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What Is Strattera Used For? Atomoxetine For ADHD

how strattera is used and what is its mechanism of action

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Strattera uses include treatment of Attention Deficit Hyperactive Disorder (ADHD) as well as other off-label uses such as treatment of mood disorders and cognitive dysfunctions. In addition to this, atomoxetine use for weight loss is also possible. Especially in the short-term, it manifests in a resultant decrease of appetite in patients. However, each of Strattera uses may pose health hazards.

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Learn About Strattera Uses And Mechanism Of Action:

What Is Strattera Used For?

The U.S. Food and Drug Administration has approved Strattera use for the treatment of ADHD in both children above 6 years and adult patients. In addition to these Strattera indications, the drug also has other off-label uses. It allows doctors to legally prescribe it for different age groups with a mired of other conditions. Off-label Strattera medication may be prescribed for the treatment of mood and eating disorders, cognitive dysfunctions, as well as addiction to stimulant drugs.

Strattera For ADHD

Strattera ADHD effectiveness in patients may be attributed to the fact that the drug improves the overall ability of patients to pay attention, concentrate, and stay focused. As a non-stimulant drug, Strattera use is generally considered to be less effective than psychostimulants use in the treatment of ADHD. However, it does cause potential side effects associated with psychostimulants as well.

Furthermore, a comparison of Strattera with Adderall, a stimulant drug, found that Adderall can be habit-forming. Hence it’s classified as controlled substances, unlike atomoxetine. However, dependence on Strattera is also possible. One of the tradeoffs of atomoxetine use and effectiveness is that it may take longer for the drug to reach its full efficacy. That’s why patients often abuse it, trying to achieve the expected effects faster.

Off-Label Uses

Although Strattera use for depression and other off-label cognitive dysfunction is allowed, it is important to examine the reported adverse events. With this in mind, patients can evaluate what level of risk to their health medication represents. Here are potential off-label uses of atomoxetine.

Mood Disorders

This is a condition that severely affects a person’s mood. It includes conditions such as major depressive disorder, seasonal affective disorder, and bipolar disorder. Strattera for depression is thought to be effective because of its noradrenergic actions. Its inhibiting effects on norepinephrine reuptake increases its ability to exert a positive effect on one’s mood.

Eating Disorders

According to the U.S. National Library of Medicine, atomoxetine uses in some patients with eating disorders have proven to be efficacious and well-tolerated. Both ADHD and eating disorders rely on a common neural substrate called dopaminergic signaling, which is vital in motor activity and emotions.

Strattera off-label use for cognitive dysfunction treatment

Cognitive Dysfunction

Strattera uses for managing cognitive dysfunctions have proven successful in patients who suffer from schizophrenia. Furthermore, Strattera for anxiety is effective in patients who have Parkinson’s disease as well.

Addictions

Data from the U.S. National Library of Medicine suggests that atomoxetine can be used for the treatment of stimulant addiction. Drugs similar to Strattera, such as Bupropion, had also proven effective. Though Strattera use was preferred since it did not increase dopamine concentration in striatum and nucleus accumbens.

Strattera Use In Patients Of Different Ages

Atomoxetine may be prescribed to patients of different age groups. Since ADHD is a condition that affects both children and adults, uses for Strattera to manage the condition among people of different ages are not uncommon. What may vary is the atomoxetine dosage among patients. Although more research still needs to be undertaken to determine its efficacy in patients of certain age ranges.

Strattera For Adults

Strattera use in adults is an effective and well-tolerated method of managing ADHD. And particularly for adults who either have a high intolerance for stimulants or a high risk of abuse, atomoxetine is a good alternative. On the other hand, Strattera generic price is fairly higher for even those with medical insurance.

Atomoxetine for anxiety or its intended indication still needs more research for geriatric patients (those over the age of 50years).

Strattera For Children

According to the Centres for Disease and Control Prevention, 3 out of 4 children in the U.S. with current ADHD received some form of treatment. Furthermore, out of an estimated total of 7 million children diagnosed with ADHD, 62% were taking ADHD medication. This means that a larger number may be exposed to Strattera use as opposed to behavioral therapy.

For children under the age of 6 years; however, behavioral therapy should be favored over atomoxetine uses. The reason for this is that the safety and efficacy of atomoxetine have not been established for use in neonates, infants, and children of 6 years and below.

In light of this, even though no adequate well-controlled studies have been conducted to link Strattera and pregnancy side effects, atomoxetine for depression or ADHD should not be used during pregnancy unless the benefit justifies the potential risk to the fetus and mother. Any use of Strattera should be agreed with a doctor.

How Does Strattera Work?

Atomoxetine mechanism of action (MOA) works by affecting the chemicals in the brain and nervous system. These chemicals influence hyperactivity and impulse control.

