Strattera

A non-stimulant ADHD medicine

Atomoxetine is the ingredient behind the Strattera name. It treats attention deficit hyperactivity disorder (ADHD) — the poor concentration, impulsiveness and restlessness that follow a person into the classroom, the workplace and family life. Children from six years old, teenagers and adults can all take it. Nothing about it is a stimulant: where amphetamine-type medicines act quickly and wear off, atomoxetine lifts the level of norepinephrine, a messenger chemical tied to attention and self-control, and works steadily in the background. Expect the effect to build over weeks, not within the hour.

Taking the capsules

Adults usually begin at 40mg once a day and move up in steps. For children the starting amount is worked out from body weight. One morning dose suits many people; when sleep becomes difficult, the day's total can be split between morning and late afternoon instead. Swallow each capsule whole with water — they are not designed to be opened. Food is not a factor; a fixed daily slot helps. If a dose slips your mind, take it as soon as you think of it — but skip it when the next one is almost due, and never double up.

What you may notice

Dry mouth, nausea, an unsettled stomach, headache, tiredness and broken sleep are the complaints that come up most. Children often go off their food and can shed a little weight, and some men find passing urine awkward or notice erectile problems. Most ease as the body adjusts. Two things matter more: jaundice (yellowing of the skin and the whites of the eyes), dark urine or tenderness below the right ribs can signal liver trouble, and new low mood or thoughts of self-harm in a young person should be taken seriously. Atomoxetine can also nudge heart rate and blood pressure up slightly.

Interactions and conditions that rule it out

Atomoxetine must not be combined with an MAOI antidepressant, an older type of depression medicine that includes phenelzine, tranylcypromine and moclobemide. Leave two weeks between stopping one and starting the other. Narrow-angle glaucoma, a form of raised pressure inside the eye, rules the capsules out. Fluoxetine and paroxetine slow the liver's handling of atomoxetine, so its level rises, and a salbutamol inhaler can add to a racing heartbeat.

Strengths, pack sizes and the other listing

This listing is generic atomoxetine capsules in 10mg, 18mg, 25mg and 40mg, with packs running from 10 up to 360 capsules. A second listing, Atomoxetine, carries 10mg, 18mg and 25mg capsules. Same medicine, different listing name and a shorter strength range — 40mg sits here alone. In practice the choice is pack size, and whether you need the top strength.