*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Common Strattera side effects include loss of appetite, insomnia, and nausea. Serious side effects require medical attention such as a risk of suicidal thoughts and behaviors, symptoms of mania, and allergic reactions.
Many people consider stopping their medication because of side effects. If you have Strattera side effects for more than the first few weeks, talk to your provider. They can help you understand your options, which may include a change in dosage, timing of dosage, or switching to a different medication.
If you are considering Strattera or want to discuss your current medication treatment with a provider, online psychiatry platforms, such as Talkiatry and Brightside Health are a good place to start. The providers on these platforms can do assessments and consult you about your prescription. They can answer any questions you have about Strattera’s side effects and other risks.
Boxed Warning: Atomoxetine (Strattera) – Risk of suicidal thoughts and behavior
Key Takeaways
Common Strattera side effects include loss of appetite, insomnia, nausea, and sexual dysfunction. There is also a risk of serious side effects that require medical attention.
If Strattera side effects last longer than a few weeks, your provider can help you determine next steps, which may include a change in dosage, timing of dosage, or medication.
There are several ways to cope with Strattera side effects, including self care practices, medication adjustments, and therapy.
If you are considering Strattera or an alternative, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry or Brightside Health.
Concerned About Medication Side Effects? Ask a Doctor
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Common Strattera Side Effects
Strattera can cause several common side effects affecting the digestive system, sleep, and sexual functioning. Some may require medical attention but many often resolve on their own.
Common side effects of Strattera for adults may include:*1
- Constipation
- Dry mouth
- Nausea
- Decreased appetite
- Dizziness
- Erectile dysfunction
- Loss of bladder control, difficulty urinating
Common side effects of Strattera for children and adolescents may include:*1
- Nausea
- Vomiting
- Tiredness
- Decreased appetite
- Abdominal pain
- Drowsiness
*All medications, including Strattera, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
Serious Strattera Side Effects
Some side effects may be severe or persistent. Seek immediate medical care if you experience any of the serious side effects listed below.
Serious side effects of Strattera that require immediate medical care include:*1
- Suicidal thoughts or actions
- Aggressive behavior or hostility
- Symptoms of mania or hypomania
- Serious heart problems
- Potentially harmful changes in blood pressure and heart rate
- Effects on children’s growth
- Liver problems
- Problems with urination
- Priapism (painful prolonged erections)
*All medications, including Strattera, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
What Are the Risks & Warnings for Strattera?
Suicidal Thoughts & Behaviors
Atomoxetine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with atomoxetine and any other medications before starting treatment.
New Psychotric Symptoms
Strattera can cause new psychotic symptoms, including hallucinations, mania, and aggression.
Priapism
There have been reports of Strattera causing priapism (sustained erections lasting more than 4 hours).
Serious Cardiovascular Events
Strattera can cause severe heart problems and sudden death, particularly in those with structural or other serious heart problems.
Elevated Blood Pressure & Heart Rate
Strattera can increase blood pressure and heart rate in children and adults.
Difficulty Urinating
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 in Children
Strattera may cause slowed or decreased growth in children, and this should be monitored during treatment with Strattera.
Severe Liver Injury
Although rare, Strattera may cause severe liver injury, and liver tests may need to be monitored when taking the medication.
Pregnancy
Strattera may not be safe during pregnancy, and its use should be discussed with a healthcare provider to weigh potential risks and benefits.
Breastfeeding
The possible risks of taking Strattera while breastfeeding are unclear. Talk to your prescriber about how this may affect your treatment and any plans to breastfeed.
Allergic Reactions
For some people, Strattera may cause an allergic reaction, which includes symptoms such as reaction, rash, and swelling of the face, hands, or feet.
Severe allergic reactions to Strattera can include:
- Breathing problems
- Swelling
- Rash or hives
If you experience trouble breathing as part of an allergic reaction, seek immediate medical care.
Drug Interactions
Taking certain medications, herbs, or supplements alongside Strattera can change how Strattera works in your body or increase the risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Substances you should avoid using while taking Strattera include:
- Blood pressure medications, both those the raise and lower blood pressure
- Monoamine oxidase inhibitors (MAOIs)
- Albuterol for asthma
- CYP2D6 inhibitors, including antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and bupropion (Wellbutrin)
This is not a comprehensive list of all possible drug interactions for Strattera. Be sure to talk with your doctor or pharmacist about any prescription or over the counter medications you take, as well as supplements, herbs, and teas.
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Important Things to Know About Taking Strattera
Before starting Strattera, it’s important to understand how the medication may affect you, especially during the first few weeks. Your prescriber will discuss how to take Strattera, your dosage, precautions, and side effects you may experience. They will also talk about what you can do if side effects become a problem.
