Atomoxetine: non-stimulant treatment in attention deficit / hyperactivity disorder (ADHD)

The Atomoxetine is a non – stimulant drug that inhibits the reuptake into the presynaptic neuronal terminal (that is, the emitting neurotransmitter) noradrenaline, so that it is in greater quantity and time available to exert its effect on the receiver located in the postsynactic neuron.

It presents a consistent efficacy against placebo in clinical trials. The rates of response and symptomatic remission seem to be slightly lower than those of stimulant treatment, but it has certain qualities that make it an interesting drug in children with anxiety and tics and in those patients who do not respond adequately to stimulants, among others.  It is available on


Up to 40% of patients who do not respond adequately to stimulants may respond to atomoxetine.

Unlike the stimulants, the effect of atomoxetine is not immediate, and begins to be observed after the third or fourth week , reaching its maximum effect from 8-12 weeks after the introduction of the same, so it is a product that requires patience to be able to observe your benefit completely. One of the most frequent errors when using atomoxetine is precipitation when considering it an unhelpful drug for not giving it a window of time, a margin, adequate for it to exert its action.

The recommended dose at the beginning must be low to make a gradual increase, in fact the slower rise patterns are associated with a better tolerance.

The most frequent adverse effects are loss of appetite (usually less than in the case of stimulants), gastrointestinal discomfort and drowsiness or fatigue, in which case it can be used at night, with a lower but acceptable effectiveness.

Atomoxetine can and does reduce symptoms of anxiety and has a protective effect on tics, so it is an interesting drug as a first option in patients with ADHD and severe anxiety disorder, or in case of tics.

The monitoring of treatment , in which the cardiovascular safety section should be included, must be similar to that of stimulants, such as methylphenidate.

While the interactions of stimulants with other drugs are rare (the most important is observed with the very rarely used inhibitors of monoaminooxi-dasa), this treatment can interact with some of them, although it usually does it very mildly, particularly with some antidepressants and neuroleptics, which should be consulted with the specialist in consultation.

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