Key facts
Generic name
Atomoxetine hydrochloride
UK brands
Strattera, and generic atomoxetine
Class
Non-stimulant, noradrenaline reuptake inhibitor
Time to full effect
Four to eight weeks
Duration
Continuous, across 24 hours
Legal status
Not a controlled drug
What atomoxetine is
Atomoxetine is a non-stimulant medicine licensed for ADHD in the UK. It was first sold as Strattera and is now widely available as a generic. It works as a selective noradrenaline reuptake inhibitor, increasing the availability of noradrenaline in the parts of the brain that handle attention and impulse control.
The practical difference from the stimulants is timing. A stimulant tells you within a day or two whether a dose is working. Atomoxetine builds gradually and is not fairly judged before about six weeks. In exchange, the effect is continuous rather than arriving in the morning and wearing off in the evening. Our guide to non-stimulant medication sets out how the group compares.
Because it is not a controlled drug, prescriptions are not limited to about a month and can be issued as repeats, which makes the ongoing arrangement simpler than it is for the stimulant options.
Who it is prescribed for in the UK
Atomoxetine is licensed for children aged six and over and for adults, as part of a wider treatment programme. Where an adult was already established on it in childhood, treatment can continue into adulthood under specialist review.
NICE guideline NG87 positions non-stimulants as the option to consider where stimulants have not helped enough at an adequate dose, have not been tolerated, or are unsuitable. Atomoxetine is often the first non-stimulant tried in adults, since it is licensed for them and guanfacine is not.
Clinical context
When atomoxetine is chosen first
There are situations where a non-stimulant is the sensible starting point rather than a fallback: where a heart condition makes a stimulant unsuitable, where tics are prominent, where a controlled drug creates genuine practical difficulty, or where continuous evening cover matters more than daytime peak effect.
It is also sometimes preferred where there is a history of substance misuse, because it has no potential for misuse itself.
Baseline pulse and blood pressure are checked before starting and monitored during treatment. Atomoxetine is generally avoided where there is significant cardiovascular disease, narrow-angle glaucoma or phaeochromocytoma, and it is not combined with monoamine oxidase inhibitors.
Dosage and titration in the UK
Atomoxetine is dosed by body weight in children and by a fixed schedule in adults. In both cases it is started at a lower dose for at least the first seven days and then increased, which gives the stomach time to settle before the target dose is reached.
It is taken once daily in the morning, or split into a morning and late afternoon dose where that is better tolerated. Capsules are swallowed whole and not opened, because the contents can irritate the eyes.
Our guide to titration explains what the appointments involve. The step that matters most with atomoxetine is patience: judging it at two or three weeks is the most common reason a medicine that would have suited gets abandoned.
Taking it with food
Nausea is the most common early complaint and is very often solved by taking the capsule with food rather than on an empty stomach. It is worth trying that before concluding the medicine does not agree with you.
How long it takes to work
Some people notice a small change within the first two weeks, but the full effect takes four to eight weeks to develop. That is a genuinely different experience from a stimulant, and it is worth knowing in advance.
Once established, the effect is continuous. There is no afternoon drop-off to plan around, no question of whether a second dose is needed, and evenings are not a different experience from mornings. Many people say they stop noticing it at all, and only recognise the benefit when they miss several days.
Keeping a brief record through the build-up period is more useful than trying to recall it at an appointment. A line a day on sleep, appetite and how the afternoon went gives a prescriber something concrete to work from.
Atomoxetine side effects
Like all medicines, atomoxetine can cause side effects, and not everyone gets them. Most appear in the first few weeks and settle. Our general guide to ADHD medication side effects covers all the licensed options.
Common
- Nausea and stomach discomfort, particularly early on
- Reduced appetite
- Dry mouth
- Tiredness or sleepiness
- Dizziness
- A modest rise in heart rate or blood pressure
- Difficulty passing urine, more often reported in adults
Less common
- Mood changes, including low mood or irritability
- Sexual side effects in adults
- Slowed growth in children, which is why height and weight are monitored
When to contact your prescriber
Seek medical advice promptly for any new or worsening thoughts of self-harm, particularly in the first months and in younger people, and for signs of liver problems such as yellowing of the skin or eyes, dark urine, unexplained itching or abdominal pain. Liver problems are rare but should be assessed the same day. Seek advice urgently if reality starts to feel distorted, for example hearing or seeing things that are not there or becoming unusually suspicious, or if mood becomes unusually elevated or overactive with little need for sleep. Do not stop the medication abruptly without advice. Suspected side effects can also be reported through the MHRA Yellow Card scheme.
- Appetite and weight Why it happens and how it is managed
- Anxiety Whether medication helps or makes it worse
- Alcohol Risks and practical guidance
How atomoxetine compares
Slower to build, continuous once established, and not a controlled drug.
Scroll the table sideways to see every column.
Neither group is better in the abstract. Stimulants help a larger proportion of people overall, which is why they are usually tried first, but where atomoxetine suits someone it can work very well and the practical advantages of a non-controlled medicine are real.
Common questions
Is atomoxetine the same as Strattera?
Yes. Strattera was the original brand name for atomoxetine. Generic versions contain the same active ingredient and are prescribed in the same way.
How long does atomoxetine take to work?
Four to eight weeks for the full effect. Some people notice a small change earlier, but judging it before about six weeks is the most common reason it gets written off too soon.
Is atomoxetine a controlled drug?
No. Unlike the stimulants, it is not a controlled drug, so prescriptions can be issued as repeats covering more than a month, and identification is not required at the pharmacy.
Can my GP prescribe atomoxetine?
A GP cannot start it. Treatment must be initiated by a specialist after a full assessment. Once your dose is stable, a GP may agree to continue prescribing under a shared care agreement, though practices can decline.
Why does atomoxetine make me feel sick?
Nausea is the most common early side effect and usually settles. Taking the capsule with food rather than on an empty stomach solves it for many people, and is worth trying before concluding the medicine does not suit.
Can atomoxetine be taken with a stimulant?
Combining medicines is sometimes considered by a specialist where a single medicine has not given enough benefit. It is a specialist decision rather than something to arrange independently.
Important
This information is general and educational. It is not a substitute for medical advice. Decisions about starting, changing or stopping ADHD medication are always made together with a Consultant Psychiatrist following a full assessment.
Considering an ADHD assessment?
Any conversation about medication starts with a diagnosis. Our GMC-registered Consultant Psychiatrists assess adults and children. Assessments are £695 online and £1,095 in person in London or Manchester.
No GP referral needed. Appointments are usually available within weeks.
References
- Attention deficit hyperactivity disorder: diagnosis and management (NG87) National Institute for Health and Care Excellence
- Atomoxetine British National Formulary
- Atomoxetine NHS medicines A to Z
- Yellow Card scheme Medicines and Healthcare products Regulatory Agency
Last reviewed September 2026. Next review due September 2027.
