Verified
The first ten days brought nausea and a dry mouth. Eating before the capsule helped. By about week five, I was finishing work tasks more consistently, although the change was gradual rather than dramatic.
15 Sept 2026
Active ingredient: Atomoxetine
Strattera
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Strattera is a prescription ADHD medicine for children, adolescents, and adults. Its active ingredient, atomoxetine, supports attention and impulse control by selectively increasing norepinephrine signalling in the brain.
Description
Strattera is a prescription non-stimulant medicine containing atomoxetine for attention deficit hyperactivity disorder (ADHD) in children, adolescents, and adults. Atomoxetine is classified as a selective norepinephrine reuptake inhibitor, or NRI.
Composition
Strattera contains atomoxetine. The dose is stated on the pack — follow the leaflet. Atomoxetine is classified as a selective norepinephrine reuptake inhibitor, or NRI.
Active Ingredient and Chemical Classification
Atomoxetine hydrochloride is the pharmaceutical form of the active substance.
Dosage and usage
- Dose: Each hard capsule contains 18 mg of atomoxetine.
- Frequency: Take the prescribed number of capsules at the frequency directed by the prescriber or stated in the leaflet; the exact schedule is not specified here.
- Timing: Take by mouth with or without food. The exact time of day is not specified here.
- Duration: Continue for the duration prescribed by the healthcare professional; the exact treatment duration is not specified here.
- Route: Swallow the hard capsules whole for oral use. Do not open, chew, crush, or sprinkle the contents onto food.
How it works
Atomoxetine blocks the norepinephrine transporter, reducing the reuptake of norepinephrine after its release between nerve cells. More norepinephrine remains available in areas of the brain involved in attention and executive function.
The medicine is not a central nervous system stimulant. Its pharmacological action differs from amphetamine-based medicines and methylphenidate, which influence dopamine and norepinephrine pathways more directly and usually produce a faster change in symptoms. Regulatory information describes atomoxetine as a non-stimulant treatment option for ADHD [1].
Norepinephrine helps the brain select relevant information, maintain alertness, and organise responses. In ADHD, altered regulation of these networks can contribute to distractibility, impulsive behaviour, and difficulty completing tasks. By increasing norepinephrine activity, atomoxetine may improve sustained attention and reduce hyperactivity or impulsive actions.
Indications
It is licensed for the treatment of ADHD, a neurodevelopmental condition involving persistent difficulties with attention, impulse control, and activity regulation.
Strattera and stimulant treatments target ADHD through different pharmacological pathways. Atomoxetine increases norepinephrine signalling mainly by transporter inhibition.
Comparison
Strattera and stimulant treatments target ADHD through different pharmacological pathways. Atomoxetine increases norepinephrine signalling mainly by transporter inhibition. Central nervous system stimulants influence dopamine and norepinephrine transmission more directly and often work within a shorter period.
| Treatment type | Main pharmacological feature | Typical clinical consideration |
|---|---|---|
| Strattera | Selective norepinephrine reuptake inhibition | Gradual response; lower misuse concern than stimulant treatment |
| Amphetamine-based stimulant | Increases catecholamine signalling | Faster effect; controlled-drug rules may apply |
| Methylphenidate-based stimulant | Blocks dopamine and norepinephrine reuptake | Faster effect; appetite, sleep, and cardiovascular monitoring may be needed |
Pharmacological Differences Between Stimulants and Non-Stimulants
Clinicians may consider a non-stimulant when stimulant treatment causes troublesome appetite loss, insomnia, mood fluctuation, or an uncomfortable increase in heart rate. Atomoxetine may also be considered when there is concern about misuse of stimulant medicines, though it can still produce adverse effects and requires monitoring.
Stimulants often provide noticeable benefit on the day they are taken. Strattera is better understood as a continuous treatment that builds its effect through regular use. Its slower onset can be frustrating during the first month, especially when a person expects an immediate change in focus.
The choice also depends on coexisting conditions. Anxiety, tics, sleep problems, cardiovascular disease, depression, and substance-use history can all affect the treatment decision. A clinician weighs these factors against the expected benefit rather than choosing solely by medication class.
Contraindications
Strattera should not be used with:
- an allergy to atomoxetine or any capsule component;
- a diagnosis of narrow-angle glaucoma;
- treatment with a monoamine oxidase inhibitor, or within 14 days of stopping one;
- pheochromocytoma or a history of pheochromocytoma unless a specialist has specifically assessed the situation;
- serious cardiovascular disease where an increase in heart rate or blood pressure could worsen the condition.
Atomoxetine is metabolised mainly through CYP2D6. Fluoxetine, paroxetine, and quinidine can substantially increase atomoxetine exposure and may require a lower starting dose or slower adjustment. Salbutamol and other medicines that raise heart rate or blood pressure can add to cardiovascular effects.
When this is not for you
Strattera is not suitable for everyone. The following situations require avoidance, specialist assessment, or a different treatment plan.
Extra caution is required with bipolar disorder, psychosis, seizures, significant liver disease, high blood pressure, rapid heartbeat, urinary outflow problems, and a history of fainting.
Give the prescriber a complete list of antidepressants, cold remedies, asthma medicines, supplements, and recreational substances before the first dose, because several can affect pulse, blood pressure, or atomoxetine levels.
Pregnancy and breastfeeding require an individual risk assessment. The medicine should not be stopped abruptly without a plan when treatment has been used for an extended period, even though atomoxetine is not associated with the same withdrawal pattern as many antidepressants.
Side effects
The most frequently discussed adverse effects include nausea, reduced appetite, dry mouth, abdominal discomfort, vomiting, dizziness, tiredness, constipation, and insomnia. Some people experience increased sleepiness instead of insomnia. Side effects may be more noticeable after starting treatment or increasing the dose.
Common Physiological and Gastrointestinal Adverse Reactions
Possible adverse effects include:
- nausea or vomiting;
- dry mouth;
- reduced appetite;
- constipation;
- abdominal pain;
- dizziness;
- fatigue or sleepiness;
- insomnia or difficulty falling asleep;
- increased heart rate or blood pressure;
- urinary hesitation or urinary retention;
- sexual adverse effects in some adults.
Eating a light meal before the dose may ease nausea. Regular fluids and fibre can help constipation when these measures are medically suitable. Dry mouth may improve with frequent sips of water and sugar-free chewing gum.
If dizziness occurs after starting or increasing atomoxetine, rise slowly from sitting or lying down and avoid driving until the effect is clear.
Atomoxetine can raise pulse or blood pressure. People with hypertension, structural heart disease, fainting episodes, or a family history of sudden cardiac death require careful assessment before treatment.
A less obvious issue is urinary difficulty. New trouble starting urination, painful urination, or an inability to pass urine requires prompt medical assessment rather than simply waiting for the symptom to settle.
Regulatory Safety Warnings and Paediatric Precautions
Atomoxetine carries a warning concerning suicidal thoughts and behaviour in children and adolescents. Clinical trials identified a small increase in suicidal ideation compared with placebo, although completed suicide was not reported in those trials. Parents and caregivers should watch for new agitation, irritability, unusual hostility, worsening sadness, withdrawal, or statements about self-harm, especially during the first weeks and after dose changes.
Any suicidal thoughts, self-harm plan, severe agitation, or sudden behavioural change requires urgent medical help. This warning does not mean that every young person will experience suicidal thinking, but it makes early observation an essential part of treatment.
Rare but serious reactions include liver injury, severe allergic reaction, prolonged erection, fainting, and significant cardiovascular symptoms. Yellowing of the skin, dark urine, severe itching, chest pain, collapse, facial swelling, or breathing difficulty needs urgent assessment.
Common mistakes
Several practical errors can make Strattera appear ineffective or less tolerable:
- judging the medicine after only a few days;
- taking capsules only on school or work days;
- doubling a dose after a missed capsule;
- opening the capsule and mixing the contents with food;
- taking a late dose despite repeated insomnia;
- ignoring new palpitations, fainting, urinary retention, or jaundice;
- stopping after mild nausea before trying an adjusted administration plan;
- failing to mention fluoxetine, paroxetine, monoamine oxidase inhibitors, or blood-pressure medicines;
- assuming that a non-stimulant medicine cannot affect mood or suicidal thinking.
