Atomoxetine
Also known as: Strattera, Axepta, Attentrol
Important: This is informational content only. Always consult Dr. Ambrish Singal or your psychiatrist before starting, stopping, or changing any medication.
What is Atomoxetine?
Atomoxetine is a non-stimulant medication for ADHD that works through norepinephrine reuptake inhibition. It is a good option for patients who cannot tolerate stimulants or have a history of substance abuse.
How It Works
Selectively inhibits norepinephrine reuptake in the prefrontal cortex, improving attention and executive function without the dopaminergic stimulant effects that carry abuse potential.
Uses
How This Drug Starts Working
Effects typically begin within 1-4 weeks depending on the condition being treated. Full therapeutic effect usually takes 4-8 weeks.
Week-by-Week Timeline
Week 1: Medication reaching therapeutic blood levels. Some initial side effects may appear as body adjusts.
Week 2-3: Initial therapeutic effects beginning. Side effects often settling.
Week 4-6: Significant therapeutic benefit in most patients.
Week 8+: Full effect established. Treatment response can be properly assessed.
What Changes First?
Physical symptoms (sleep, appetite, energy) typically improve before emotional and cognitive symptoms. Others may notice improvement before you feel it yourself.
Why Does It Take Time?
Psychiatric medications work by gradually rebalancing brain chemistry and neural circuits. Unlike pain medications that block a sensation, these drugs help your brain rebuild healthy patterns — which requires time.
Complete Dosage Guide
How to Take
Take exactly as prescribed by your doctor. Maintain consistent timing each day.
Starting Dose
Your doctor will determine the appropriate starting dose based on your condition, age, weight, and other factors.
Dose Increases
Dose adjustments are made gradually based on your response and side effects. Follow your doctor's instructions for any changes.
Maximum Dose
Your doctor will not exceed safe maximum doses. Never take more than prescribed.
When to Take
Take at the same time daily for best results. Ask your doctor whether morning or evening is better for your specific medication.
If You Miss a Dose
If you miss a dose, take it as soon as you remember unless close to your next dose. Never double up. Contact your doctor if you miss multiple doses.
Food & Drink
Ask your doctor or pharmacist about specific food interactions for your medication.
How Long to Take
Duration of treatment varies by condition. Never stop medication without discussing with your doctor first — some medications require gradual tapering.
Dosage by Age Group
adult
Start 40mg/day. Increase after 3 days to 80mg. Maximum: 100mg/day.
child
Under 70kg: Start 0.5mg/kg/day. Target: 1.2mg/kg/day. Maximum: 1.4mg/kg/day or 100mg.
elderly
No specific guidelines. Start at lower doses.
Special Populations
Pregnancy
Category C. Limited human data.
Kidney Conditions
No dose adjustment needed.
Liver Conditions
Reduce dose to 50% in moderate and 25% in severe hepatic impairment.
Side Effects
Common
- Decreased appetite
- Nausea
- Vomiting
- Fatigue
- Dizziness
- Mood swings
- Dry mouth
- Constipation
Serious
- Suicidal ideation (boxed warning in children/adolescents)
- Liver injury (rare but serious)
- Cardiovascular effects (increased HR/BP)
- Urinary retention
- Priapism
What You Should Know
Overdose Risks
May cause somnolence, agitation, hyperactivity, abnormal behavior, and GI symptoms. Seizures and cardiac symptoms in severe cases.
Safe Discontinuation
Can be stopped without tapering. No withdrawal syndrome. Effects wear off over several days.