ADHD Medication and Treatment Reviews

Strattera: ADHD Medication

Generic name: atomoxetine hydrochloride
Strattera is a non-stimulant ADHD medication used to treat symptoms of attention deficit hyperactivity disorder in children ages 6-12, adolescents, and adults.

What is Strattera? What Does Strattera Do?


Strattera (generic name: atomoxetine hydrochloride) is an alternative to the stimulant ADHD medications most commonly used to treat symptoms of attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, adolescents, and adults. It is a selective norepinephrine reuptake inhibitor (SNRI) medicine. Strattera is a non-stimulant; it is not considered a controlled substance by the Drug Enforcement Agency (DEA). It has not been studied in children under the age of 6.

Strattera was the first and only non-stimulant medication approved for ADHD treatment in the United States by the Food and Drug Administration (FDA). It was also the first non-stimulant medication to be approved for treating adults with ADHD.

Is Strattera Better Than Adderall?

Strattera and Adderall are both medications used to treat ADHD, but they are fundamentally different. Adderall is a stimulant and Strattera is a non-stimulant medication. Strattera is the brand name for the drug atomoxetine, which is a norepinephrine reuptake inhibitor that allows the neurotransmitter norepinephrine to be available to the brains neurons for longer. Adderall is the brand name for the combination of the drugs dextroamphetamine and amphetamine, and it acts on the central nervous system by boosting the number of dopamine and norepinephrine transmitters in the brain.

Generally speaking, stimulant medications are significantly more effective than Strattera for treating ADHD. Strattera is used, however, in special circumstances and patient populations:

  • About 15% of people either do not get benefits from or tolerate stimulant medications; for one in seven people, Strattera may be the drug of choice
  • Many parents and adult patients find the idea of taking a “stimulant” either frightening or otherwise unacceptable
  • Substance use disorders are very common in people who have ADHD. The first-line stimulant medications are considered to be risky with people who have experienced either active or recent uncontrolled drug and alcohol abuse, and Strattera again becomes the drug of choice
  • Stimulants should not be used with patients who have co-existing conditions such as untreated glaucoma, structural heart defects, and uncontrolled seizures. Strattera is often used in such circumstances
  • Strattera can be additive to other second-line ADHD medications such as the alpha agonist medications guanfacine and clonidine

In these circumstances, non-stimulant medications like Strattera are an effective alternative.

What is the Typical Dosage for Strattera?

The optimal dosage of Strattera varies by patient. Capsules are available in 10mg, 18mg, 25mg, 40mg, 80mg, and 100mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day. Your doctor may adjust your daily dosage after 3 days until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Dosing for children and adolescents less than 70 kg:

For children, Strattera should be initiated at a total daily dose of approximately 0.5 mg/kg and gradually increased after a minimum of 3 days to a target total daily dose of approximately 1.2 mg/kg. No additional benefit has been demonstrated for doses higher than 1.2 mg/kg/day.

Dosing for adults and adolescents greater than 70 kg:

Strattera should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a target total daily dose of approximately 80-90 mg per day in divided doses.

The maximum dosage that was studied and, therefore, recommended is 100mg/day.

As with all medications, follow your Strattera prescription instructions exactly. Strattera is taken orally, with or without food, once or twice daily.

As with all medications, follow your Strattera prescription instructions exactly. Strattera is taken orally, with or without food, once or twice daily.

The most common reason why patients don’t experience optimal benefits from Strattera is a high level of side effects, which prevents them from taking a dose high enough to be therapeutic. As a result, it is vitally important that the severity of side effects be lowered by dividing the dose through the day. Although Strattera was studied and approved by the FDA at a frequency of one dose per day, the short duration of the atomoxetine molecule in the body means that people will experience greater effectiveness with fewer and less severe side effects if the dose is divided and taken at least twice a day and sometimes three times a day. The first dose is typically taken first thing in the morning. If a second dose is prescribed, it is typically taken in the late afternoon or early evening. It should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. Capsules should never be opened, crushed, or chewed. If your child is unable to swallow the capsule, discuss a different medication with your doctor.

Before starting or refilling a Strattera prescription, read the medication guide included with your pills, as it may be updated with new information.

During treatment, your doctor should check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

What Are the Most Common Side Effects of Strattera?

The most common side effects of Strattera are as follows:

Side Effects in Children and Adolescents (Ages 6 – 17):

  • upset stomach
  • decreased appetite
  • nausea
  • vomiting

Side Effects in Adults:

  • constipation
  • dry mouth
  • nausea
  • decreased appetite
  • dizziness
  • sexual side effects
  • problems passing urine

Serious Side Effects:

  • severe allergic reaction
  • difficulty urinating including trouble starting and emptying the bladder
  • Seek immediate medical attention if you have trouble breathing, see swelling or hives, or experience any other signs of an allergic reaction

Strattera and Familial Mental Health Issues

Disclose to your physician all mental health issues including any family history of suicide, bipolar illness, or depression. Atomoxetine is a potent trigger for mania in genetically predisposed people.  As a result, the FDA recommends evaluating every patient for past symptoms consistent with a diagnosis of bipolar or a family history of bipolar or cyclic mood disorders prior to administrating Strattera to avoid inducing a manic episode. Strattera may create new or exacerbate existing behavior problems, bipolar disorder, or suicidal ideation. It can cause psychotic or manic symptoms in children and teenagers.

Strattera carries the same black box warning that every antidepressant medication has regarding the risk for inducing suicidal thoughts. Strattera was developed by the same laboratory that discovered Prozac (fluoxetine), but it does not have any detectable benefits for either depression or anxiety disorders. It does have a 0.4% incidence of new suicidal thinking (compared to none in placebo groups) but with no history of people acting on those thoughts. If suicidal thoughts occur, call your clinician to discuss a course of action

Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including anxiety, hearing voices, agitation, panic attacks, trouble sleeping, irritability, hostility, aggressiveness, or depression.

Strattera and Liver Problems

Discuss any existing liver problems with your doctor. Strattera has been associated with two cases of severe liver injury since it was approved by the FDA. Contact your doctor immediately if you or your child experiences these signs of liver problems: itching, right upper belly pain, dark urine, yellow skin or eyes, or inexplicable flu-like symptoms.

Strattera and Heart- or Blood-Pressure Related Problems


Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Strattera.

Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Strattera.

If side effects are bothersome, or do not go away, talk to your doctor. The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

What Precautions are Associated with Strattera?

You should not take Strattera if you have:

  • taken, or plan to take an antidepressant monoamine oxidase inhibitor or MAOI within 14 days
  • untreated narrow-angle glaucoma
  • an allergy to atomoxetine or any other ingredients in Strattera
  • a rare tumor called pheochromocytoma

If you’re thinking of becoming pregnant, discuss the use of Strattera with your doctor. Animal studies indicate a potential risk of fetal harm; infants may be born prematurely, with low birth weight, with spinal abnormalities, or experience withdrawal. Strattera is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Store Strattera in a secure place out of the reach of children, and at room temperature. Do not share your Strattera prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

The effects of Strattera on children under 6 and on the elderly have not been studied.

What Interactions Are Associated with Strattera?

Before taking Strattera, discuss all other active prescription medications with your doctor. Strattera can have a dangerous interaction with antidepressants including MAOIs, asthma medicines, and blood pressure medicines.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription and let all doctors and physicians know you are taking Strattera before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

1Strattera (atomoxetine hydrochloride) capsules label. Eli Lilly and Company. http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021411s035lbl.pdf

2Clemow, David. Suboptimal Dosing of Strattera (atomoxetine) for ADHD Patients. Postgraduate Medicine (Mar. 2015) https://www.tandfonline.com/doi/abs/10.3810/pgm.2014.09.2814

3Farone, Stephen. Adderall XR vs. Strattera in School-Aged Children: 3 Month Projected Outcomes. Guildford Journals (2007). https://guilfordjournals.com/doi/pdf/10.1521/adhd.2007.15.5.14

More Information on Strattera and Other ADHD Medications:

Free Download: The Complete Guide to ADHD Medications
A Parent’s Guide to Psychiatric Medications for Children with ADHD
How Does ADHD Medication Work? Your First Questions Answered.