What doctors say
In clinical practice, prescribers usually set expectations before treatment begins: atomoxetine is a daily medicine, and the first week does not reliably predict the final result. The useful outcome may be improved planning, fewer unfinished tasks, better listening, or less impulsive interruption rather than a dramatic feeling of stimulation.
Doctors also assess function across settings. A child may concentrate better at school while still struggling with bedtime routines. An adult may complete work more reliably while continuing to experience anxiety or disorganisation at home.
A treatment review commonly considers:
- attention and task completion;
- impulsivity and emotional regulation;
- appetite, sleep, pulse, and blood pressure;
- mood changes or suicidal thinking;
- adherence and missed doses;
- interactions with newly prescribed medicines.
The main advantage is a non-stimulant mechanism with gradual, day-long coverage for many patients. The limitations are slower onset, nausea, fatigue, appetite effects, and the need to monitor mood and cardiovascular symptoms.
Frequently asked questions
How long does Strattera take to work?
FDA prescribing information reviewed in 2022 describes atomoxetine as a medicine requiring regular daily administration rather than immediate symptom relief. Some patients notice early changes within two to four weeks, while a fuller response may take six to eight weeks after dose optimisation. A slow response does not automatically mean treatment failure.
Can Strattera be taken once daily?
FDA prescribing information reviewed in 2022 describes once-daily and divided-dose administration as possible approaches. Many people take the full daily amount in the morning, while others use two doses to improve tolerability. The selected schedule should match the prescribed total dose and the person’s sleep, nausea, and symptom pattern.
Can Strattera cause suicidal thoughts?
FDA safety information first highlighted this risk in paediatric and adolescent treatment in 2005, with monitoring needed during initiation and dose changes. New suicidal thoughts, severe agitation, unusual hostility, or marked mood deterioration require urgent medical assessment. Caregivers should report behavioural changes promptly rather than waiting for the next routine appointment.
Can Strattera be used with antidepressants?
WHO guidance on safe psychotropic prescribing published in 2019 supports checking for pharmacokinetic and pharmacodynamic interactions before combining medicines. Monoamine oxidase inhibitors must not be combined with atomoxetine, and fluoxetine or paroxetine can increase atomoxetine exposure. The prescriber may need a different starting dose or closer monitoring.
Does Strattera treat depression?
FDA prescribing information from 2022 supports atomoxetine for ADHD, not as a general treatment for depression. Some patients with ADHD and low mood may experience mood changes when attention and daily functioning improve, but this does not make atomoxetine an antidepressant. Persistent depressive symptoms need separate assessment.
Is Strattera suitable for people with Tourette’s syndrome?
Clinical research indexed in PubMed by 2011 found that atomoxetine can be considered in some patients with ADHD and tic symptoms. It does not consistently worsen tics, though individual responses differ. A clinician should monitor both attention symptoms and tic frequency during treatment.
What should happen after a missed dose?
SAHPRA-aligned medicine-use principles reviewed in 2022 favour returning to the regular schedule rather than taking extra medicine to compensate. A single missed dose is usually handled by taking the next dose at the normal time. Repeated missed doses should be discussed during treatment review because inconsistent use can make the response difficult to assess.
Do you offer anonymous delivery?
Your order will be securely packed and shipped within 24 hours. This is exactly what your package will look like (images of an actual item sent). It has the size and look of a regular private letter (24x11x0.7 cm) and its contents cannot be seen.
Strattera: Reviews and Experiences
3.6
Based on 4 reviews
Verified
School concentration improved after several weeks, but appetite dropped in the afternoon. The prescriber changed the timing, and meals became easier to manage.
24 Sept 2026
Verified
Sleep was difficult when I took it late. Moving the dose earlier helped, but I still had occasional tiredness. The benefit was better organisation, not extra energy.
01 Oct 2026
Verified
The first few weeks were mixed. There was more irritability and one episode of dizziness, so the prescribing team reviewed the dose instead of increasing it.
14 Oct 2026
Sources
- U.S. Food and Drug Administration (2022). Strattera (atomoxetine hydrochloride) Prescribing Information
