Atomoxetine, a selective
norepinephrine (NE) reuptake inhibitor, was approved for
attention deficit/hyperactivity disorder (
ADHD) treatment in children, adolescents and adults. We searched the database PubMed/MEDLINE (2000 to October 1, 2021). Only publications in English were considered.
Atomoxetine inhibits the presynaptic
norepinephrine transporter (NET), preventing the reuptake of NE throughout the brain along with inhibiting the reuptake of
dopamine in specific brain regions such as the prefrontal cortex (PFC). The novel mechanism of
atomoxetine also includes several new brain imaging studies and animal model studies. It is mainly metabolized by the highly polymorphic drug metabolizing
enzyme cytochrome P450 2D6 (
CYP2D6).
Atomoxetine is effective and generally well tolerated.
ADHD is often accompanied by multiple comorbidities. A series of studies have been published suggesting that
atomoxetine is effective in the treatment of
ADHD symptoms for children with various types of comorbidity. In some cases, it is possible that
atomoxetine may have a positive influence on the symptoms of comorbidities.
Atomoxetine can be administered either as a single daily dose or split into two evenly divided doses, and has a negligible risk of abuse or misuse. The latest guideline updated that clinical dose selection of
atomoxetine was recommended based on both
CYP2D6 genotype and the peak concentration. To have a more comprehensive understanding of
atomoxetine, this review sets the focus on the mechanism, clinical efficacy and dosage regimen in detail, and also touches on those studies regarding adverse reactions of
atomoxetine.