Atomoxetine
Definition
Atomoxetine is a prescription drug that is used to treat symptoms of impulsivity, inattentiveness, and hyperactivity, which are hallmark features of attention deficit hyperactivity disorder (ADHD). In the United States, atomoxetine is sold under the brand name Strattera.
Purpose
Atomoxetine is the only nonstimulant drug that has proven effective for alleviating all three of the hallmark features of ADHD. The drug is frequently used along with other psychological, educational, or social therapies in ADHD management.
Description
Atomoxetine is a selective norepinephrine inhibitor. By enhancing the activities of norepinephrine in certain areas of the brain, atomoxetine reduces chemical imbalances that are believed to contribute to ADHD symptoms.
Although the exact way that atomoxetine works in the brain is not well understood, the drug is believed to correct chemical imbalances between dopamine and norepinephrine. These two naturally occurring chemicals are commonly referred to as neurotransmitters. Their function is to regulate transmission of impulses from one cell to another. Atomoxetine may restore normal attention spans, correct impulsiveness, and calm hyperactivity by counteracting the neurotransmission abnormalities that cause symptoms of ADHD.
Before atomoxetine was approved by the FDA in 2002, all the drugs previously approved for ADHD were stimulants. Stimulants such as amphetamines have the potential to be abused and are sometimes sold illegally. As a result, strict rules are in place to monitor dispensing of prescription stimulants, and patients must obtain new prescriptions from their doctors each month. Because atomoxetine is not a stimulant, it is easy for patients to obtain refills for their medication and fewer physician visits are required. Many patients prefer atomoxetine over stimulants for the convenience the drug offers.
Recommended dosage
In adults or children weighing more than 150 lb (70 kg), the initial dose of atomoxetine is typically 40 mg taken once a day. The dosage can be increased after three days to 80 mg. This can be given either as a single dose in the morning or divided evenly in the morning and late afternoon. If a higher dosage is needed, the dose can be increased after 2–4 weeks to a maximum of 100 mg per day. The dosage must be lowered in individuals that have liver disease, since atomoxetine is broken down by the liver.
Atomoxetine should be initiated at a total daily dose of 1 mg/lb (0.5 mg/kg) in children that weigh less than 150 lb (70 kg). After at least three days, the dose can be increased to 2.4 mg/lb (1.2 mg/kg). Children may either take the entire dose in the morning or may split the dose evenly in the morning and late afternoon.
Improvements in ADHD symptoms may be noticed within 24 hours of first taking atomoxetine, although 3–4 weeks may be required for full benefits to be seen.
