The Transition from Strattera to Atomoxetine
For many years, Strattera was a well-known non-stimulant medication prescribed for Attention-Deficit/Hyperactivity Disorder (ADHD). However, the manufacturer, Eli Lilly, has discontinued the brand-name drug [1.4.4, 1.4.9]. This has led many to ask, "What is the new name for Strattera?" The simple answer is that there isn't a new brand name, but rather the widespread availability of its generic version, atomoxetine [1.4.7].
Strattera was first approved by the U.S. Food and Drug Administration (FDA) in 2002 [1.2.4]. After its patent expired, the FDA approved the first generic versions of atomoxetine in 2017 [1.4.8]. Due to declining sales following the introduction of these more affordable generics, Eli Lilly officially discontinued all strengths of Strattera in 2023 [1.4.1, 1.4.4]. Patients now receive prescriptions for atomoxetine, which is chemically identical to the original Strattera and works in the same way [1.4.7].
How Atomoxetine Works: A Non-Stimulant Approach
Atomoxetine is in a class of medications called selective norepinephrine reuptake inhibitors (NRIs) [1.2.9]. Unlike stimulant medications such as Adderall or Ritalin, atomoxetine is not a controlled substance and has a low potential for abuse or dependence [1.3.8].
Its primary mechanism of action involves increasing the levels of norepinephrine, a natural chemical messenger (neurotransmitter) in the brain [1.2.9]. Norepinephrine is crucial for regulating attention, impulsivity, and focus [1.2.3]. By blocking the reuptake of this neurotransmitter, atomoxetine makes more of it available in the brain, which can help improve ADHD symptoms [1.2.3]. It may take between one to four weeks of consistent daily use to notice the initial therapeutic effects, with full benefits potentially taking a month or longer to become apparent [1.2.4, 1.2.3].
Atomoxetine vs. Stimulant Medications
Stimulants are generally considered first-line treatments for ADHD because they are highly effective and work quickly, often within the same day they are taken [1.6.1, 1.6.7]. However, they are not suitable for everyone. Atomoxetine provides a valuable alternative for several reasons:
- Lower Abuse Potential: As a non-stimulant, atomoxetine is not a controlled substance and is a preferred option for individuals with a history of substance use disorder [1.6.1].
- Different Side Effect Profile: While stimulants can cause insomnia, decreased appetite, and have a higher risk of misuse, atomoxetine has a different set of potential side effects, which may include nausea, fatigue, and dry mouth [1.2.4, 1.3.8].
- Comorbid Conditions: Atomoxetine can be a good choice for patients with co-existing conditions like anxiety or tics, which can sometimes be worsened by stimulants [1.6.8].
- Consistent Coverage: It provides 24-hour coverage with a single daily dose, unlike some short-acting stimulants that require multiple doses throughout the day [1.3.8].
Below is a comparison of key features between atomoxetine and typical stimulant medications.
| Feature | Atomoxetine (Generic Strattera) | Stimulant Medications (e.g., Adderall, Ritalin) |
|---|---|---|
| Drug Class | Selective Norepinephrine Reuptake Inhibitor (NRI) [1.2.1] | Amphetamine, Methylphenidate [1.2.3] |
| Controlled Substance | No [1.3.1] | Yes, Schedule II [1.6.3] |
| Abuse Potential | Low [1.3.8] | High [1.6.3] |
| Onset of Action | Slow (1-4+ weeks) [1.2.3] | Fast (often within hours) [1.6.7] |
| Common Side Effects | Nausea, dry mouth, fatigue, decreased appetite [1.2.9] | Insomnia, decreased appetite, weight loss, irritability [1.6.1] |
| Primary Use Case | Second-line therapy; good for patients with substance use history or who cannot tolerate stimulants [1.6.1, 1.6.5] | First-line therapy for ADHD [1.6.5] |
Important Safety Information and Side Effects
Before taking atomoxetine, it is crucial to discuss your full health history with a healthcare provider. Atomoxetine is not recommended for individuals with certain severe heart problems, narrow-angle glaucoma, or a type of adrenal gland tumor called pheochromocytoma [1.2.1].
Common side effects can include:
- Dry mouth [1.3.6]
- Nausea and vomiting [1.2.9]
- Decreased appetite and weight loss [1.2.9]
- Fatigue or drowsiness [1.2.9]
- Constipation [1.2.9]
- Dizziness [1.2.1]
Atomoxetine also carries a boxed warning from the FDA regarding an increased risk of suicidal thoughts in children and adolescents, particularly during the first few months of treatment or after a dose change [1.2.1, 1.2.9]. It is vital for caregivers and patients to monitor for any unusual changes in mood or behavior and report them to a doctor immediately [1.2.9]. Rare but serious side effects can include severe liver damage, heart problems, and prolonged, painful erections (priapism) [1.2.1].
Conclusion
While the brand name Strattera is no longer on the market, its active ingredient is widely accessible under the generic name atomoxetine. As a non-stimulant medication, it remains an important and effective treatment option for many children and adults with ADHD, particularly those for whom stimulants are not an ideal choice. It works by increasing norepinephrine levels in the brain to improve focus and reduce impulsivity. Though it takes longer to become fully effective than stimulants, its lower potential for abuse and different side effect profile make it a valuable alternative in the management of ADHD.
For more information on ADHD treatment options, consult a healthcare professional. One authoritative source for further reading is the National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd
