Atomoxetine side effects

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Atomoxetine Side Effects: A Comprehensive Overview

Cardiovascular Side Effects of Atomoxetine

Atomoxetine, a selective norepinephrine reuptake inhibitor, has been associated with several cardiovascular side effects. Studies have shown that atomoxetine can cause small but statistically significant increases in blood pressure and heart rate. Specifically, systolic blood pressure increases in adults, while diastolic blood pressure increases in children and adolescents. These changes tend to occur early in the treatment, stabilize over time, and return to baseline upon discontinuation of the drug. Palpitations have also been reported more frequently in adults taking atomoxetine compared to those on a placebo . However, the overall cardiovascular effects are considered minimal and of little clinical significance.

Common Adverse Effects in Children and Adolescents

In children and adolescents, atomoxetine is generally well-tolerated but can cause several common side effects. These include headache, decreased appetite, vomiting, somnolence, and dizziness . A study comparing different dosing methods found that a slower titration schedule (twice daily dosing over two weeks) resulted in fewer early adverse events like decreased appetite and somnolence compared to a faster titration schedule (once daily dosing over three days). Additionally, a rare side effect such as chills has also been reported in a case study.

Gastrointestinal and Neurological Side Effects

Atomoxetine can also cause gastrointestinal and neurological side effects. Commonly reported issues include dry mouth, nausea, constipation, and dizziness. Insomnia and somnolence are also frequently observed, with somnolence being more prevalent in faster titration schedules . These side effects are generally mild and tend to decrease over time or upon discontinuation of the drug.

Behavioral and Psychological Side Effects

Behavioral and psychological side effects are also noted, particularly in children with developmental disabilities (DD) and autism spectrum disorders (ASD). Atomoxetine has been associated with irritability, which appears to be more common in individuals with DD compared to typically developing individuals. In some cases, atomoxetine has been effective in reducing ADHD symptoms in children with ASD, but the response rate is lower compared to typically developing children, and side effects like decreased appetite are common .

Severe and Rare Side Effects

While generally well-tolerated, atomoxetine can cause severe and rare side effects. A notable case reported a hypertensive crisis in an 8-year-old male with ASD and ADHD, highlighting the importance of close monitoring during treatment. Additionally, high doses of atomoxetine have been linked to weight loss, urinary system complications, liver disorders, and behavioral issues, emphasizing the need for careful dosage management.

Conclusion

Atomoxetine is an effective treatment for ADHD with a generally well-tolerated side effect profile. Common side effects include cardiovascular changes, gastrointestinal issues, and neurological symptoms, which are usually mild and manageable. However, severe and rare side effects necessitate careful monitoring, especially in vulnerable populations like children with developmental disabilities. Overall, atomoxetine remains a valuable treatment option, particularly for those who cannot tolerate stimulant medications.