side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more

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> Strattera


US brand name: Strattera
Generic name: atomoxetine

Class: Norepinephrine-Selective Reuptake Inhibiting Antidepressants Technically Strattera is a non-stimulant treatment for ADD. Chemically it’s an antidepressant.

1.  FDA Approved Uses of Strattera (atomoxetine)

ADD/ADHD for adults and children

2.  Off-Label Uses of Strattera (atomoxetine)

  • Depression
  • Panic/anxiety
  • Bipolar depression

3.  Strattera’s pros and cons

3.1  Pros

When it works, it really works! Far less likely to trigger mania in the bipolar or seizures in the epileptic than most antidepressants. Either is still possible, it’s just that the odds are higher (i.e. the events are less likely). In adults at least. With a low side effect profile for most people, this drug proves to be either ineffectual or just the greatest thing ever for someone.

3.2  Cons

Tends to poop-out rapidly for some people, especially if they increase their dosage (titrate) too fast. Approved only for ADD/ADHD so doctors won’t prescribe it or insurance plans won’t cover it for depression or bipolar. Doctors frequently screw up the titration. If you’re bipolar and you haven’t stabilized it can aggravate your cycling. (This doesn’t contradict the above. While Strattera (atomoxetine) is much less likely to trigger mania than an SSRI, it’s practically guaranteed to make bipolar cycling a lot worse if you start taking it while you’re cycling. it’s a fine distinction.)

4.  Strattera (atomoxetine) Side Effects

4.1  Typical Side Effects

The usual for anything that does norepinephrine-selective reuptake inhibition - headache, dry mouth, urinary hesitance, constipation, somnolence (wanting to sleep all the time) and/or early awakening. For most people the headache tends to go away and will only reappear, if at all, with a dosage increase. The urinary hesitance, constipation, and dry mouth can go away or stay forever. The somnolence/fatigue/constantly being tired is dosage-dependent and often an indicator that you’re taking too much. Early awakening can be constant or strike at random throughout the time you take it. If you have a job that requires you to be at work in the morning, consider it a feature and not a bug.

4.2  Not So Common Side Effects of Strattera (atomoxetine)

Nausea (taking it with food usually helps), farting (pull my finger Beavis), higher or lower blood pressure, weight loss regardless of appetite change. Some women will bleed like a stuck pig when it’s that time of the month. Oh, yeah, and there’s that wonderful feeling of euphoria. That can last for months. But Strattera (atomoxetine HCl) isn’t a party drug, kids. You can’t just take it before a rave, it takes days of being on the correct dosage to get that effect, which may or may not happen. One buzzkill for guys could be a variety of sexual dysfunctions ranging from pain during or immediately after ejaculation (although for a small segment of the population that could be a bonus) to not being able to get it up with a forklift. Sometimes these these side effects are temporary, sometimes they aren’t.
Everyone is freaking out about serious liver problems that a handful of people developed. Don’t mix Strattera with alcohol or a history of liver problems, and talk to your doctor about getting periodic liver function and complete blood panels.

4.3  Freaky Rare Side Effects of Strattera (atomoxetine)

NSRIs are well known for having few side effects at all, let alone freaky rare ones. One guy had bloody sperm and someone else developed salivary duct stones. That’s it.

5.  Interesting Stuff Your Doctor Probably Won’t Tell You about Strattera (atomoxetine)

Taking Strattera with food interferes with how well Strattera is absorbed. It’s probably not enough to make a difference, but you never can tell. As Strattera will often give people nausea that ranges from mild to severe, and taking medications with food usually prevents that sort of thing, you’ll sure as hell absorb a lot more taking your Strattera with food and keeping it all down than if you take it on an empty stomach and spench it up ten minutes later.


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6.  Strattera’s Dosage and How to Take Strattera (atomoxetine)

This med can work wonders for more people if they and their doctors would just have some goddamn patience!!! The initial dosage is 18–25 mg. Got that? 18–25mg. Not 40mg. Not 60mg. 18–25mg.
Unfortunately some bean counter in the bowels of Eli Lilly’s accounting department determined that it was more profitable to restrict the size and number of 18mg and 25mg sample packs (only four capsules in each now), and let some people just fail with this med. So most of the sample packs sent out now are only 40mg capsules. It’s more profitable for Lilly if Strattera doesn’t work for everyone it could work for!! Isn’t that crazy? Anyway, the highest an adult should start at is 25mg a day and just stay there for at least two weeks. Wait at least that long before going up to 40mg, and then only if it’s going to make a big difference, not a small difference.

Once you get past the 25mg a day barrier, dosages are as follows: 36–40 mg a day, 50 mg a day, 60 mg a day, 80 mg a day, 100 mg a day. Doses are usually divided between morning and afternoon, but some people get drowsy with Strattera, while others get hyper, so the dosing can be really flexible.

7.  How Long Strattera (atomoxetine) Takes to Work

3–4 days. Unless you absolutely cannot deal with the side effects, you should give it at least one week before raising the dosage and two weeks giving up.

