Atomoxetine

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Atomoxetine.png
chemical structure of atomoxetine

Atomoxetine hydrochloride is a prescription drug used in the treatment of attention-deficit hyperactivity disorder (ADHD). It is classified as a selective norepinephrine reuptake inhibitor, and is approved for use in children, adolescents, and adults. However, its efficacy has not been studied in children under 6 years old. Its advantage over stimulants for the treatment of ADHD is that it is not considered to have significant abuse potential, is not scheduled as a controlled substance and has proven in clinical trials to offer 24 hour coverage of symptoms associated with ADHD in adults and children.

Atomoxetine is manufactured and marketed under the brand name Strattera® by Eli Lilly and Company. It is available in capsule form in dosages of 5 mg, 10 mg, 18 mg, 25 mg, 40 mg, and 60 mg.

It is important to note that Strattera carries a bold warning for liver injury. Two confirmed cases have been reported by Eli Lilly and Company out of approximately two million prescriptions written. In both cases upon discontinuation of atomoxetine, patients' liver functions returned to normal.

Safety & Abuse Liability

Atomoxetine (also known as tomoxetine), is often termed a “non-stimulant”, implying it is free from the addictive liabilities of amphetamine (Adderall) and methylphenidate (Ritalin). Unfortunately, very little testing has been completed. There are no studies to date on whether atomoxetine increases activity or not. There are also very few studies assessing its abuse liability.

Typically, three types of studies are conducted to measure abuse liability. One directly tests whether people or non-humans will self-administer the drug. The second tests whether the subjective effects of the drug are similar to known drugs of abuse. The third indirectly assesses whether a drug “feels good” by giving the drug in a specific location and testing whether animals will spend more time in that area (conditioned place preference).

To date, two studies have reported that monkeys will not self-administer atomoxetine at the doses tested (Gasior et al, Neuropharm 30:758, 2005; Wee & Woolverton, Drug Alcohol Depend 75:271, 2004). However, rats, pigeons and monkeys trained to distinguish cocaine or methamphetamine from saline indicate that atomoxetine produces effects indistinguishable from low doses of cocaine or methamphetamine, but not at all like high doses of cocaine (Spealman, JPET 271:53, 1995; Sasaki et al., Psychopharm 120:303, 1995). No place preference studies have been conducted with atomoxetine.

These findings suggest that atomoxetine has a low to moderate risk for abuse, but that it is not completely safe and harmless.

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