Atomoxetine Mechanism Of Action

How Strattera works refers to the process of inhibiting the reuptake of norepinephrine in the brain. It increases the levels of this neurotransmitter. Evidently, this is achieved by selective inhibition of the presynaptic norepinephrine transporter. Reuptake is a normal mechanism by which the body controls how long a nerve signal lasts. However, if someone has significantly low levels of a neurotransmitter, reuptake can be a problem. The matter is that it restricts the volume of neurotransmitters being actively circulated in the brain.

Strattera mechanism of action and how fast it works

Does Strattera Work Immediately?

Many patients come up with the question of whether atomoxetine works immediately if it inhibits the reuptake of norepinephrine in the brain. The simple answer is “No,” the drug does not get to work immediately.

How Long Does It Take For Strattera To Work?

Some people report small changes in hyperactivity and impulse control within two weeks of Strattera use. Generally, it may take 4 to 8 weeks for the drug to achieve maximum effectiveness.

Atomoxetine Warnings And Contraindications

There are situations when atomoxetine uses may cause harmful effects to a specific group of people with certain medical conditions. The following are some of the warnings and contraindications of atomoxetine.

Hypersensitivity

Atomoxetine for anxiety or ADHD is contraindicated in any person with a known hypersensitivity to atomoxetine. For example, due to allergic reactions, Strattera use may cause painful swelling under the skin of some patients. This condition is known as angioedema. In some, it may cause hives (urticaria), swollen red bumps on the skin.

Narrow-Angle Glaucoma

This is a condition whereby the iris is either pushed or pulled forward, causing a blockage in the drainage angle of the eye. In clinical trials, Strattera use was associated with an increased risk of dilation of the patient’s pupils. Consequently, its use is not recommended in patients with narrow-angle glaucoma as it may act as a trigger for the condition.

warning: Strattera may cause suicidal ideation

Suicidal Ideation

Atomoxetine use in the treatment of ADHD and other off-label uses increase the risk of suicidal ideation in the short-term. Children and adolescents are the most vulnerable groups. This effect is common because the atomoxetine mechanism of action is similar to antidepressants. According to the National Institute of Health, 1 in 50 children taking antidepressants experiences increased suicidal thoughts.

Severe Liver Injury

Reported cases of hepatotoxicity occurred within 3 to 12 weeks of initiation of atomoxetine use in the majority of cases. A reason for this is that, during Strattera use, the drug is actively broken down in the liver, producing products that may be toxic. For patients who may try snorting Strattera to get high, there may be an increased risk. Snorting sends the entire dosage into the bloodstream at once.

Snorting atomoxetine or any other use of a drug different from the prescribed one is illegal and is considered as abuse. Patients should not try to use the drug in any other way.

Serious Cardiovascular Events

Patients who experience symptoms such as chest pain, unexplained syncope, or other cardiac disease-related symptoms during atomoxetine usage should consult and report these symptoms to their doctor. It may also be advised to undergo a cardiac evaluation. Continued use of the drug has been seen to increase the heart rate. Therefore, the patients who are on atomoxetine should monitor their heart rates and blood pressure on follow up visits to their doctor.

Emergence Of New Psychotic Or Manic Symptoms

The Medicines and Healthcare Products Regulatory Agency indicated that, at normal doses, atomoxetine for depression could be related to treatment-emergent psychotic or manic symptoms in young patients with no prior history of the condition.

Atomoxetine Safe And Responsible Usage

Atomoxetine, a non-stimulant drug approved by the FDA for management of Attention Deficiency Hyperactive Syndrome, may also be prescribed for other off-label instances. Cases, where Strattera for depression disorders is prescribed to patients, are not uncommon. Therefore, health professionals should educate patients, their families, and caregivers about the potential benefits of using Strattera, as well as the associated risks of Strattera indications. In case of abuse, patients need to seek professional help. Rehab for drug addicts and addiction centers provide a wide range of treatment options to meet the individual needs of the patients. Since even though the drug is not a controlled substance, habitual dependence is still possible. That’s why patients need always to be cautious.

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Sources
  1. Dadashova R, Silverstone PH. Off-label use of atomoxetine in adults: is it safe? Mental Illness. 2012; 4(2): e19. doi:10.4081/mi.2012.e19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253379/.
  2. National Center on Birth Defects and Developmental Disabilities. Data and Statistics About ADHD. Center for Disease Control and Prevention. 2019. https://www.cdc.gov/ncbddd/adhd/data.html.
  3. Wooltorton E. Suicidal ideation among children taking atomoxetine (Strattera). Canadian Medical Association Journal. 2005; 173(12): 1447. doi:10.1503/cmaj.051474. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1316159/.
  4. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012. Atomoxetine. https://www.ncbi.nlm.nih.gov/books/NBK548671/.
  5. Atomoxetine: risk of psychotic or manic symptoms in children and adolescents. Medicines and Healthcare products Regulatory Agency. 2014. https://www.gov.uk/drug-safety-update/atomoxetine-risk-of-psychotic-or-manic-symptoms-in-children-and-adolescents.
Roger Weiss

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

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