Nonstimulants Drugs for Treatment Attention Deficit Hyperactivity Disorder.
The only currently existing, approved nonstimulant ADHD medication is atomoxetine (Strattera).
HOW DOES THIS DRUG WORK?
Strattera is a selective norepinephrine reuptake inhibitor, which essentially means it increases the activity of the brain chemical (or neurotransmitter) norepinephrine. More norepinehrine is thought to increase attention and control hyperactivity and impulsivity in ADHD.
WHAT ARE THE BENEFITS?
The effectiveness of Strattera in the treatment of ADHD was established in four studies of pediatric patients ages 6 to 18. Compared with placebo, Strattera proved to be superior with respect to reducing impulsiveness, hyperactivity, and inattention. The effectiveness of Strattera for long-term use (for more than nine weeks) in child and adolescent patients has not been thoroughly evaluated.
POTENTIAL SIDE EFFECTS
Common side effects are loss of appetite, drowsiness, headache, stomachache, nausea, vomiting, dizziness, dry mouth, diarrhea, constipation, difficulty sleeping, sexual dysfunction, agitation, irritability, and difficulty urinating.
MAJOR CAUTIONS
The foremost warning associated with use of Strattera is an increase in suicidal thoughts and actions in some children and teenagers, particularly those with bipolar disorder or depression in addition to ADHD. Psychotic symptoms (hearing voices, believing things that are not true, being suspicious), manic symptoms, heart-related problems such as stroke or heart attack, and liver problems have also been reported. Like stimulants, Strattera may also cause slowing of growth in children.
MEDICAL PRECAUTIONS
People with the following conditions, disorders, or family history should discuss their risks with their physician:
- Suicidal thoughts or actions
- Heart problems, heart defects, irregular heartbeat, high blood pressure, or low blood pressure
- Mental problems, psychosis, mania, bipolar illness, or depression
- Liver problems
- Narrow-angle glaucoma
- Allergy to anything in Strattera
- Pregnant or planning to become pregnant
- Breast-feeding
KNOWN DRUG INTERACTIONS
Concurrent use of Strattera and MAOIs such as Nardil, Parnate, and Emsam may cause a serious, sometimes fatal reaction. Use with CYP2D6 inhibitors such as paroxetine (Paxil), fluoxetine (Prozac), and quinidine (Quinidex) may increase Strattera plasma concentrations. Due to the possibility of boosted effects, you should check with your doctor before combining Strattera with Proventil and similar asthma medications, and with drugs that raise blood pressure such as the phenylephrine in some over-thecounter cold medications. Use with albuterol (or other beta-agonists) may potentiate the action of albuterol on the cardiovascular system.
FOOD OR SUPPLEMENT INTERACTIONS
In conjunction with heavy alcohol drinking, Strattera may cause liver damage. Alcohol may also contribute to mood problems.
NUTRIENT DEPLETION/IMBALANCE
None known.
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