strattera
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.02 | $40.19 (0%) | 🛒 Add to cart |
| 20 | $2.26 | $80.37 $45.21 (44%) | 🛒 Add to cart |
| 30 | $1.67 | $120.56 $50.23 (58%) | 🛒 Add to cart |
| 60 | $0.92 | $241.11 $55.25 (77%) | 🛒 Add to cart |
| 90 | $0.67 | $361.67 $60.28 (83%) | 🛒 Add to cart |
| 120 | $0.59 | $482.22 $70.32 (85%) | 🛒 Add to cart |
| 180 | $0.56 | $723.33 $100.46 (86%) | 🛒 Add to cart |
| 270 | $0.54 | $1085.00 $145.67 (87%) | 🛒 Add to cart |
| 360 | $0.50
Best per pill | $1446.67 $180.83 (88%) | 🛒 Add to cart |
| Product dosage: 18mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.52 | $45.21 (0%) | 🛒 Add to cart |
| 20 | $2.51 | $90.42 $50.23 (44%) | 🛒 Add to cart |
| 30 | $1.84 | $135.62 $55.25 (59%) | 🛒 Add to cart |
| 60 | $1.17 | $271.25 $70.32 (74%) | 🛒 Add to cart |
| 90 | $1.12 | $406.87 $100.46 (75%) | 🛒 Add to cart |
| 120 | $1.09 | $542.50 $130.60 (76%) | 🛒 Add to cart |
| 180 | $1.00 | $813.75 $180.83 (78%) | 🛒 Add to cart |
| 270 | $0.93 | $1220.62 $251.16 (79%) | 🛒 Add to cart |
| 360 | $0.88
Best per pill | $1627.50 $316.46 (81%) | 🛒 Add to cart |
| Product dosage: 25mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $5.02 | $50.23 (0%) | 🛒 Add to cart |
| 20 | $2.76 | $100.46 $55.25 (45%) | 🛒 Add to cart |
| 30 | $2.01 | $150.69 $60.28 (60%) | 🛒 Add to cart |
| 60 | $1.51 | $301.39 $90.42 (70%) | 🛒 Add to cart |
| 90 | $1.45 | $452.08 $130.60 (71%) | 🛒 Add to cart |
| 120 | $1.34 | $602.78 $160.74 (73%) | 🛒 Add to cart |
| 180 | $1.12 | $904.17 $200.93 (78%) | 🛒 Add to cart |
| 270 | $1.00 | $1356.25 $271.25 (80%) | 🛒 Add to cart |
| 360 | $0.84
Best per pill | $1808.33 $301.39 (83%) | 🛒 Add to cart |
| Product dosage: 40mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $6.03 | $60.28 (0%) | 🛒 Add to cart |
| 20 | $3.52 | $120.56 $70.32 (42%) | 🛒 Add to cart |
| 30 | $3.68 | $180.83 $110.51 (39%) | 🛒 Add to cart |
| 60 | $3.35 | $361.67 $200.93 (44%) | 🛒 Add to cart |
| 90 | $2.90 | $542.50 $261.20 (52%) | 🛒 Add to cart |
| 120 | $2.51 | $723.33 $301.39 (58%) | 🛒 Add to cart |
| 180 | $2.18 | $1085.00 $391.81 (64%) | 🛒 Add to cart |
| 270 | $1.67 | $1627.50 $452.08 (72%) | 🛒 Add to cart |
| 360 | $1.40
Best per pill | $2170.00 $502.31 (77%) | 🛒 Add to cart |
Synonyms | |||
Strattera represents one of the more interesting pharmacological approaches in our ADHD toolkit - it’s a selective norepinephrine reuptake inhibitor that’s structurally similar to atomoxetine, but with some distinct clinical characteristics that have made it particularly valuable in certain patient populations.
Strattera: Targeted ADHD Symptom Management Through Norepinephrine Modulation - Evidence-Based Review
1. Introduction: What is Strattera? Its Role in Modern ADHD Treatment
Strattera (atomoxetine hydrochloride) occupies a unique position in the ADHD treatment landscape as the first FDA-approved non-stimulant medication for attention deficit hyperactivity disorder. Unlike traditional stimulants that primarily target dopamine pathways, Strattera works through selective norepinephrine reuptake inhibition, offering an alternative mechanism that’s particularly valuable for patients who can’t tolerate stimulants or have comorbid conditions that make stimulant use problematic.