How Long Does It Take for Strattera to Work?
Strattera can take about 4-8 weeks to become fully effective, but some individuals may notice their symptoms improve after the first week or two. Each person may have a different response time based on how their body absorbs and processes the medication.
Can Strattera Worsen Symptoms at First?
Yes, some people starting Strattera may experience uncomfortable side effects such as increased constipation, dry mouth, and nausea.1 Strattera can also increase the risk of suicidal thoughts and behaviors in some people, including young adults and adolescents. If you experience any worsened symptoms or side effects, contact your provider as soon as possible.
What Happens If I Miss a Dose?
If you forget to take your Strattera dose, take it as soon as you remember. If your next dose is due soon, skip the missed one and take your next scheduled dose. Do not take two doses at once to make up for a missed dose. Keep taking your medication as prescribed unless your provider changes your instructions.
Who Experiences Side Effects More?
Some patients are more likely to experience side effects from Strattera than others. While side effects may develop for anyone, those with certain risks should be cautious with Strattera, possibly avoiding it.
Adolescent patients and their parents should be aware of the risk of increased suicidal ideation when starting Strattera. Discuss any health conditions for yourself or your child with your physician when considering treatment. This information will help them select the most suitable medication for you.
Those with a history of certain health concerns have a higher risk of side effects, such as:
- Liver problems
- Kidney problems
- Heart problems
- High blood pressure
- A higher risk of stroke
- Suicidal thoughts and behaviors
- Pregnancy or breastfeeding
- Psychotic or manic symptoms
- Prior allergic reactions to atomoxetine
- A history of narrow-angle glaucoma
- A history of pheochromocytoma (tumor on the adrenal gland)
Those taking certain medications also have a higher risk of side effects, such as:
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
- Albuterol for asthma
- CYP2D6 inhibitors, including antidepressants such as fluoxetine (Prozac), paroxetine (Paxil), and bupropion (Wellbutrin)
How to Cope With Common Strattera Side Effects
There are ways to cope with the most common Strattera side effects*. Many may go away on their own during the first few weeks. Contact your provider if side effects don’t go away after a few weeks or get worse.
Nausea
Taking Strattera can cause nausea for some people. To lessen this, follow the meal timing instructions for your medication. Also, drink plenty of water and eat smaller, more frequent meals. You may also find ginger or peppermint teas soothing, but talk with your healthcare provider first. Over-the-counter medicine, supplements, and even tea may have interactions with Strattera you should be aware of.
Dry Mouth
Dry mouth is another potential side effect of Strattera, which can be uncomfortable. To manage it, sip water frequently and use sugar-free lozenges or gum to promote saliva production. Avoiding caffeine and alcohol can also help alleviate dry mouth symptoms.2
Sleep Changes
Sleep changes such as drowsiness and insomnia are common when taking Strattera. Try to follow a regular sleep schedule and get daily light exposure. Also, consider keeping a sleep diary to track patterns and potential problems. Getting 30 minutes of exercise during the day can help you get better rest, but avoid intense activity before bed. Your provider may also recommend taking your medication at a certain time of the day or using sleep aids.
Sexual Side Effects
Men taking Strattera may experience erectile dysfunction, decreased sex drive, and delayed ejaculation. Women may have problems with orgasms and decreased sex drive.1 These effects often go away after the first few weeks of taking Strattera. Try scheduling sexual activity before taking a dose. If this doesn’t help or sexual side effects remain a problem, tell your provider. They may consider a change of dosage or medication.
*All medications, including Strattera, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Concerned About Medication Side Effects? Ask a Doctor
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
More Ways to Manage Strattera Side Effects
Here are more ways to cope with and reduce the impact of Strattera side effects.
Practice Good Sleep Habits
Following good sleep habits can help you get better rest while your body adjusts to your new medication. Try waking up and going to bed around the same time each day. Create a relaxing and comfortable sleeping environment as well. If you feel drowsy during the day, avoid activities that require you to be alert, such as driving or operating machinery.
Healthy Lifestyle Activities
Eating well, sleeping enough, and getting adequate exercise can all help you maintain a healthy lifestyle. While these activities are important for good physical and mental health, they can also support your body through the ups and downs of starting a new medication.
Follow a Daily Routine
Following your normal routine is important even if you don’t feel like your medication is working yet. Doing your regular daily activities can keep life more predictable and reduce stress as your body adjusts to taking Strattera. Also, be sure you are taking your medication as prescribed and at the same time every day.