8.  How to Stop Taking Strattera (atomoxetine)

Your doctor should be recommending that you reduce your dosage by 20–40mg a day every 3–4 days if you need to stop taking it. Based on the 13 hour half-life. There’s really nothing in the way of a discontinuation syndrome. Suddenly stopping can result in a nasty rebound of symptoms, or the short-lived mania that sometimes accompanies the discontinuation of an antidepressant, but that’s about it.

9.  Strattera (atomoxetine) Half-Life & Average Time to Clear Out of Your System

Strattera (atomoxetine) does one of those weird double metabolisms. Atomoxetine itself has a mean average half-life of five hours, with poor metabolizers (7% of the Caucasian population, 2% of the African American population in Lilly’s trials) taking up to 24 hours to process it. Then the metabolite is further metabolized into yet another substance, and that has a mean average half-life of 6–8 hours, with the poor metabolizers taking 34–40 hours to deal with it. While Lilly has the resources to tell a poor metabolizer from a regular person, you and your doctor may not. There is a lab test for CYP2D6 efficiency, according to the Strattera (atomoxetine HCl) PI sheet, but your doctor may have to contact Eli Lilly to find out just what it is and how to order it. And how much it costs.
Presume a total half-life of 13 hours and that it’s out of your system in 3–4 days.

Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream1, so there’s nothing swimming around to attach itself to your brain and start doing stuff. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood.

10.  Days to Reach a Steady State

As the active portion of atomoxetine has a half-life in people with normal metabolisms of 6 to 8 hours, and as most people take it once a day, you may or may not reach a steady state in 36 to 48 hours. Eli Lilly didn’t provide any steady state data.

Steady state is the flipside of half-life. This is when you can expect to get over side effects caused by fluctuating amounts of a medication in your bloodstream. Often, but not always the same amount of time as the plasma clearance above.

11.  Shelf Life

3 Years

12.  How Strattera Works

Based upon the Communications Interference Hypothesis of psychiatric and neurological conditions (or brain cooties as we often call them), atomoxetine effectively raises the norepinephrine levels in your brain by letting your synapses soak in norepinephrine for longer than usual by slowing (inhibiting) the mechanism of norepinephrine transmission deeper into the neurons (reuptake). An increase in norepinephrine can often result in a similar increase in dopamine. Because Strattera does most of this in your frontal and prefrontal cortices it works better as an ADD/ADHD med than an antidepressant, in that there is a shitload more money in treating ADD/ADHD with a drug that is not a stimulant than as an antidepressant for people who would get similar results from Wellbutrin or a TCA.

13.  Comments

The other reason why Strattera is an ADD/ADHD med instead of an antidepressant is people with MDD who respond to a drug that is a norepinephrine-selective reuptake inhibitor (NSRI) make up something like 10–15% of the depressed population. At most. So in clinical trials that don’t target people with depression symptoms specific to norepinephrine issues Strattera will (and did) bomb and not be the bomb.

Regardless of why you’re taking it, I can’t stress the importance of a slow titration and staying at a dosage that works instead of ramping up to a target dosage. Like SSRIs, Strattera can frequently and suddenly stop working (poops out), but if you’re taking 80mg (or more) a day within two weeks of starting, you’re just asking for it to poop out on you. Lowering the dosage might help, but there’s no guarantee it will work as well as it used to, if at all.

I miss taking Strattera. I miss getting up at 5:00 a.m. (No, really, I actually like getting up early in the morning) ready to deal with the day. I miss how Strattera and Provigil worked so well together to regulate my sleep, keep me focused in the day time, and were the only really effective antidepressant combination, along with Risperdal, until the nowhere-near-as-good Vivactil & Lamictal cocktail I’m on now.

My brain liked it. My liver hated it.

For years Strattera (atomoxetine) was available only in the US. It is now available in Australia, Canada, Ireland, New Zealand and the UK.


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14.  Strattera Ratings, Reviews, & Other Sites of Interest

Strattera Ratings & Reviews Page.

14.1  Rate Strattera

Give your overall impression of Strattera on a scale of 0 to 5. Detailed ratings and reviews are available on the Strattera Ratings & Reviews Page.

Get all critical about Strattera

3.5 stars Rating 3.5 out of 5 from 109 criticisms.
Vote Distribution: 11 – 3 – 8 – 11 – 45 – 31


14.2  Rate this article

If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.

Get all judgmental about the Strattera (atomoxetine) Synopsis

4.5 stars Rates 4.3 out of 5 from 145 value judgments.
Vote Distribution: 6 – 1 – 3 – 7 – 36 – 92



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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.



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14.4  Discussion board

If you have any questions not answered here, please see the Crazymeds Strattera discussion board.



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15.  References

Instant Psychopharmacology 2nd Edition Ronald J. Diamond M.D. © 2002. Published by W.W. Norton

Mosby’s Drug Consult 2007 (Generic Prescription Physician’s Reference Book Series)

PDR: Physicians’ Desk Reference 2010 64th edition


1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.

3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!


If you have any questions not answered here, please see the Crazymeds Strattera discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher crazymeds.us


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Strattera, and all other drug names on this page and used throughout the site, are a trademark of someone else.

will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.




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All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
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All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

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