The Pros and Cons of Strattera for ADHD: A Nonstimulant Medication Option


While stimulants like Adderall and Concerta are the most commonly prescribed medications for the treatment of attention deficit hyperactivity disorder (ADHD), they are not always well tolerated. They may cause side effects such as insomnia, irritability, and weight loss resulting from loss of appetite. They also present a risk of dependence and cardiovascular side effects—conditions that can be especially risky for adults, for whom many of stimulant drugs (such as Ritalin) have not been approved.

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There is an alternative, however: Atomoxetine, known by its brand name, Strattera, is the only nonstimulant ADHD drug sold in the United States—and the first ADHD drug to be approved specifically for adults, in 2002. Research has shown that it is both safe and effective for long-term use, although perhaps not as effective or quick-acting as stimulants. A 2008 study published in the Journal of Attention Disorders followed nearly 400 adults with ADHD who took Strattera for up to four years. The participants saw their ADHD symptoms reduced by more than 30%, and the authors reported no unexpected side effects.

Unlike stimulants, which target levels of dopamine and norepinephrine in the brain, Strattera affects only the latter. Dopamine is involved in pleasure and addiction processes, which may explain why the risk of abuse associated with Strattera appears to be lower. Strattera, in fact, is the only adult ADHD drug that is not classified as a controlled substance, which means it can be prescribed with refills.

Serious side effects are less likely with Strattera than with stimulants, although the drug is not without safety concerns of its own. It works in similar ways to some antidepressants, and, like those antidepressants, has been issued a warning about increased suicide risk in children. In rare cases, it has also been shown to cause sexual and urinary problems.
Last Updated: January 16, 2009

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