Nonstimulants

Strattera: ADHD Medication FAQ

Strattera (atomoxetine) is a non-stimulant ADHD medication used to treat symptoms of attention deficit hyperactivity disorder in children and adults. Learn how Strattera works, how it’s taken, and common side effects of the drug.

Strattera: Non-Stimulant Medication for ADHD

Strattera is a non-stimulant medication used to treat symptoms of attention deficit hyperactivity disorder (ADHD or ADD) including distractibility, impulsivity, and hyperactivity in children, teens, and adults.

Strattera has long been advertised as the first non-stimulant ADHD medication, however, doctors also commonly prescribe non-stimulant medications like Intuniv, clonidine, and guanfacine as well.

How Does Strattera Work?

Also known by the generic name atomoxetine, Strattera is a norepinephrine (noradrenaline) reuptake inhibitor approved for ADHD treatment. It’s unknown how it works to improve ADHD symptoms.

Strattera’s structure, models of action, length of time needed to work, and side effects are in many ways similar to a group of medications for mood disorders called “Selective Serotonin Reuptake Inhibitors,” or SSRIs. In fact, it was first studied as a treatment for mood disorders. When it was not found to be successful, it was tried for ADHD.

Strattera is considered a third-line treatment for ADHD by the American Academy of Child and Adolescent Psychiatry (AACAP) because it alleviates symptoms for only about half of patients who try it. When it does work, its beneficial effects are not as robust as stimulant medications. It is often used by patients who are unwilling or unable to take stimulant medications.

Strattera is approved for use with children aged 6 years and older, as well as teens and adults with ADD. Safety and effectiveness have not been established in patients less than six years of age.

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How is Strattera Taken?

Strattera takes from one to four weeks to work. The dose determined by trial and error using a process called titration that measures benefits against side effects. After four weeks, the dose can be increased. Capsules are available in 10, 18, 25, 40 and 60 mg strengths. Since it is not a stimulant medication, prescriptions can be called into the pharmacist and renewals can be written for it. The initial dose is 0.5 mg/kg. The targeted clinical dose is approximately 1.2 mg/kg. Medication is often given in two doses, one in the morning and one in the evening.

The suggested plan is to use a starting dose for four days and then move up to the target dose. After a month, the dose might be increased again. The goal is to decrease the level of common ADHD symptoms like hyperactivity, distractibility, and impulsivity.

What are the Most Common Side Effects?

The most common side effects are decreased appetite, nausea, vomiting, fatigue, dyspepsia (indigestion), dizziness, and mood swings. If these side effects occur, it is recommended that the medication be continued for a short period of time to see if they decrease or go away. If they do not, the medication needs to be discontinued. Work with your family physician and let the clinical benefits noted with your child guide you.

Larry Silver, M.D., is a member of ADDitude’s ADHD Medical Review Panel.

Strattera is manufactured by Eli Lilly and Company. For more information, visit the patient and healthcare professional website.