Atomoxetine dosage
Pro Research Analysisby 
Searched over 200M research papers for "atomoxetine dosage"
Atomoxetine Dosage Guidelines for ADHD
Recommended Atomoxetine Dosage in Children and Adolescents
Research consistently shows that atomoxetine is most effective for children and adolescents with ADHD when dosed based on body weight. The optimal target dose is 1.2 mg/kg/day, with studies indicating that increasing the dose to 1.8 mg/kg/day does not provide additional benefit over 1.2 mg/kg/day. Lower doses, such as 0.5 mg/kg/day, are less effective, suggesting a clear dose-response relationship up to the 1.2–1.4 mg/kg/day range, after which the effect plateaus 15. For children and adolescents weighing over 70 kg, a fixed dose of 80 mg/day is recommended .
Atomoxetine Dosage in Adults
For adults, atomoxetine is typically prescribed at a fixed dose, starting at 40 mg/day and titrated up to 80 mg/day. Some patients may require up to 100 mg/day, but higher doses should be approached with caution due to the potential for non-linear pharmacokinetics and increased side effects 24.
Once-Daily vs. Divided Dosing
Atomoxetine can be administered once daily in the morning, which has been shown to be as effective as divided dosing (morning and evening). Once-daily dosing provides continuous symptom relief throughout the day and into the evening and morning hours, making it convenient and effective for most patients .
Dose-Response and Plateau Effect
Meta-analyses and clinical trials confirm that atomoxetine’s effectiveness increases with dose up to about 1.2–1.4 mg/kg/day in children, after which further increases do not yield additional symptom improvement. This supports current regulatory recommendations and helps avoid unnecessary higher dosing 15.
Individual Variability and Pharmacogenetics
There is significant variability in how patients metabolize atomoxetine, largely due to genetic differences, especially in the CYP2D6 enzyme. Poor metabolizers may have much higher drug levels at standard doses, increasing the risk of side effects. Personalized dosing strategies, including consideration of genetic testing and therapeutic drug monitoring, may help optimize treatment for individual patients 910.
Safety and Tolerability
Atomoxetine is generally well tolerated, with most adverse events being mild to moderate. Discontinuation rates due to side effects are low (<5%). However, clinicians should be cautious with higher doses, especially in populations at risk for cardiac side effects, such as females who may experience QT interval prolongation 18.
Special Populations and Other Indications
In conditions outside of ADHD, such as cognitive impairment after traumatic brain injury or depression in Parkinson’s disease, atomoxetine has been studied at doses ranging from 1 mg/kg in animal models to 80 mg/day in adults. However, its efficacy in these settings is less established, and dosing should be individualized 37.
Conclusion
The most effective and commonly recommended atomoxetine dosage for children and adolescents with ADHD is 1.2 mg/kg/day, with no added benefit above 1.4 mg/kg/day. For those over 70 kg and adults, 80 mg/day is standard, with careful titration if higher doses are needed. Individual factors, especially genetic differences in drug metabolism, can significantly affect optimal dosing, highlighting the importance of personalized approaches in atomoxetine therapy. Atomoxetine is safe and well tolerated at recommended doses, with once-daily dosing providing effective symptom control throughout the day.
Sources and full results
Most relevant research papers on this topic