Atomoxetine
Non-stimulant — ADHD (NRI)
Indications
ADHD (children ≥6 yrs and adults), esp. tics, anxiety, substance misuse risk
Adult dose
Start 40 mg/day, target 80–100 mg/day after 7 days.
Paediatric dose
≥6 yrs (<70 kg): 0.5 mg/kg/day, target 1.2 mg/kg/day; max 1.4 mg/kg or 100 mg.
Common side effects
NauseaReduced appetiteSedation/insomniaDizzinessMild BP/HR rise
Serious side effects
Hepatotoxicity (rare)Suicidal ideation (children/adolescents)Cardiovascular eventsSeizuresPsychotic symptoms
Contraindications
PhaeochromocytomaSevere CV diseaseNarrow-angle glaucomaMAOI within 14 days
Monitoring
- HR, BP at baseline, after dose changes, 6-monthly
- Liver symptoms
Notable interactions
- CYP2D6 inhibitors (paroxetine, fluoxetine) — raise levels significantly (use lower dose)
- MAOIs
Curated reference based on BNF, Maudsley Prescribing Guidelines and NICE. Verify against current BNF and local guidelines before prescribing.