30 Strattera: ADHD Medication Related Links

  1. My 12 year old son has been taking Strattera for 5 weeks now. He started with 2 weeks of 10mg then moved up to 18 mg and he will be on that for another week before ramping up again. He has had no side effects so far. I think we are finally starting to see some improvement in his symptoms after 5 weeks…he seems calmer and more focused. We are giving him the Strattera every night after dinner. He sleeps great at night and has had no stomach problems. I did notice that he seemed a little more anxious and withdrawn after starting the 10 mg and again after starting the 18 mg but that went away after about 3 days. My son moved up to the 25 mg dose last Friday. On Saturday he seemed more unfocused. There did not seem to be any extra anxiety or any other side effects this time.

  2. My 8 year old daughter was taking two 25mg pills every morning and then Intuniv 3mg at night. She started having severe stomach cramps daily. We switched the Strattera to 25mg in the morning and 25mg at night and now she rarely has stomach cramps.

  3. My son takes Straterra and we are having success with one exception, stomach problems. The problem was the dye used in the capsules and not the medication itself.

  4. My 9 year old daughter is up to 25 mg of Strattera. However, there are some nights when she wakes up in the middle of the night and cannot fall back to sleep for long periods of time.

  5. I am male and 55 years old recently diagnosed with ADHD. I am on 80 mg of Strattera. It has helped much with anxiety and impulsivity. I am having negative side effects: I feel more spacey, food tastes bland and my appetite has decreased.

  6. I am 39 and newly diagnosed. I started on Strattera this past weekend and am on 40 mg twice a day as of two days ago. I was very drowsy the first two days, but it hasn’t been that bad since. On the other hand, I haven’t noticed much other difference in my attention or organizational capacity, either.

  7. I am taking 18mg once per day and this is the second week. The first week I had insomnia like crazy and lately I have been sleeping more than ever in my life.

  8. I am 56 year old Retired Special Ed teacher, and have been taking 40mg BID Strattera for over 5 years—works great for me. However, I did develop a small facial tic (excessive eye blinking).

  9. I am a 52 year old female with ADHD, and I take 60mg of Strattera daily, and the only problem I have with mine is occasionally I have dry cotton mouth. I have been taking it now for 5 years.

  10. I am on 40mg Strattera as well as 30mg Vyvanse. The first few weeks of Strattera were a little rocky, but four months into it, I am very pleased with it. However, the Vyvanse gets me motivated and the Strattera helps me to focus.

  11. I started at 40 mg and had a crazy over-the-top response to it (stared at a wall in bed for several hours). Now I’m on 10 mg. If I take it at night (after 5:00pm), I feel pretty good except for a little dry mouth and insomnia. However if I take it first thing in the morning, I spend the majority of the morning and early afternoon exhausted and kind of out of it.

  12. I’m 38 years old. And last month I diagnosed ADHD. I started Strattera 40mg, I don’t have a effectiveness yet, but I feel very strong sleepiness all day as side effect.

  13. I started at 18mg and worked up to 60mg over the course of a month. I felt restless and cranky all the time. However, now that it is fully kicked in (I’ve been on it for about 4 months), it is worth it.

  14. My 8 yr old was on Strattera for several months. Starting low at 10, increasing to 10 at night and 10 at morning, to 18 at night and 25 in the morning. It worked wonders for her ADHD combined type. Inattentive and impulsive at school, and impulsive and struggling with behavior at home. Initially, she was extremely tired the first two weeks. Thankfully we started it over a school break, but she napped for hours every mid day. After it built up, it made her very calm and focused and she teacher noticed a great improvement. Although maybe a little too calm for my liking. She wasn’t walking around like a zombie, but she just wasn’t as vibrant as before, so I was on the fence. She was still eating and playing like a normal child. We stayed on it because she in her own words, liked how she didn’t feel so crazy inside. However, it caused stomach issues early on. She would vomit about a hour after taking her medication. This happened 5-6 separate occasions. We did quickly learn that a high fat high protein breakfast remedied that. But as we increased the dosage, the stomach issues increased as well. Stomach aches and headaches that wouldn’t go away made it hard to get her to want to take her meds. We took the summer off then ended up switching.

