Strattera: Side Effects, Uses, Dosages, Warnings

What Is Strattera Used to Treat?

Strattera is most often used for the treatment of ADHD. It is approved for use in adults and children ages 6 and older. A physician may prescribe Strattera once ADHD has been diagnosed, and it significantly impacts a person’s quality of life. It may be used as a first-line treatment or in combination with other medications.

Additionally, Strattera may be used off-label for the treatment of other conditions. Off-label use means the medication is being used to treat a disorder not approved by the FDA. Prescribers may use Strattera off-label when they believe it may provide benefits based on their professional judgment.

Strattera is commonly used as an FDA-approved medication to treat:^1,2

• Attention-deficit hyperactivity disorder (ADHD)

Strattera may also be used off-label for treating:³

• Treatment-resistant depression
• Adults with ADHD and partially responsive major depressive disorder
• Neurogenic orthostatic hypotension

Who Should Not Take Strattera?

Strattera should be avoided in those who have an allergy to the medication. Also, individuals on certain medications, such as monoamine oxidase inhibitors (MAOIs), should avoid taking Strattera because it can lead to serious reactions.¹ Strattera should be taken with caution in individuals with a history of other medical problems, including heart, liver, or kidney disease.

People who may need to avoid taking Strattera include:^1,3,4

• Individuals taking or who recently quit taking monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
• Those with a history of narrow-angle glaucoma
• Those with a history of pheochromocytoma
• Those with a history of heart, liver, or kidney disorders

Strattera Dosages for FDA-Approved Treatment

Strattera is FDA-approved for treating ADHD in adults and children ages 6 and older. When a medication is FDA-approved, it means the FDA has assessed the safety and efficacy of the medication and has met the regulatory standards set by the FDA for its intended use. The starting Strattera dosage is dependent on the age, weight, and medical history of the individual.

Strattera Forms & Strengths

Strattera is available in capsule form and has many different strengths. The appropriate strength of Strattera for each individual depends on the disorder being treated, the person’s age, and the response to the medication. Strattera is not available in extended-release, delayed-release, or sustained-release formulations. It is an immediate-release medication typically taken once or twice daily.

The effects of Strattera may be noticed within a few weeks. However, it is important to remember that individual responses may vary, and the medications’ full benefit may only be noticed several weeks later. Regular follow-up with a healthcare provider is important to assess the effectiveness and make adjustments as necessary.

Strattera is available in the following forms and strengths:²

• 10 mg oral capsule
• 18 mg oral capsule
• 25 mg oral capsule
• 40 mg oral capsule
• 60 mg oral capsule
• 80 mg oral capsule
• 100 mg oral capsule

It is important to take Strattera as recommended by your healthcare provider and pharmacist to achieve maximum effectiveness.

How Should I Take Strattera?

Strattera should be swallowed whole around the same time every day. It is important to follow the directions on the prescription label. Strattera capsules should not be opened, chewed, or crushed when taking them. Strattera can be taken with or without food.⁴

What Happens If I Miss a Dose of Strattera?

If a dose of Strattera is missed, take the missed dose as soon as you remember it. However, if it is close to the time to take the next dose, the previous dose can be skipped, and you can continue with your regular dosing schedule. Never double the dose to make up for a missed dose.

Side Effects of Strattera

As Strattera impacts norepinephrine in the brain and throughout the body, it can cause various side effects. These side effects may range from mild to severe and may manifest in different symptoms in the body. It is important to note that not everyone will experience side effects, and side effects may resolve or lessen over time.

Common Side Effects of Strattera

Some common Strattera side effects include gastrointestinal symptoms such as nausea, vomiting, and decreased appetite. Strattera may also impact cardiovascular health by increasing blood pressure and heart rate. While these side effects can be bothersome, not everyone experiences them, and they may resolve as your body adjusts to the medication. However, if side effects are severe, persistent, or concerning, it is important to seek medical care or discuss with your healthcare provider.

Common side effects of Strattera include:²

• Abdominal Pain
• Vomiting
• Nausea
• Headache
• Decrease Appetite
• Drowsiness
• Fatigue
• Dry mouth

Serious Side Effects of Strattera

Although uncommon, there are potentially serious side effects associated with Strattera. These can include liver problems, changes in mood, allergic reactions, and cardiovascular complications. If you experience severe symptoms, it is necessary to seek immediate medical care.

Serious side effects of Strattera may include:⁴

• Shortness of breath
• Fast or irregular heartbeat
• Chest pain
• Difficulty breathing
• Yellowing of your skin or eyes
• Swelling of the face, throat, tongue, or lips
• Hallucinations
• Suicidal ideation
• Seizures
• Aggressive behavior
• Painful and long-lasting erection (priapism)
• Decreased growth and weight in children

This is not a complete list of side effects. You should talk with your healthcare provider about all of the potential risks of Strattera before you start taking the medication.

Does Stopping Strattera Cause Withdrawal Symptoms?

There is no evidence that taking Strattera leads to drug-discontinuation syndrome or withdrawal.¹ However, discontinuation of the medication should be done under the guidance of your healthcare provider, and it may be best to wean off the medication slowly over time.

Allergic Reactions to Strattera

Although rare, allergic reactions are possible when taking Strattera. These symptoms may include hives, itching, swelling, severe dizziness, or difficulty breathing. Individuals who have experienced allergic reactions to other drugs, particularly those in the same class as Strattera (norepinephrine reuptake inhibitors), should exercise caution when starting this medication. If an allergic reaction occurs, you should stop taking the medication and seek immediate medical attention.

