Atomoxetine
A non-stimulant ADHD capsule that works all day, every day. Slower and a bit less powerful than stimulants, but no peaks, crashes or controlled-drug paperwork.
Quick answer: Atomoxetine is a once- or twice-daily non-stimulant for ADHD. It takes 4–6 weeks to work, sometimes 12, and smooths symptoms across the whole day, including mornings and evenings. It’s a good option when stimulants don’t suit, cause anxiety or tics, or when misuse is a worry. Common side effects are nausea, less appetite, tiredness and, in adults, erection or ejaculation problems.
At a glance
- For
- ADHD in children 6+, teens and adults
- Works
- Helps about half to two-thirds of people; on average a bit less than stimulants
- Cost
- $25 a script on the PBS with an authority when stimulants are unsuitable ($7.70 concession); otherwise private
- Kicks in
- Some effect in 1–2 weeks; full effect at 4–6 weeks, up to 12
- Dose
- Based on weight in children; usually 40 mg rising to 80 mg daily in adults
- Watch for
- Nausea, less appetite, tummy pain, tiredness, higher pulse and blood pressure, low mood
No buzz, no crash, no S8 forms. The trade-off is patience: give it 6 weeks before you judge it.
Brand names
- Strattera, and generic atomoxetine brands
How it works
Atomoxetine blocks the reuptake of noradrenaline (and, in the front of the brain, dopamine), so more is available where attention and impulse control are managed. Unlike stimulants, it doesn’t act on the brain’s reward centre, so it isn’t habit-forming.
Used for
- ADHD in children aged 6 and over, teenagers and adults (TGA-approved)
- Often chosen when stimulants cause anxiety, tics, poor sleep or appetite loss, or when misuse is a concern
- Can be combined with a stimulant under specialist guidance
Side effects
Nausea, less appetite and tummy pain are the most common, especially early; taking it with food helps. Tiredness or trouble sleeping, mood changes and a slightly higher pulse and blood pressure are common. Adults may notice erection, ejaculation or period changes.
Full side-effect list (from the product information)
How often, from the official product information. Bold = serious.
Very common more than 1 in 10
- Nausea, vomiting or tummy pain
- Less appetite
- Headache
- Sleepiness (children)
- Dry mouth (adults)
- Trouble sleeping (adults)
Common 1 in 10 to 1 in 100
- Tiredness, dizziness or irritability
- Low mood or anxiety
- Weight loss
- Constipation or indigestion
- Faster heartbeat or raised blood pressure
- Hot flushes, sweating or chills
- Erection or ejaculation problems, less libido, period pain
- Trouble passing urine
- Rash or itch
Uncommon 1 in 100 to 1 in 1,000
- Suicidal thoughts (mainly children and teens)
- Fainting
- Muscle spasms
- Shortness of breath
- Palpitations
Rare 1 in 1,000 to 1 in 10,000
- Liver injury
- Seizures
- Raynaud’s (cold, white fingers)
- Priapism (an erection lasting over 4 hours)
Get help urgently if
- Thoughts of self-harm, or a big change in mood or behaviour. Call 000 or Lifeline 13 11 14
- Yellow skin or eyes, dark urine or itching with tummy pain (liver)
- An erection lasting more than 4 hours
- Chest pain, fainting or a racing heartbeat
Good to know
- Give it time. Judge it at 6–12 weeks at the right dose.
- Not a controlled (S8) medicine: no state permit, and it’s fine to travel with.
- Some antidepressants (fluoxetine, paroxetine) and bupropion raise atomoxetine levels a lot. Tell your doctor what else you take.
- Not with MAO inhibitors. Caution with heart disease or high blood pressure: pulse and blood pressure are checked.
- Can be stopped without tapering, but symptoms return.
Common questions
How long does atomoxetine take to work?
Some effect may show in 1–2 weeks, but full benefit usually takes 4–6 weeks and can take up to 12. Judge it after that, at the right dose.
Is atomoxetine a stimulant?
No. It’s a non-stimulant that works on noradrenaline. It isn’t habit-forming and isn’t a controlled (S8) medicine.
What are the side effects of atomoxetine?
Nausea, tummy pain and less appetite are the most common, especially early. Tiredness, mood changes, higher pulse and blood pressure, and sexual side effects in adults can also happen. Low mood or suicidal thoughts in young people need urgent review.
Information only. Not a recommendation or endorsement of any product. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist. In an emergency, call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries.
More information
- Strattera product information (TGA)
- PBS: Atomoxetine
- Australian evidence-based clinical practice guideline for ADHD (AADPA, 2022)
- Healthdirect: Medicines information
maladywise.com/medicines/atomoxetine/