Atomoxetine

Well-studied non-stimulant ADHD treatment with robust RCT support. Slower onset than stimulants (2–6 weeks) but no abuse potential.

A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.

Multiple large RCTs demonstrate efficacy for ADHD symptoms in children and adults versus placebo. Effect sizes are moderate and generally smaller than stimulant medications. Full therapeutic effect takes 2–6 weeks. Also increases prefrontal dopamine via noradrenergic mechanisms.

• FDA-approved non-stimulant ADHD treatment
• No abuse potential or controlled-substance scheduling
• Effective for ADHD with comorbid anxiety

Adults: start 40 mg/day, target 80 mg/day, max 100 mg/day. Titrate over 2–4 weeks.

• Decreased appetite
• Nausea
• Insomnia
• Dry mouth
• Increased heart rate

Black box warning for suicidal ideation in children and adolescents. Hepatotoxicity (rare). CYP2D6 poor metabolizers require dose adjustment. Cardiovascular effects (heart rate, blood pressure increases).

Less effective than stimulants for most ADHD patients but preferred when stimulant abuse risk, anxiety comorbidity, or tic disorders are concerns.

• Focus70
• Mood35
• Anxiety30