Atomoxetine

Also known as: (R)-N-Methyl-3-phenyl-3-(o-tolyloxy)propan-1-amine

Therapeutic indications

Atomoxetine is indicated for:

Attention-Deficit/Hyperactivity Disorder (ADHD)

Irrespective of gender only Children (1 year - 12 years old) , Adolescents (12 years - 18 years old)

Atomoxetine is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children of 6 years and older and in adolescents as part of a comprehensive treatment programme. Treatment must be initiated by a specialist in the treatment of ADHD, such as a paediatrician or child/adolescent psychiatrist. Diagnosis should be made according to current DSM criteria or the guidelines in ICD.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - Over 70 kg body weight, 40 mg once daily for 7 days and 80-100 mg once daily thereafter

Treatment 2: Oral - Dosing of children/adolescents up to 70 kg body weight

Attention-Deficit/Hyperactivity Disorder (ADHD)

Irrespective of gender only Adults (18 years old or older)

Atomoxetine is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults as part of a comprehensive treatment programme. Treatment must be initiated by a specialist in the treatment of ADHD, such as a psychiatrist. Diagnosis should be made according to current DSM criteria or the guidelines in ICD.

In adults, the presence of symptoms of ADHD that were pre-existing in childhood should be confirmed. Third-party corroboration is desirable and atomoxetine should not be initiated when the verification of childhood ADHD symptoms is uncertain. Diagnosis cannot be made solely on the presence of one or more symptoms of ADHD. Based on clinical judgment, patients should have ADHD of at least moderate severity as indicated by at least moderate functional impairment in 2 or more settings (for example, social, academic, and/or occupational functioning), affecting several aspects of an individual’s life.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 40 mg once daily for 7 days and 80-100 mg once daily thereafter

Contraindications

Active ingredient Atomoxetine is contraindicated in the following cases:

Monoamine oxidase inhibitors (MAOI)

Atomoxetine should not be used in combination with monoamine oxidase inhibitors (MAOI). Atomoxetine should not be used within a minimum of 2 weeks after discontinuing therapy with MAOI. Treatment with MAOI should not be initiated within 2 weeks after discontinuing atomoxetine.

Pheochromocytoma

Atomoxetine should not be used in patients with pheochromocytoma or a history of pheochromocytoma.

Narrow-angle glaucoma

Atomoxetine should not be used in patients with narrow-angle glaucoma, as in clinical trials the use of atomoxetine was associated with an increased incidence of mydriasis.

Severe cardiovascular disorders, cerebrovascular disorders

Atomoxetine should not be used in patients with severe cardiovascular or cerebrovascular disorders. Severe cardiovascular disorders may include severe hypertension, heart failure, arterial occlusive disease, angina, haemodynamically significant congenital heart disease, cardiomyopathies, myocardial infarction, potentially life-threatening arrhythmias and channelopathies (disorders caused by the dysfunction of ion channels). Severe cerebrovascular disorders may include cerebral aneurysm or stroke.

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