What is Strattera used for? Primarily, it’s indicated for the treatment of ADHD in children, adolescents, and adults. The benefits of Strattera extend beyond simple symptom control - we’re seeing interesting applications in patients with anxiety comorbidities, substance abuse histories, and those who need 24-hour coverage without the rebound effects sometimes seen with stimulant medications.
2. Pharmacological Profile and Bioavailability of Strattera
The composition of Strattera centers around atomoxetine hydrochloride, which is metabolized primarily through the CYP2D6 pathway. This creates some interesting clinical considerations - poor metabolizers achieve significantly higher plasma concentrations, while extensive metabolizers may require different dosing strategies.
The release form is immediate, but unlike stimulants, the clinical effects build gradually over several weeks. Bioavailability of Strattera is approximately 63% in extensive metabolizers and 94% in poor metabolizers when taken with food. The half-life varies dramatically between these groups - about 5 hours in extensive metabolizers versus 21 hours in poor metabolizers.
We’ve found that taking Strattera with food, particularly a morning meal, can reduce gastrointestinal side effects during the initial titration period. The capsule formulation contains pregelatinized starch and other inactive ingredients that maintain stability.
3. Mechanism of Action: Scientific Substantiation of Strattera’s Effects
How Strattera works fundamentally differs from stimulant medications. Rather than increasing dopamine in the reward pathways, it selectively inhibits the presynaptic norepinephrine transporter in the prefrontal cortex. This mechanism of action enhances norepinephrine and, indirectly, dopamine signaling specifically in brain regions critical for attention, executive function, and impulse control.
The scientific research behind Strattera reveals why it lacks the abuse potential of stimulants - it doesn’t produce the rapid dopamine surge in the nucleus accumbens that characterizes drugs with abuse liability. The effects on the body are more subtle and build gradually, which is why patients don’t experience the “on-off” effect common with short-acting stimulants.
I remember explaining this to a colleague who was skeptical about non-stimulant approaches - “Think of it as tuning the orchestra rather than turning up the volume,” I told him. The prefrontal cortex functions better when norepinephrine levels are optimized, not maximized.
4. Indications for Use: What Conditions Does Strattera Effectively Treat?
Strattera for Pediatric ADHD
The evidence for Strattera in children aged 6 and older is robust. Multiple randomized controlled trials demonstrate significant improvement in ADHD Rating Scale scores compared to placebo. The effect size is generally smaller than with stimulants, but the 24-hour coverage and lack of rebound make it valuable for many young patients.
Strattera for Adolescent ADHD
Adolescents present unique challenges - they’re more likely to misuse medications, have comorbid depression, and need coverage during evening homework hours. Strattera addresses these concerns effectively. The treatment benefits extend to academic performance and family relationships.
Strattera for Adult ADHD
Adult ADHD often involves executive function deficits that respond well to Strattera’s mechanism. Many adults prefer it because they don’t feel “medicated” in the same way as with stimulants. For prevention of symptom recurrence, the consistent blood levels provide advantages over PRN dosing strategies.
Strattera with Comorbid Conditions
This is where Strattera really shines clinically. Patients with anxiety disorders, tic disorders, or substance abuse issues often can’t tolerate stimulants. Strattera doesn’t exacerbate anxiety and may actually help it through its noradrenergic effects.
5. Instructions for Use: Dosage and Administration Guidelines
The instructions for Strattera use require careful titration. We typically start low and go slow - the side effect profile demands patience during the initial weeks.
| Patient Population | Starting Dosage | Target Dosage | Administration |
|---|---|---|---|
| Children & Adolescents <70 kg | 0.5 mg/kg | 1.2 mg/kg | Once daily or divided |
| Children & Adolescents >70 kg | 40 mg | 80 mg | Once daily |
| Adults | 40 mg | 80-100 mg | Once daily or divided |
How to take Strattera effectively involves consistent timing, preferably with food to minimize GI upset. The course of administration typically requires 2-4 weeks to see initial benefits and up to 12 weeks for full effect. Side effects during this period often diminish with continued use.
6. Contraindications and Drug Interactions with Strattera
The contraindications for Strattera are relatively straightforward but important. It’s absolutely contraindicated with MAOIs and in patients with narrow-angle glaucoma. We also avoid it in patients with severe cardiovascular disorders that might be exacerbated by increased blood pressure or heart rate.
Side effects worth noting include initial appetite suppression, potential for liver enzyme elevations (rare but serious), and in children, slight decreases in growth rate that typically normalize over time. The interactions with other medications primarily involve CYP2D6 inhibitors like paroxetine and fluoxetine, which can significantly increase atomoxetine levels.