Consider Therapy
Psychotherapy can help you cope with the impact of side effects and develop strategies to manage them. For in-person therapy, your primary care provider or insurance company can provide a referral. Or, family members and friends may recommend someone to you.
To find an online therapist, an online therapist directory is a great starting point. Many online psychiatry platforms, such as Talkiatry and Brightside Health, also offer therapy services.
Should I Stop Taking Strattera If I Start Feeling Side Effects?
Do not stop taking Strattera on your own. Tell your provider about any side effects so they can advise you on your next steps. Typically, withdrawal symptoms are rare when stopping the medication. However, it’s still important to follow your provider’s guidance. They will give you new instructions if you need to adjust or switch your medication.
When Should I Call My Doctor About Strattera Side Effects?
Side effects are among the top reasons people want to stop taking medication. While some effects can be managed and may fade on their own, some do not go away unless a person stops taking the medication. Medications can cause side effects even when taken correctly.
Contact your provider as soon as possible if side effects continue or become hard to tolerate. They will advise you on your treatment options and your next steps. While not common, some people taking Strattera may experience serious side effects. These effects often require immediate medical care and some may be life-threatening. If you notice any of the serious side effects listed above, seek medical care immediately.
When Should I Seek an Alternative to Strattera Due to Side Effects?
Strattera’s initial side effects usually go away on their own after a few weeks. If your side effects continue and you decide to change your medication, work with your provider to find an alternative. There are many Strattera alternatives available. Stimulant and non-stimulant medications can help reduce ADHD symptoms, though potential risks and benefits can vary.
Qelbree is another FDA-approved non-stimulant medication for ADHD. Like Strattera, Qelbree is thought to work by increasing levels of the norepinephrine in the brain, which may improve attention and focus.
Some antidepressants have shown to be effective ADHD treatments, such as Wellbutrin, Effexor XR, imipramine, and desipramine. These are the most widely studied antidepressants for treating ADHD symptoms. They may be helpful for those who need to avoid or can’t tolerate stimulant medications.
Stimulant medications are often the primary medication used to treat ADHD. If non-stimulant medications aren’t a good fit, there are many FDA-approved stimulants available to try, including Adderall, Vyvanse, Concerta, and Ritalin. While they can be effective, these medications also come with risks to consider.
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How to Get a Prescription for Strattera or Alternative Medications
The first step of getting a prescription for Strattera or an alternative in person is an evaluation of your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may refer you to a psychiatrist or specialist, if needed. They will determine if a prescription for Strattera or an alternative should be part of your treatment.
To get an online prescription for a Strattera or an alternative, you will also start with an evaluation. We have thoroughly reviewed online psychiatry platforms like Talkiatry and Circle Medical, which can prescribe non-controlled substances such as Strattera.
Stimulant medications are controlled substances used to treat ADHD symptoms and may be considered as an alternative to Strattera. To get prescribed stimulants, you must do your evaluation with an online psychiatry provider that can and will prescribe controlled substances.
We have thoroughly evaluated online providers like Circle Medical that provide assessments and prescribe stimulant ADHD medication. If your provider feels a stimulant medication may help your ADHD symptoms, they may offer you a stimulant prescription online.
Questions to Ask Your Provider
Your doctor, psychiatrist, or therapist can discuss possible side effects of Strattera with you, especially those that may happen when starting your treatment. Ask them whether these side effects will go away on their own and what to do if they persist.
Also, many online psychiatry services provide convenient access to mental health care for depression and anxiety problems. You get a mental health evaluation, diagnosis, and personalized treatment plan. Some platforms also allow you to change providers, if needed.
Questions to ask your care team about Strattera side effects may include:
- I am currently taking another medication. Will Strattera interact with it in any way?
- How long will it take for me to adjust to taking Strattera?
- How quickly can Strattera cause side effects?
- What are the first days of Strattera side effects like?
- Does Strattera have any potential effects on appetite?
- What is the best dosage to reduce side effects, especially in the first week?
- When should I reach out to you if I am experiencing side effects?
- If I’m not able to tolerate the side effects, are there Strattera alternatives to consider?
- What can I expect if I need to stop taking this medication?
- What are some ways to cope with side effects?
- What can I do if my side effects don’t go away after the first few weeks?
- Can I skip or lower a dose to avoid side effects?
- Can I switch my medication if the side effects last or get worse?
- What should I do if I have serious side effects?
