Strattera (atomoxetine) is approved for treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children 6 years of age and older and adolescents as a part of a more comprehensive treatment programme. No significant difference in effects between Strattera and Ritalin (methylphenidate) has been shown in children and adolescents, but in short-term placebo-controlled trials Strattera has shown a significant improvement of symptoms in children and adolescents. Thus the absolute symptom reduction ranged between 12,7 % - 25,1 %. The effect is less in adults. On contrary to Amphetamine and Ritalin, Strattera is not acting centrally. One study indicates that Strattera doesn’t worsen tics in children and adolescents.
The most common adverse effects of Strattera in children and adolescents include abdominal pain, decreased appetite, vomiting, somnolence and headache. New data has shown an increased risk of suicidal behaviour in 7 - 12 years children, and therefore children treated with Strattera must be monitored closely. In adults the most common adverse effects are dry mouth, headache, insomnia, nausea, and decreased appetite.
The daily cost of Strattera is 30,98 kr. - 61,96 kr. (depending on the weight). Thus, treatment with Strattera is more expensive compared to treatment with Ritalin and should be for those, who have not achieved effect with alternatives or those, who are at risk for abuse. Furthermore, the effect of the treatment should be assessed with withdrawal in mind, as there is a considerable placebo-effect.
Treatment must be initiated by or under the supervision of a physician with appropriate knowledge and experience in treating ADHD (NBS).
Strattera was marketed 28th August 2006. There is no general reimbursement for Strattera, but it is possible to apply for single reimbursement.
Institute for Rational Pharmacotherapy, 14 November 2006