Atomoxetine Flashcards
Another name for Atomoxetine
Strattera
Indicators of Atomoxetine
ADHD
off label: TRD
initial dosage of Atomoxetine
40 mg/ daily
How to dose Atomoxetine
Increase by 40 mg after three days
When it is 80 mg, it can be in the morning or BID dosing
BID = Better GI tolerability, Can take at QHS if makes you tired.
Max dose of Atomoxetine
100 mg / daily or BID
How to dose Atomoxetine with impaired kidney function
No dose change
How to dose Atomoxetine with impaired liver function
Mild impairment: no dose change
Moderate impairment: 50% reduction
Severe impairment: 75% reduction
How does Atomoxetine work:
It causes more NE to be in the synapse
Selective NE reuptake inhibitor ; Indirectly increases dopamine in the PFC
Why use Atomoxetine:
Generally reserved for patients with a history of substance use disorder or those who cannot tolerate or do not have a sufficient response to preferred agents
Hypertension or any other reason to not use a stimulant
Why does Atomoxetine not cause habit forming behaviors
DA is not released in the nucleus accumbens
5 advantages of Atomoxetine over stimulants
No abuse
No controlled substance
Does not worsen tics
Less likely to cause insomnia
If stopped, less likely to cause withdrawal symptoms.
3 disadvantages of Atomoxetine to stimulants
takes longer to have therapeutic effects (2 - 4 weeks)
Less effective than stimulants
Potential for liver damage
Consider the most likely similar non-stimulant to Atomoxetine
Bupropion
Less side effects and risks
Labs to consider for Atomoxetine
Baseline LFTs
Potentially monitor blood pressure
Common side effects of Atomoxetine
Nausea, insomnia, dry mouth, decreased appetite, fatigue, dizziness, constipation, urinary hesitancy.
