Kamaptin (Atomoxetine)

Atomoxetine is used in the management of attention deficit hyperactivity disorder (ADHD), a neurodevelopmental condition that affects attention, hyperactivity and impulse control.

• Attention deficit hyperactivity disorder (ADHD): reduces symptoms of inattention, hyperactivity and impulsivity.
• ADHD in children and adolescents: supports improved focus and behavior in school settings.
• ADHD in adults: aids in maintaining attention and reducing distractibility.

• Atomoxetine selectively inhibits the presynaptic norepinephrine transporter (NET), preventing reuptake of norepinephrine into neurons. This increases extracellular norepinephrine concentrations, particularly in the prefrontal cortex and other brain regions involved in attention and executive function, thereby enhancing signal transmission and improving the regulation of attention, impulsivity and activity levels. The drug does not significantly affect dopamine reuptake in the striatum, distinguishing it from stimulant medications.

Atomoxetine may cause a range of adverse reactions, which are categorized by frequency and severity.

Common Side Effects

• Nausea
• Decreased appetite
• Dry mouth
• Insomnia
• Dizziness
• Headache

Serious or Rare Side Effects

• Suicidal thoughts or behavior
• Severe hypertension or cardiovascular events
• Liver injury (hepatotoxicity)
• Allergic reactions including anaphylaxis
• Cardiac arrhythmias

Before initiating atomoxetine therapy, several precautions should be considered to ensure safe use.

• Assess cardiovascular status: evaluate blood pressure and heart rate prior to treatment.
• Monitor psychiatric symptoms: watch for worsening mood, depression, or suicidal ideation.
• Avoid use in narrow‑angle glaucoma: contraindicated due to potential intra‑ocular pressure increase.
• Evaluate liver function: monitor hepatic enzymes in patients with known liver disease.
• Do not discontinue abruptly: taper under medical supervision to reduce withdrawal effects.
• Store at room temperature: keep in the original container, protect from moisture and heat.

Atomoxetine can interact with other medicines, affecting its plasma levels or increasing the risk of adverse events.

Major Interactions (Avoid)

• Monoamine oxidase inhibitors (MAOIs): concurrent use may cause hypertensive crisis.
• Strong CYP2D6 inhibitors (e.g., fluoxetine, paroxetine): can markedly raise atomoxetine concentrations.
• Sympathomimetic agents (e.g., decongestants): may exacerbate hypertension.

Moderate Interactions (Monitor Closely)

• Antihypertensive drugs: atomoxetine may reduce their effectiveness.
• Other serotonergic agents (e.g., SSRIs, SNRIs): monitor for serotonin syndrome.
• Alcohol: may increase central nervous system side effects such as dizziness.