Atomoxetine

Atomoxetine
Clinical data
Trade namesStrattera, others
Other names(R)-N-Methyl-3-phenyl-3-(o-tolyloxy)propan-1-amine
AHFS/Drugs.comMonograph
MedlinePlusa603013
License data
Pregnancy
category
Routes of
administration		By mouth
Drug classNorepinephrine reuptake inhibitor
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability63–94%[7][8][9]
Protein binding98%[7][8][9]
MetabolismLiver, via CYP2D6[7][8][9]
Elimination half-life4.5–25 hours[7][8][9][10][11]
ExcretionKidney (80%) and faecal (17%)[7][8][9]
Identifiers
  • (3R)-N-Methyl-3-(2-methylphenoxy)-3-phenylpropan-1-amine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.120.306 Edit this at Wikidata
Chemical and physical data
FormulaC17H21NO
Molar mass255.361 g·mol−1
3D model (JSmol)
  • CC1=C(C=CC=C1)O[C@H](CCNC)C2=CC=CC=C2
  • InChI=1S/C17H21NO/c1-14-8-6-7-11-16(14)19-17(12-13-18-2)15-9-4-3-5-10-15/h3-11,17-18H,12-13H2,1-2H3/t17-/m1/s1 checkY
  • Key:VHGCDTVCOLNTBX-QGZVFWFLSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Atomoxetine, sold under the brand name Strattera among others, is a selective norepinephrine reuptake inhibitor (sNRI) medication used to treat attention deficit hyperactivity disorder (ADHD)[12] and, to a lesser extent, cognitive disengagement syndrome (CDS).[13][14][15] It may be used alone or along with stimulant medication.[16][17] It enhances the executive functions of self-motivation, sustained attention, inhibition, working memory, reaction time,[18] and emotional self-regulation.[19][20] Use of atomoxetine is only recommended for those who are at least six years old.[12] It is taken orally.[12] The effectiveness of atomoxetine is comparable to the commonly prescribed stimulant medication methylphenidate.[21][22][23][24]

Common side effects of atomoxetine include abdominal pain, decreased appetite, nausea, feeling tired, and dizziness.[12] Serious side effects may include angioedema, liver problems, stroke, psychosis, heart problems, suicide, and aggression.[12][25] There is a lack of data regarding its safety during pregnancy; as of 2019, its safety during pregnancy and for use during breastfeeding is not certain.[26][27]

It was approved for medical use in the United States in 2002.[12] In 2022, it was the 213th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[28][29]

  1. ^ "Atomoxetine (Strattera) Use During Pregnancy". Drugs.com. 22 August 2019. Archived from the original on 22 March 2019. Retrieved 7 February 2020.
  2. ^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)". nctr-crs.fda.gov. FDA. Retrieved 22 October 2023.
  3. ^ Anvisa (15 September 2023). "RDC Nº 816 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 816 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 18 September 2023). Archived from the original on 19 October 2023. Retrieved 19 October 2023.
  4. ^ "Strattera 10mg hard capsules - Summary of Product Characteristics (SmPC)". (emc). 8 February 2021. Archived from the original on 8 October 2021. Retrieved 11 June 2022.
  5. ^ Cite error: The named reference Strattera FDA label was invoked but never defined (see the help page).
  6. ^ "Active substance(s): atomoxetine" (PDF). List of nationally authorised medicinal products. European Medicines Agency. 2016. Archived (PDF) from the original on 12 June 2022. Retrieved 12 June 2022.
  7. ^ a b c d e "Atomoxetine (Rx) – Strattera". Medscape Reference. WebMD. Archived from the original on 10 November 2013. Retrieved 10 November 2013.
  8. ^ a b c d e Cite error: The named reference TGA was invoked but never defined (see the help page).
  9. ^ a b c d e "Atomoxetine Hydrochloride capsule [Mylan Pharmaceuticals Inc.]". DailyMed. Mylan Pharmaceuticals Inc. October 2011. Archived from the original on 10 November 2013. Retrieved 10 November 2013.
  10. ^ Cite error: The named reference Sa2005 was invoked but never defined (see the help page).
  11. ^ Cite error: The named reference PMID26314574 was invoked but never defined (see the help page).
  12. ^ a b c d e f "Atomoxetine Hydrochloride Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 4 April 2019. Retrieved 22 March 2019.
  13. ^ Becker SP, Willcutt EG, Leopold DR, Fredrick JW, Smith ZR, Jacobson LA, et al. (June 2023). "Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome". Journal of the American Academy of Child and Adolescent Psychiatry. 62 (6): 629–645. doi:10.1016/j.jaac.2022.07.821. PMC 9943858. PMID 36007816.
  14. ^ Wietecha L, Williams D, Shaywitz S, Shaywitz B, Hooper SR, Wigal SB, et al. (November 2013). "Atomoxetine improved attention in children and adolescents with attention-deficit/hyperactivity disorder and dyslexia in a 16 week, acute, randomized, double-blind trial". Journal of Child and Adolescent Psychopharmacology. 23 (9): 605–613. doi:10.1089/cap.2013.0054. PMC 3842866. PMID 24206099.
  15. ^ Treuer T, Gau SS, Méndez L, Montgomery W, Monk JA, Altin M, et al. (April 2013). "A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability". Journal of Child and Adolescent Psychopharmacology. 23 (3): 179–193. doi:10.1089/cap.2012.0093. PMC 3696926. PMID 23560600.
  16. ^ "Parent's Medication Guide: ADHD". American Psychiatric Association (Guidelines (Tertiary source)). American Psychiatric Association & American Academy of Child and Adolescent Psychiatry (AACAP). June 2013. Archived from the original on 2 February 2017. Retrieved 1 January 2017. Though not FDA-approved for combined treatment, atomoxetine (Strattera) is sometimes used in conjunction with stimulants as an off-label combination therapy.
  17. ^ Isfandnia F, El Masri S, Radua J, Rubia K (July 2024). "The effects of chronic administration of stimulant and non-stimulant medications on executive functions in ADHD: A systematic review and meta-analysis". Neuroscience and Biobehavioral Reviews. 162: 105703. doi:10.1016/j.neubiorev.2024.105703. PMID 38718988.
  18. ^ Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, et al. (September 2021). "The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder". Neuroscience and Biobehavioral Reviews. 128: 789–818. doi:10.1016/j.neubiorev.2021.01.022. PMC 8328933. PMID 33549739.
  19. ^ Kamradt JM, Ullsperger JM, Nikolas MA (December 2014). "Executive function assessment and adult attention-deficit/hyperactivity disorder: tasks versus ratings on the Barkley deficits in executive functioning scale". Psychological Assessment. 26 (4): 1095–1105. doi:10.1037/pas0000006. PMID 24885846.
  20. ^ Cite error: The named reference Hanwella_2011 was invoked but never defined (see the help page).
  21. ^ Cite error: The named reference Rezaei_2016 was invoked but never defined (see the help page).
  22. ^ Cite error: The named reference Hazell_2011 was invoked but never defined (see the help page).
  23. ^ Cite error: The named reference Bushe_2016 was invoked but never defined (see the help page).
  24. ^ British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 344–345. ISBN 9780857113382.
  25. ^ "Atomoxetine Pregnancy and Breastfeeding Warnings". Drugs.com. Archived from the original on 22 March 2019. Retrieved 3 March 2019.
  26. ^ Cite error: The named reference Ornoy2018 was invoked but never defined (see the help page).
  27. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  28. ^ "Atomoxetine Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.