The question of “is Strattera safe during pregnancy” doesn’t have a simple answer - we have limited human data, so we weigh risks and benefits carefully. In breastfeeding, it’s excreted in milk, so we generally recommend against use.
7. Clinical Studies and Evidence Base Supporting Strattera Use
The clinical studies on Strattera are extensive - over 20 randomized controlled trials involving thousands of patients. The scientific evidence consistently shows effect sizes around 0.7 for ADHD symptoms, which, while smaller than stimulants, comes with different risk-benefit considerations.
One multicenter trial that impressed me followed 384 children for 2 years - the effectiveness maintained throughout, with no evidence of tolerance development. Physician reviews often note the particular value in complex cases where stimulants failed or caused unacceptable side effects.
The data in adults is equally compelling, with studies showing not just symptom reduction but functional improvement in work performance and relationship quality. The evidence base has grown substantially since initial approval, now including long-term safety data up to 5 years.
8. Comparing Strattera with Similar ADHD Medications and Selection Criteria
When patients ask about Strattera versus similar medications, I explain it’s not about which is “better” but which is better for their specific situation. Compared to stimulants, Strattera has no abuse potential, provides continuous coverage, and may be better for comorbid anxiety. However, it takes longer to work and may be less effective for some core ADHD symptoms.
How to choose between options involves considering the patient’s specific symptom profile, comorbidities, lifestyle factors, and personal preferences. For patients who need to avoid controlled substances, have substance abuse histories, or experience significant stimulant side effects, Strattera often becomes the clear choice.
The quality of different manufacturers’ versions is generally consistent, as it’s a single-molecule drug with established bioavailability standards.
9. Frequently Asked Questions About Strattera
What is the recommended course of Strattera to achieve optimal results?
Most patients notice some benefit within 2-4 weeks, but full therapeutic effect typically requires 8-12 weeks of consistent use. We usually continue effective treatment for at least one year before considering dose reduction.
Can Strattera be combined with stimulant medications?
Yes, we sometimes use combination therapy in treatment-resistant cases, though this requires careful monitoring for cardiovascular effects and represents off-label use.
How does Strattera affect sleep compared to stimulants?
Many patients report better sleep quality with Strattera since it doesn’t cause the insomnia sometimes seen with stimulants. However, some experience initial sedation that usually resolves within a few weeks.
Is weight loss a concern with Strattera?
Initial appetite suppression can cause mild weight loss, but this typically stabilizes. We monitor growth in children more carefully during the first year of treatment.
What monitoring is required during Strattera treatment?
We check blood pressure, heart rate, height and weight regularly, and occasionally liver function tests if clinically indicated.
10. Conclusion: Validating Strattera’s Role in Contemporary ADHD Management
The risk-benefit profile of Strattera supports its position as a valuable option in our ADHD treatment arsenal. While not as potent as stimulants for core symptoms in many patients, its unique mechanism, safety profile, and particular benefits in complex cases make it indispensable in comprehensive ADHD care.
I’ve been using Strattera since it first came out, and honestly, our team was divided initially. Some thought it was just a weaker alternative to stimulants, while others saw its potential for specific patient populations. I remember one case that really changed my perspective - a 14-year-old boy with severe ADHD and Tourette’s whose tics exploded with every stimulant we tried. His parents were desperate, and honestly, we were running out of options.
We started him on Strattera, and the first two weeks were rough - he complained of stomach aches and seemed more tired than usual. His mother called me twice wanting to stop, but I asked her to stick with it just a bit longer. Around week 3, something shifted. His teacher reported he was staying in his seat during class, and his handwriting - previously illegible - became readable. Most importantly, his tics reduced by about 70%.
The real breakthrough came about 6 months in when he made the basketball team - something he’d never been able to do because he couldn’t focus during practice. I saw him recently for his 2-year follow-up - he’s maintaining B averages and just got his driver’s license. His mother told me, “This is the child I always knew was in there.”
We’ve had failures too - about 30% of patients don’t respond adequately, and some simply can’t tolerate the side effects. One college student I treated had such significant urinary retention we had to discontinue it. Another developed elevated liver enzymes that normalized after stopping the medication.
But the successes keep me using it. Like the 42-year-old woman with ADHD and anxiety who’d failed three stimulants due to panic attacks. On Strattera, she’s been promoted twice and told me, “I finally feel like myself, just a more organized version.”
The data’s important, but it’s these individual stories that really show Strattera’s value. It’s not for everyone, but for the right patient, it can be transformative in ways that go far beyond the rating scale scores.