Strattera (Atomoxetine)
Strattera (Atomoxetine) is a newly approved (U.S. FDA December 2002) selective norepinephrine reuptake inhibitor (SNRI) antidepressant. Atomoxetine was originally developed by pharmaceutical company Eli Lilly in the 1980's as a potential treatment for depressive illness. The compound was selected from a series of potent inhibitors of norepinephrine reuptake, and reached large-scale phase II clinical trials for depression in 1990. Development for depression appeared to stop at that time, despite some evidence that the drug was fairly effective. In 1996, Lilly restarted preclinical development of the medication as a potential therapy for ADHD and it was approved in 2002 for the treatment of ADD/ADHD in patients 6 years of age and older.

Atomoxetine appears to work for ADD/ADHD by helping to modulate norepinephrine (NE) transmission. The neurotransmitter norepenephrine (along with dopamine), is believed to play an important role in modulating the brain systems that control attention and activity. For this reason, Atomoxetine may also have value for treating mood disorder symptoms like sleepiness, fatigue, and lack of mental clarity.

Although Atomoxetine has a relatively short half-life of 5.2 hours (the amount of time before half the drug is metabolized in the body), one study has suggested that for children and adolescents, once-daily dosing in the morning is as effective as twice-daily dosing. As patients clearly prefer medications which only need to be taken once-daily, this may make Atomoxetine an especially user-friendly medication for young ADD/ADHD patients. Atomoxetine is available in 5, 10, 18, 25, 40, and 60 mg capsules. In children and adolescents weighing < 70 kg, the recommended starting dose is 0.5 mg/kg/day. This dose may be increased after 3 days to a total of 1.2 mg/kg/day. It may be administered once daily or divided and given as a morning and an afternoon dose. The maximum recommended daily dose is 1.4 mg/kg/day or 100 mg, whichever is less. It has been noted by some clinicians that the onset of symptom control with atomoxetine is delayed compared to the stimulants. A trial period of at least two weeks is recommended to determine the efficacy of therapy.

On December 17, 2004, drug maker Eli Lilly added a warning to the Strattera label, advising patients to stop taking Strattera if they develop jaundice or liver injury. This label change discusses two reported cases of severe liver injury out of the more than 2 million patients who have taken the medication since approval. Both patients have recovered with normal liver function after discontinuing the medication.

(NOTE: Like many antidepressants, Atomoxetine may cause a number of side effects when beginning treatment. The most common side effects reported from Strattera are sleepiness, nausea and loss