ADHD: ATOMOXETINE

Question 1

Atomoxetine MOA

Answer 1

A
Noradrenaline reuptake inhibitor
Causes increased levels of noradrenaline at the synaptic cleft

Question 2

When should atomoxetine dose be taken?

Answer 2

morning
if given as divided dose, last dose should be no later than early evening

Question 3

Atomoxetine - children max licensed dose

Answer 3

100mg daily

Question 4

Atomoxetine - adults max licensed dose

Answer 4

dose max of 120mg not licensed

Question 5

CI

Answer 5

• QT prolongation
• History of seizures
• Mental health e.g. psychosis, depression mania, etc.
• phaeochromocytoma
• severe CVD

Question 6

SEs

Answer 6

• Sexual dysfunction (in adults)
• Anxiety/ Depression
• Worsening of tics (very common children)
• Seizures
• Weight & appetite decreased
• Psychiatric disorders (uncommon in children)/ Suicidal thoughts/ behaviours
• Hep impairment

Question 7

Avoid this drug class, and for 2 weeks after stopping it, because it is predicted to increase the risk of adverse effects when given with atomoxetine

Answer 7

MAOIs - tranylcypromine, phenelzine, isocarboxazid

Question 8

Atomoxetine - monitoring

Answer 8

Monitor on initiation, every 6 months and after a dose change.

Pulse
BP
Appetite
Weight
Height

Question 9

Atomoxetine - dose adjustments in HI

Answer 9

1/2 dose in moderate impairment
1/4 dose in severe