Atomoxetine

ADHD in children (6+), young people and adults. NICE recommends atomoxetine when stimulants (methylphenidate and lisdexamfetamine) are not tolerated or haven’t worked after adequate trials. Also considered as first-line when there are concerns about stimulant misuse, significant anxiety, or when 24-hour coverage is needed.

Atomoxetine selectively blocks the noradrenaline transporter in the prefrontal cortex. Because noradrenaline and dopamine share the same transporter in this brain region, blocking it increases BOTH neurotransmitters where they’re needed for attention and executive function. Unlike stimulants, it doesn’t directly increase dopamine in the reward pathways, which is why it has no abuse potential. It works like an antidepressant - building up over weeks to a steady therapeutic level.

Patients who can’t tolerate stimulants (anxiety worsening, tics, cardiovascular concerns, insomnia), those who haven’t responded to adequate trials of both methylphenidate and amphetamine-based stimulants, those with concurrent anxiety disorder (atomoxetine often helps anxiety as well as ADHD), and patients where controlled drug status is a concern (history of substance misuse, occupational reasons). CYP2D6 poor metabolisers (about 7% of Caucasians) will have higher blood levels - dose adjustment may be needed.

Order online and we review your request. A prescriber checks your consultation form for clinical appropriateness and contacts you if anything else is needed. Once approved, your medication is dispensed and delivered to your door.

Tracked: Tracked delivery, arrives in two working days - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer the branded version, let us know in your order form and we will confirm any price difference.

Atomoxetine from £34.99 per pack.

Common: decreased appetite, nausea, abdominal pain, headache, drowsiness. Atomoxetine: increased heart rate, raised blood pressure, mood changes. Guanfacine: sedation, bradycardia, hypotension.

Atomoxetine: avoid in phaeochromocytoma, severe cardiovascular disorders, narrow-angle glaucoma. Guanfacine: avoid in significant cardiac conduction disorders.

Atomoxetine: CYP2D6 inhibitors (fluoxetine, paroxetine) increase levels. MAOIs: avoid. Guanfacine: CYP3A4 inhibitors/inducers affect levels. Both: caution with QT-prolonging drugs.

Limited data in pregnancy. Stimulants may affect fetal growth. Use only if benefit clearly outweighs risk. Discuss with specialist before conception. Not recommended during breastfeeding.

Takes 3-6 weeks to reach full effect - don’t judge it too early. Start at 40mg daily for at least 7 days, then increase to target dose (usually 80-100mg in adults, weight-based in children). Can be taken once daily (morning or evening) or split into two doses. Take with food. Common side effects: nausea (especially early on - usually settles), appetite suppression, dry mouth, insomnia or drowsiness (varies by person), increased heart rate. Monitor for mood changes - rare reports of suicidal thoughts, particularly in young people. Liver function: very rare severe liver injury reported - stop if jaundice or dark urine develops. Sexual side effects (erectile dysfunction, reduced libido) can occur in adults.