, stop signs, contraindications
Side effects · 6
- Reduced appetite, nausea, dry mouth, digestive complaints
- Mild increase in heart rate and blood pressure (noradrenergic effect)
- Fatigue, somnolence or conversely insomnia, dizziness
- Mood changes, irritability; rarely suicidal ideation in youth (boxed warning)
- Rare but serious liver injury; discontinue immediately if jaundice appears
- Sexual dysfunction, urinary hesitancy in men
Contraindications · 5
- MAO inhibitor concurrently or within 2 weeks: severe, potentially fatal reaction
- Narrow-angle glaucoma: contraindicated due to the noradrenergic effect
- Serious cardiovascular disease, pheochromocytoma, uncontrolled hypertension
- Known liver disease; elevated exposure in CYP2D6 poor metabolizers
- Pregnancy and breastfeeding: only with clear medical justification after risk assessment
Related Nootropics
Same therapeutic category
Studies
Related research and clinical findings
Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis
Ostinelli EG, et al., Cortese S
Nonstimulant Medications for Attention-Deficit/Hyperactivity Disorder (ADHD) in Adults: Systematic Review and Meta-analysis
Cutler AJ, et al., Faraone SV
Atomoxetine Increased Effect over Time in Adults with Attention-Deficit/Hyperactivity Disorder Treated for up to 6 Months: Pooled Analysis of Two Double-Blind, Placebo-Controlled, Randomized Trials
Upadhyaya HP, et al., Findling RL
Once-daily treatment with atomoxetine in adults with attention-deficit/hyperactivity disorder: a 24-week, randomized, double-blind, placebo-controlled trial
Adler LA, et al., Wietecha L
Atomoxetine in comorbid ADHD/PTSD: A randomized, placebo controlled, pilot, and feasibility study
Back SE, et al., Hamner M
FAQ
FAQ
Non-stimulant prescription ADHD drug: a selective norepinephrine reuptake inhibitor.
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Structure & chemistry
The information here is strictly for educational and scientific purposes. It does not replace medical advice or clinical consultation, and it does not encourage illegal substance or pharmaceutical use. Data is sourced. When in doubt, consult your doctor.