Atomoxetine: Treatment of attention-deficit/hyperactivity disorder through selective norepinephrine reuptake inhibition

Atomoxetine (Strattera™), a selective norepinephrine reuptake inhibitor, is the first non-stimulant to be approved for treating attention-deficit/hyperactivity disorder (ADHD). It is the only medication that has received FDA approval for use in adults as well as children with this condition. The results of 9 clinical trials of atomoxetine, including a number of double-blind, placebo-controlled multicenter studies, have demonstrated its high degree of efficacy in controlling the symptoms of ADHD, and favorable patient tolerability, in children, adolescents and adults. While most of the clinical trials employed a twice-a-day dosing schedule, a single daily dose has been shown to be equally efficacious and safe. Transient gastrointestinal side effects were most frequently reported, which in most cases did not lead to discontinuation of atomoxetine therapy. Additional long-term studies are ongoing; direct comparison trials with stimulant agents, and evaluations of atomoxetine in ADHD patients with co-morbid conditions such as substance abuse, depression, anxiety and tics, are warranted to explore the potential for further expanding the use of this novel medication.