Prescriber’s Tips
Your provider will share important information about your Strattera prescription. They will explain how to take your medication and the best way to store it. They will also explain what to avoid when taking it and what to do about any side effects that occur. Follow these tips for safe and effective use of Strattera.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to. Keeping a consistent dosing schedule reduces the chance of unwanted side effects.1
- Take your medication at the same time each day. Doing so can help you remember to take it, which will help it be as effective as possible. Your healthcare provider can determine the best time to take your medication based on how you respond to it and your sleep patterns.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Strattera has a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- You should take your first dose while you are home and not needing to drive. Strattera has been known to cause drowsiness in some patients. Avoid driving after taking Strattera until you know how it affects you.1
- Ask your doctor whether it is safe to drink alcohol while taking Strattera.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications.
Frequently Asked Questions
What Is Strattera (Atomoxetine) & What Is It Used to Treat?
Strattera (atomoxetine) is a non-stimulant ADHD medication in the selective norepinephrine reuptake inhibitors drug class. It is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) in adults and in children ages 6 and older.1
What Does Strattera Do?
Strattera is thought to work by affecting the levels of two chemical messengers in the body, serotonin and norepinephrine. This activity may help improve attention and decrease impulsivity for some.1
How Does Strattera Make You Feel During the First Week?
During the first week or two of taking Strattera, the medication is building up in your body. This may trigger side effects for some people. Because it can take several weeks of continuous use for Strattera to start working, you may not notice any difference in your symptoms for a while.
How Long Do Strattera Side Effects Last?
The duration of Strattera side effects can vary. In most cases, mild side effects tend to improve after the first few weeks. But when they last longer than that or get worse, medical care is likely needed to address them. Individual response, dosage, and overall health can affect how long Strattera side effects may last.
Is Anger a Side Effect of Strattera?
While infrequent, worsened aggressive behavior or hostility is a possible side effect of Strattera. Irritability is also a symptom of ADHD, depression, and other conditions. It’s important to watch for these potential changes during treatment, especially for those with other mental health conditions.1
What Are the Long-term Side Effects of Strattera?
Possible side effects from long-term Strattera use can vary from person to person. Some may experience effects on growth and weight gain, as well as changes in liver function.4 However, not everyone will have these issues, and many tolerate Strattera well over time.
How Do the Side Effects of Strattera and Adderall Compare?
The side effects of Strattera and Adderall can vary due to their different active ingredients and they work in the body. Strattera is a non-stimulant drug, with common side effects such as dry mouth and nausea. In contrast, Adderall is a stimulant drug, commonly causing side effects such as appetite changes, heart rate increase, and anxiety.3
Can Strattera Affect My Sleep?
Yes. While it may not affect everyone who takes it, insomnia is a common side effect of Strattera.
Can Strattera Affect My Mood?
Strattera does have a increased risk of suicidal thoughts and behaviors for some people. If you notice a change in your mood or worsened mental health symptoms after taking Strattera, seek immediate medical care.
Should I Stop Taking Strattera If I Experience Side Effects?
Do not stop taking Strattera abruptly unless you have been advised to do so by your provider. Tell your provider about any side effects so they can advise you on your next steps. Even though withdrawal symptoms are rare when stopping the medication, there may be other considerations. Your provider may suggest changing your dosage, the timing of your dosage, or switching your medication.
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Strattera- atomoxetine hydrochloride capsule. (February 28, 2024). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Talha, B., & Swarnkar, S. A. (2020). Xerostomia. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK545287/
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LABEL: ADDERALL- dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate tablet. DailyMed: National Library of Medicine. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Fedder, D., Patel, H., & Saadabadi, A. (2021). Atomoxetine. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493234/
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary updates: Added “Key Takeaways” feature. Edited for clarity. Condensed “What is Strattera & How Is It Used?” and moved to FAQs. Revised content for common and serious side effects. Removed “Mild Side Effects” section. Combined “Strattera Side Effects in Children” with “Common Side Effects”. Revised and moved content from “Allergic Reactions” and “Strattera Warnings & Precautions” to new “What Are the Warnings & Risks of Strattera?” feature. Added new sections “Who Experiences Side Effects More?” and “Important Things to Know About Taking Strattera”. Revised and moved FAQ section to the end. Revised “How to Manage Side Effects” , added “More Ways to Manage Strattera Side Effects”, “Should I Stop Taking Strattera If I Start Feeling Side Effects?”,”When Should I Seek an Alternative to Strattera Due to Side Effects?”, “How to Get a Prescription for Strattera or Alternative Medications” and all included subsections. Retitled “Questions to Ask Your Healthcare Provider About Strattera Side Effects” to “Questions to Ask Your Provider”. Replaced “Final Thoughts” with “Prescriber’s Tips” feature. Removed “For Further Reading”
Author: Max Ruvinov, PharmD, MBA
Medical Reviewer: Heidi Moawad, MD
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