This week, we need to take a look at a non-stimulant drug used to treat ADD/ADHD. It’s brand name is Atomoxetine, but you may recognize it as Strattera. Despite its very hefty price tag, it is becoming widely used for adults and children.
Strattera is known as a selective norepinephrenine reuptake inhibitor. This means that it strengthens the chemical signal between the nerves that use norepinephrine to send messages. It does not seem to affect the dopamine systems as directly as stimulants drugs do, but it does cause a secondary increase in dopamine levels in the brain area located behind your eyes. This is the area that is associated with the ability to mentally rehearse responses and inhibit impulsivity. It’s also associated with your working memory. It is not thought to be at such a high risk for abuse because it is not a Schedule II drug (known for significant potential for addiction) like the stimulants.
While professionals still prefer to try stimulants first, this drug has a gradual and subtle onset. It takes a few days to reach a maximum effect, and some report they’ve had to take it for as long as 3 weeks before seeing any effects. It is taken once or twice a day, and that makes it preferable for children as they don’t have to remember a dose at school.
Now that you know how it works, what about side effects, conflicting conditions, etc? Before beginning Strattera, you should let your doctor know if you have:
- current or past depression, psychosis, or other mental conditions
- substance abuse
- heart disease
- high blood pressure
- epilepsy or another seizure disorder
- liver disease
- kidney disease
- pregnancy, nursing, or plans to become pregnant
Common side effects include the following:
- problems sleeping/insomnia
- dry mouth
- decrease in appetite
- weight loss
- upset stomach
- nausea and/or vomiting
- mood swings
- ear infections
In adults, there can be sexual side effects including a decreased libido, ejaculatory problems, impotence, urination problems, and painful menstrual periods.
Of course, the drug company that makes Strattera, Lilly Pharmaceuticals, says this is a safe drug overall. They report conducting 6 placebo-controlled studies in children, adolescents, and adults to submit the results to the FDA. Early studies indicated that the potential for abuse is lower and the side effects milder than those reported when using stimulant medications.
Two of the trials said its effects were as good as those produced by stimulant medications. The researchers did, however, say they wanted to conduct larger studies to check out this claim.
The short term studies showed that Straterra increased the heart rates and bloodpressures in children. The long-term effects of increased heart rate and blood pressure are still not known. Children also fell below their height and weight growth curves during a more long-term study. The long-term effects are unknown as to whether Strattera use will effect adult height.
The studies also showed side effects in sexual functioning. Also of concern is the question of how this drug will affect kids whose sexual organs are still developing.
So there you have it – the good, the bad, and the ugly – about taking the non-stimulant Strattera. I am still of the opinion that if you want to try a “pill” for your ADD/ADHD symptoms, wouldn’t you prefer a more natural route?