Anyone suffering from ADHD, whether child or adult, has heard of Ritalin. It’s the most common solution for hyperactive disorder, and the general go-to for doctors.
Like most widely prescribed medicines, it’s good, but not perfect. That’s where atomoxetine comes in.
What Exactly is Ritalin?
If you’re one of the many people for whom Ritalin isn’t effective, or for whom the side effects are too severe, it might be time to ask your doctor about non-stimulant ADHD medication.
And atomoxetine – or Strattera, it’s most common brand-name version – is at the top of that list.
Of course, it’s always best to know as much as you can about it beforehand.
What is a Non-Stimulant ADHD Medication?
There are two general types of ADHD medication – stimulant, and non-stimulant. The difference is exactly what you’d guess – stimulants speed things up, and non-stimulants slow things down.
(This explanation would make a doctor cringe, for the record, but it’s quite good for our purposes.)
On average, the unpleasant side effects of stimulants are absent with non-stimulants. This includes heightened anxiety, an inability to gain weight, or increased jitteriness. These benefits come with a new set of side effects, however.
The kind of medicine your body prefers will depend heavily on age, diet, genetics, and the presence of other medication in the body.
We should discuss age first.
Who Should Use Atomoxetine?
The short answer is easiest – no one under 6.
It’s not that atomoxetine is explicitly dangerous for children, but rather that its effects haven’t been tested on anyone under 6.
This is true for a great many ADHD medications.
Diagnosis, after all, usually comes after age 6, and it’s rare that a doctor wants to give a child medication that early – in which case, stimulants are usually prescribed first.
As for the rest of us, making a switch is something to be discussed with your doctor.
Why Switch to Atomoxetine?
The primary reason to switch to any new medication should be the same – the new medication works.
Atomoxetine’s side benefits are worthless if the drug itself isn’t helping either you or your child concentrate.
If it helps, however, there are a number of reasons to prefer this over Ritalin, Adderall, or other stimulants.
Four Stimulant Side Effects to Kiss Goodbye
It goes without saying, but in medicine, as in life, nothing is guaranteed. What we’re describing here is the average effect. You won’t know for yourself until you try, under the supervision of a doctor. The most unpleasant side effects produced by stimulants can also, in select cases, be produced by atomoxetine.
If you dislike Ritalin because it makes your child aggressive, atomoxetine is worth a doctor’s discussion, and a try. But it’s not a guarantee. Our predictions here are based on averages, not absolutes. That said, the average success here is quite good. Consider four stimulant side effects that aren’t usually present with atomoxetine:
1. Decreased Jitters and Nervous Tics
Ritalin and similar medications can help the ADHD mind focus quite well, but often trade concentration for general jitters, nervous tics, and an uncomfortable heightened sense of awareness.
Non-stimulants do not generally come with these side effects. You should discuss the use of atomoxetine with your doctor if these symptoms become difficult to manage.
2. Decreased Social Discomfort
Stimulants can adversely affect emotions in the same way they affect the body. Side effects can include, as we mentioned above, a hyper sense of awareness, which newcomers to the medicine do not often like.
In more extreme examples, stimulants can make the user suspicious, paranoid, and quite unable to calm down. School can become torturous, friendships difficult, and peace of mind impossible.
In short, if you or your child can’t mentally slow down, and it becomes a hindrance to living and studying well, you might be a prime candidate for atomoxetine.
3. Decreased Risk of Substance Abuse
At present, atomoxetine is not a controlled substance is. Methylphenidate, and its cousin amphetamine, are both controlled substances.
You’ve probably guessed already that the latter two are the main ingredients in stimulant ADHD medicines.
This means, on average, that non-stimulants are less addictive than stimulants. It’s something to consider if you have a history of substance abuse.
This does not mean you can just take all the atomoxetine you want, or stop all at once, and have no withdrawal symptoms. As always, both taking and ceasing the medication should be discussed at length with a doctor.
4. Decreased Risk of Weight Loss
A common side effect of any stimulant is weight loss – diet pills, in fact, are stimulants themselves, and work by exploiting this very side effect. But what’s useful for dieters is very bad for children.