Allergic reactions to Strattera may include:

• Hives
• Itching
• Swelling of the lips, face, tongue, or throat
• Difficulty breathing
• Severe dizziness or lightheadedness
• Chest tightness or pain
• Difficulty swallowing

If you are experiencing an allergic reaction to Strattera, it is crucial to stop taking the medication and seek immediate medical attention. Depending on the allergic response and your medical history, alternative medications may be considered to treat ADHD. Your healthcare provider can discuss other options and ensure your safety moving forward.

Strattera Warnings & Precautions

Before taking Strattera, it is important to be aware of the warnings and precautions associated with the medication. Strattera carries a black box warning, indicating the potential for an increased risk of suicidal thoughts and behaviors, particularly in children and adolescents.¹ Strattera may also cause severe liver injury, and regular liver function tests may be necessary. It is important for your healthcare provider to know of all pre-existing medical conditions, including heart problems, glaucoma, and urinary retention.

Precautions for taking Strattera include:²

• Increased risk of suicidal ideation: Strattera may increase the risk of suicidal thoughts and behaviors, especially in children and adolescents. It is important to monitor for any signs of worsening depression or changes in behavior.
• Risk of liver injury: Although rare, Strattera may cause severe liver injury, and liver tests may need to be monitored when taking the medication.
• Cardiovascular events: Strattera can cause severe heart problems and sudden death, particularly in those with structural or other serious heart problems.
• Elevated blood pressure and heart rate: Strattera can increase blood pressure and heart rate in children and adults.
• Psychiatric symptoms: Strattera can cause new psychotic symptoms, including hallucinations, mania, and aggression.
• Urinary retention: A small percentage of individuals taking Strattera may experience the inability to fully empty the bladder or difficulty initiating and maintaining urine flow.
• Slowed or decreased growth: Strattera may cause slowed or decreased growth in children, and this should be monitored during treatment with Strattera.
• Priapism: There have been reports of Strattera causing priapism (sustained erections lasting more than 4 hours).

Interactions With Strattera

Strattera has the potential to interact with certain medications, substances, and herbs, which can cause worsening side effects or impact the effectiveness of the medication. It is important for your healthcare provider to be aware of all medications, substances, and herbs you are taking to minimize potential risks and provide safe and effective management for your condition. This is not a complete list of possible interactions. Talk with your healthcare provider about all medications, herbs, and supplements you are taking before starting Strattera.

Four substances you should avoid while taking Strattera include:²

• Monoamine oxidase inhibitor (MAOI) antidepressants: Taking Strattera with monoamine oxidase inhibitors may cause severe reactions such as high body temperature, muscle spasms, rapid changes in heart rate and blood pressure, and mental status changes. MAOIs include isocarboxazid, phenelzine, selegiline, and tranylcypromine.
• CYP2D6 inhibitors: Some medications may increase the concentration of Strattera in the body. These medications include antidepressants such as fluoxetine, paroxetine, and bupropion.
• Albuterol: Taking oral or IV albuterol can further increase your blood pressure and heart rate.
• Antihypertensive medications: Medications used to decrease blood pressure may be less effective when taking Strattera.

Can You Overdose on Strattera?

While you can overdose on Strattera, it is relatively rare. Taking more than prescribed or taking Strattera with other medications can increase the risk of an overdose. Signs of overdose may include sleepiness, agitation, mania (increased activity or talking), abnormal behavior, rapid heart rate, tremors, or seizures.

What Should You Do If You Take Too Much Strattera?

If you are worried about an overdose, call the poison control helpline at 1-800-222-1222. If you develop severe symptoms such as seizures, difficulty breathing, or coma, you should immediately seek emergency services or call 911.

Questions to Ask Your Healthcare Provider About Strattera

If you are considering or currently taking Strattera, your healthcare provider will be able to answer any questions you have about the medication. It is important to be aware of the potential risk and benefits of Strattera and what to expect for symptom improvement. If you are in need of a psychiatrist or want to switch providers, online psychiatry services are a good option to consider. These services offer the convenience of remote consultations with qualified psychiatrists and therapists specialized in ADHD.

Questions to ask your care team about the effects of Strattera include:

• How long will it take for me to adjust to taking Strattera?
• Am I at risk for more severe side effects if I am already taking other anxiety /depression medications?
• What is the best dosage to ensure fewer side effects?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Are there any specific lifestyle adjustments I should consider while taking Strattera?
• Are there any potential interactions between Strattera and other medications or supplements I am currently taking?
• How frequently should I have follow-up appointments when starting Strattera?
• What treatment options are available if Strattera is not effective or if I experience severe side effects?
• How do I compare different ADHD medications, such as Qelbree vs Strattera?

In My Experience

In my experience, Strattera is a great medication when treating ADHD. I have used this medication many times in patients with ADHD and have seen the positive impact it can have. It is especially beneficial in those with ADHD who are unable to take stimulant medications. It is important to know the risks and side effects of any medication you are taking. However, it is important to keep in mind that severe side effects are typically rare. However, if you have concerns, it is important to discuss them thoroughly with your healthcare provider.

For Further Reading

• Stimulant vs Non-Stimulant ADHD Meds: Key Differences
• ADHD Medication Side Effects: Everything You Need to Know
• 6 Best Non Stimulant ADHD Medications: 6 Options
• SSRIs vs SNRIs: How They Work & Key Differences
• SNRI Medications: Types, Side Effects, and Risks