  15. My 13 year old daughter takes strattera. At first it gave her severe stomach pain and she felt like she was going to throw up. She barely ate anything for weeks. Then those problems decreased, and she rarely experiences those side effects anymore. It has been very helpful and we have seen much improvement in her focus and all areas in her life.

  16. After being given a sample prescription and reading up on it I had real concerns and did not take it. I fought (with knowledge) for a main line treatment for adhd (adderall) and am fully satisfied. The only real reason I could find why they would prescribe this is that it has low potential for abuse. It is far less likely to work and because it is stimulant like it carried the same or worse cardiac risk. You need to focus your hyperactivity on learning, do not trust that your doctor is up to speed, and be sure to explain how severe your condition is to you because most doctors think adhd is minor and not worth any risk to treat.

  17. Started Strattera this morning as my first attempt to treat my recently diagnosed ADD. I am a 43-year-old woman. My response was very negative to this medication. Approximately 1 to 2 hours after taking it I became extremely exhausted, dizzy, dry mouth, and slurred speech. I also had moments of feeling “high” -but not the good kind. It felt like I was floating, accompanied by small episodes of anxiety.These effects lasted throughout the day on and off for several hours and into the evening. I took only 25 mg to start. I cannot imagine trying to ride this out as it made me a completely nonfunctional person as a mom of three kids I can’t afford to wait weeks or a month for the symptoms to resolve or decrease. Awful 🙁

  18. Strattera is something to be careful with. I have definitely read several good reviews and heard other people talk about Strattera being effective, but it must vary from one individual to another for some reason, and it seems to me that for some people it works really well and for others it causes an enormous negative disruption in the patient’s mental state. During a quest to find better medication after Concerta didn’t seem to affect me as well as it did when I was younger, I tried Strattera briefly. I don’t remember the specific dosage but I know it was pretty low (probably either 10mg or 18mg) , and I was instructed to take one pill every day for a week, and then start taking two pills a day, at which point I would be at the minimum recommended dose for my weight, age, symptom severity, etc. During the week that I took one pill I didn’t notice much in the way of changes to my behavior or symptoms, which wasn’t much of a surprise because in the past I took pretty high dosages of other medications. The first day that I took two started out okay, but all day at work I felt some tension building, and around 3 o’clock I just went haywire: I felt irrationally angry and ready to get in a fight with the next person who spoke to me. I left work around that time because it was the end of my shift, and luckily it was only a five minute drive home because I after arriving at home I proceeded to succumb to a full-blown mental breakdown, for which there was no apparent catalyst. I figured perhaps I just wasn’t used to the drug yet, and continued to take it the same way for the next week or so. Although the side effects were not as severe in that following week, I would get into an argument or transition into a mood that I can describe as having been- depending on the day- anywhere from just irritable to “rage mode” every day around the same time (3 o’clock/mid-afternoon), and it would last until the medication wore off. I have several friends who are also AD/HD and those of them who have tried Strattera have had similar experiences. I have nothing against the medication, if it works for a person then it works, however please be careful with it and pay close attention to any behavioral changes like this, because chances are it is not “just a bad day/week” and this is not the appropriate medication.

  19. I’m a 56 y.o. male, diagnosed with ADHD, ODD, Depression. Been on Strattera for ~ a year. Started out with 80mg, did great, then felt after about 3 months, my focus started slipping. Bumped it to 100mg, and felt an edginess to my mood. Backed off to 80mg again. Can’t take any amphetamine based meds because it causes joint pain. Strattera for me has had some side-effects: bladder tingle, trouble urinating. Also, increase libido and ejaculation before actual climax. No kidding. For the most part, I’ve been pretty happy with the increased focus.

Tips for Good Medication and Treatment Reviews

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