Use of atomoxetine in people with ADHD Review article

Abstract

This article discusses the use of atomoxetine in the treatment of ADHD in adults, particularly in situations where psychostimulants are contraindicated, ineffective, or poorly tolerated. Atomoxetine works by inhibiting norepinephrine reuptake and indirectly increases the availability of dopamine in the prefrontal cortex, which improves concentration, impulse control, and reduces hyperactivity. Unlike psychostimulants, its effects develop gradually – the first benefits usually appear after a few weeks, and the full effect after approximately three months. The drug is particularly useful in patients with ADHD comorbid with anxiety, depression, a history of addiction, or a risk of stimulant abuse. The article emphasizes the need for cautious dosing, especially in individuals who are slow metabolizers or taking CYP2D6 inhibitors, due to the risk of adverse effects. The possibility of combination therapy with atomoxetine and methylphenidate is also discussed, primarily when monotherapy is insufficient. The clinical cases presented demonstrate the effectiveness of atomoxetine in patients in whom methylphenidate caused severe anxiety or psychotic symptoms. In summary, atomoxetine is a valuable and safe alternative to psychostimulants and an important tool in the individualized treatment of ADHD.