Atomoxetine is a non-stimulant medication that is taken for treating ADHD. It is a selective noradrenaline re-uptake inhibitor, which can only be taken by the children of at least six years of age and above and adolescents. Only in rare cases, it is recommended to extend the treatment even in adulthood for adolescents. Currently, in U.K., Strattera is the only brand of atomoxetine present in the market.

The Dos and Don’ts

Each human is different and so its physical composition. So, if a medicine for treating ADHD is suggested for a child, it might not be appropriate to recommend it to other child having ADHD. In case of certain children having ADHD, only behavioral and other therapies work well, rather than medications. Keeping these points in mind, there are some dos and don’ts for this medication that needs to be taken care of.

The Dos

Use atomoxetine with utmost care when one or combination of the following has taken place.

• Liver disease (the victim will be given a low dose)
• Last-stage kidney disease
• High blood pressure
• Low blood pressure
• Depression (even in the past)
• A history of suicidal thoughts
• A past of manic symptoms such as, hallucinations or delusional thinking
• A past of fits (seizures)
• Fast beating heart pulses
• Abnormal heart rhythm called ‘prolonged QT interval’ or any family history regarding this disease
• Abnormality in the heart composition
• Diseases related to the heart and blood vessels
• Diseases connected with the blood vessels associated with the brain

The Don’ts

Atomoxetine should be avoided for:

• Children under six
• Victims with narrow angle glaucoma, a disorder in the eyes
• Victims who have allergy to items used in the capsules

Atomoxetine with Other Medications

Before using this medicine, always remember to inform your doctor about the medications that are already being taken by your child. Such medications include those that are taken without any prescription. Not only this, but you also need to speak to the doctor or pharmacist about taking any new medicine once the medication of atomoxetine is been started. Medicines with which you need to pay attention to take atomoxetine are:

• Monoamine Oxidase Inhibitors (MAOIs)
  These are antidepressants that are taken for treating depression and must never be given with atomoxetine. This is because MAOI includes phenelzine, tranylcypromine, and isocarboxacid that when given with atomoxetine leads to negative effects in the body. If atomoxetine needs to be given, it should be given only after 14 days from the last consumption of these antidepressants.
• Beta Agonists
  These medications are used to treat asthma such as salbutamol. If atomoxetine is taken with these medicines, it affects the manner in which the body reacts to these beta agonists. So, if salbutamol is taken through inhaler, orally (as tablets or syrup), or as an injection with atomoxetine, it might results in fast heart beating. However, it will not worsen the condition of asthma. If asthmatic children take atomoxetine with salbutamol as an inhaler, it will not create any problems. In short, you need to take the advice of the doctor.
• Medicines that Affect Noradrenaline
  Atomoxetine when given medicines that affect noradrenaline has a high probability of different side effects. Listed are these medicines.
  • Antidepressants such as imipramine, venlafaxine, mirtazapine, and reboxetine
  • Decongestants including pseudoephedrine and phenylephrine that are present in cough and cold medications, which are often consumed. Therefore, verify with the pharmacist prior to taking the decongestants with atomoxetine.

There are certain medicines whose dose should be adjusted when atomoxetine is also given along with any or combination of them because of the specific side effects caused because of their union. Table 1.1 lists the medicines along with the side effect.

Side Effects of Atomoxetine

Like all medicines, atomoxetine too has side effects. However, it is not mandatory that all people taking it will experience these side effects. There are many side effects of atomoxetine. Listed are the most common side effects of atomoxetine.

• Stomachache
• Vomiting
• Headache
• Decreased appetite
• Sleepiness
• Feeling sick

Some more side effects of atomoxetine are:

• Constipation
• Indigestion
• Dizziness
• Fatigue and tiredness
• Rash
• Irritation
• Mood changes
• High blood pressure
• Increased heart rate
• Weight loss
• Difficulty in sleeping or causing sleepiness (should avoid activities such as riding bikes, driving cars, and climbing trees due to sleepiness)

Atomoxetine is also responsible for the cause of psychiatric disorders and further worsening such conditions. These are:

• Depression
• Suicidal or self-harming thoughts
• Hostility
• Anxiety
• Agitation
• Psychosis
• Hallucinations
• Mania

This is not all. To be aware of all the possible side effects, go through the patient information leaflet that you get along with the medicine from a medical shop. If you observe any of these side effects, consult your doctor.

Initially, due to atomoxetine, your child might lose weight temporarily, as this medicine results in reduced appetite. Therefore, as a precautionary measure, your child’s height and weight needs to be monitored. However, if in the long run, the growth is improper or the weight is not satisfactory, it is advisable to stop the intake of this medicine to cope up with growth problems.

Regular monitoring of children and adolescents taking atomoxetine is a must due to such critical side effects. It is recommended to the stop the intake of this medicine slowly after consulting to your doctor.

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