Atomoxetine can suppress the appetite, but not to the extent a stimulant does. That appetite suppression, too, is a side effect, and not a guaranteed outcome. It’s easier on average to keep weight on with a non-stimulant.
Non-stimulants offer, on average, increased social comfort, weight gain, and less potential for abuse.
Of course, they come with their own set of side effects, and it’s best you know about those, too.
What are the Downsides to Atomoxetine?
All non-stimulants come with the same general set of risks, most of which deal with digestive health. A few others, however, are decidedly adult.
First, though, we should cover the two side effects for which you should call a doctor immediately: heart and liver problems.
1. Liver: Yellow Skin, Dark Urine, Belly Pain, or Itching
Before we explain, know that liver complications are rare, and usually signaled by a family history of liver problems. That said, if you or your child is itching, tell a doctor. If any of the other symptoms appear, call a doctor right away.
2. Heart: Fainting, Short of Breath, or Chest Pains
Again, heart problems with atomoxetine are far more likely for someone with a family history of cardiac trouble. Your doctor will be able to decide if it’s worth the risk. If you or your child has any of these symptoms, however, it’s time to call a doctor.
3. Thoughts of Suicide and Feelings of Helplessness
This is more common in teenagers, but it’s something to watch for regardless.
It’s also a side effect that will be stronger if your teenager already has a history of depression or suicidal thoughts. Keep a close watch on him or her for the first couple weeks. These side effects are rare, but harder to spot in a teenager that just doesn’t want to talk to parents. Make sure he or she knows what to expect, and keep communication open.
Those three – heart, liver, and mind – are the ones to watch for, and thankfully the rarest. The more common side effects are far more annoying than deadly.
Gut Side Effects
Atomoxetine is better than stimulants for weight retention, but that doesn’t mean it’s easy on the stomach. Watch for these side effects, and discuss them with your doctor or pediatrician.
4. Nausea, Upset Stomach, and Vomiting
Don’t be scared – this isn’t a guaranteed outcome. However, it’s common for the body to try to reject new medicine, and this usually means trouble with eating and digestion. These symptoms can be managed in most cases. If they’re unbearable, see a doctor or pediatrician right away.
This is far more common in adults than children. In rare cases, atomoxetine can make passing stool difficult. It might be embarrassing to discuss with a doctor, but it’s important that you do so. Managing your health and concentration is too important to risk over a prescription for a minor laxative.
6. Decreased Appetite
We mentioned this earlier. Atomoxetine can cause a loss of appetite – on average, not the greater weight loss of a stimulant, but certainly not something to ignore.
Adults, of course, can usually force themselves to eat. If it’s becoming a problem for a child, however, make sure you talk to a pediatrician.
Teenage Side Effects
7. Drowsiness or Dizziness
This is something that all atomoxetine users should watch for, but it’s a greater risk for young adults, most of whom are probably just learning to drive. Inexperience and fatigue make for a bad combination behind the wheel.
If you experience drowsiness, know that it should eventually disappear as your body gets used to the medication. If it doesn’t, however, do what we keep recommending – see a doctor.
Adult Side Effects
You might have guessed where we were going with this. Atomoxetine can adversely affect sexual performance.
Any new medication, of course, can affect confidence, but there are two things in particular to watch for:
8. Low Sex Drive, and Priapism
If you know what priapism is, you’re probably wondering how these two things can go together.
Priapism, simply put, is an erection that won’t go away. It’s eventually painful, and carries with it a high risk of tissue damage if it remains for too long. Non-stimulants are sometimes used as a way to regulate blood pressure, which they often do by dilating the blood vessels. This is exactly the way that Viagra works.
These side effects are not universal, so don’t be put off. They are, however, not something you’d expect from an ADHD medication, nor are they something you’d tell your doctor when discussing ADHD medication. And if you don’t know, you can’t discuss it.
How Do I Know if Atomoxetine is Right for Me?
The answer should be obvious by now – discuss it with a doctor, and try it. In the end, the person who will know best how well the medication works is you, and you alone.
Be honest with your doctor, follow his or her dosing instructions, and study your symptoms.
You’ve nothing to lose but better ADHD management.