Strattera (atomoxetine) is a non-stimulant medication primarily prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults and children ages 6 years and older. While its primary function is to manage ADHD symptoms such as inattention and impulsivity, some individuals have reported weight loss as a side effect. This article delves into the relationship between Strattera and weight loss, exploring the potential mechanisms, clinical evidence, and important considerations for individuals considering or currently taking this medication.
What is Strattera?
Strattera is a brand-name drug containing the active drug atomoxetine. It is a selective norepinephrine reuptake inhibitor, meaning it works by increasing the levels of norepinephrine in the brain. Norepinephrine is a neurotransmitter that plays a role in attention, focus, and impulse control. Unlike traditional ADHD medications like Adderall, Strattera is not a stimulant, making it less likely to be abused or cause dependence, tolerance, or withdrawal symptoms upon discontinuation. Strattera is available as a generic option known as atomoxetine, which may save you money.
Key Facts About Strattera
- Drug Class: Selective norepinephrine reuptake inhibitor
- Form: Oral capsule
- Generic Available: Yes (atomoxetine)
- Prescription Required: Yes
- Controlled Substance: No
- FDA Approval: Approved for ADHD in adults and children ages 6 years and older
Does Strattera Cause Weight Loss?
While weight loss is not the primary intention of Strattera, it is a potential side effect that some individuals may experience. Clinical studies have shown that weight loss can occur in both children and adults taking Strattera.
- Clinical Studies: In clinical studies up to 18 weeks, 3% of children and teens taking Strattera experienced weight loss. In studies up to 25 weeks, 2% of adults lost weight.
- Weight Monitoring: Children taking Strattera should have their weight checked often during treatment, as the medication can slow growth (both weight and height) in children.
- Individual Variability: Not all studies have shown weight loss in patients taking Strattera, and individual responses to the medication can vary widely.
Potential Mechanisms of Weight Loss with Strattera
The exact mechanisms by which Strattera may lead to weight loss are not fully understood, but several factors may contribute:
Decreased Appetite
Weight loss might be due to decreased appetite, which is a common side effect of Strattera. When you feel less hungry, you are less likely to eat, which can cause you to consume fewer calories. Strattera suppresses appetite, probably due to the gastrointestinal problems mentioned before and the medication’s influence on norepinephrine pathways in the brain.
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Gastrointestinal Side Effects
Many people also experience nausea and stomach upset while taking Strattera. These gastrointestinal issues can further reduce appetite and lead to decreased food intake. Common side effects, such as nausea, vomiting, and dry mouth, can be managed properly and will lessen throughout the treatment.
Impact on Metabolism
Strattera influences norepinephrine levels, which indirectly increases dopamine levels. Norepinephrine increases heart rate and blood pressure and appears dose-dependent. Some studies suggest that Strattera may increase resting metabolic rate, potentially leading to an increase in calorie expenditure, which could contribute to weight loss in certain individuals.
Clinical Evidence and Studies
Several studies have investigated the effects of Strattera on weight:
- Studies in Children: Studies in children taking Strattera have shown that weight gain is slower compared to normal population data for the first 9-12 months of treatment. In one study, children who took Strattera for up to 9 weeks lost 0.5 kg on average.
- Studies in Adults: Another small study showed that women identified as obese who took Strattera for 12 weeks lost 3.6 kg on average.
- Schizophrenia Study: A small study of people with schizophrenia taking an antipsychotic compared body weight of those adding on Strattera or a placebo for 24 weeks. This study did not show significant weight loss.
Strattera vs. Adderall: Impact on Weight
Both Strattera and Adderall are effective for ADHD; however, they have different mechanisms of action and potential effects on weight. Strattera is a non-stimulant that primarily affects norepinephrine, while Adderall is a stimulant that increases both dopamine and norepinephrine levels.
- Strattera: May cause appetite suppression, leading to decreased calorie intake and potential weight loss.
- Adderall: Increases metabolic rate, causing the body to burn more calories, which can also lead to weight loss.
It’s important to note that individual responses to these medications can vary, and some people may experience weight gain with either medication.
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Managing Weight Loss While Taking Strattera
If you are concerned about potential weight loss while taking Strattera, there are several steps you can take to manage this side effect:
Monitor Eating Habits
Being mindful of your dietary choices is a crucial aspect of weight management while on Strattera. Aim to maintain a balanced and nutritious diet that provides your body with the necessary nutrients. Consider incorporating a variety of food groups, including fruits, vegetables, lean proteins, and whole grains, into your meals. Regular, well-balanced meals can help ensure you meet your calorie and nutritional needs, even if you experience appetite suppression.
Stay Hydrated
Drinking an adequate amount of water is essential while taking Strattera, as it can help alleviate some of the side effects associated with the medication, such as dry mouth and nausea. Staying well-hydrated can also support your overall health and well-being. Aim to drink enough water throughout the day to maintain proper hydration.
Small, Frequent Meals
If you experience a decreased appetite, try eating smaller, more frequent meals throughout the day rather than trying to consume large meals. This can help ensure you get enough calories and nutrients without feeling overwhelmed.
Nutrient-Dense Foods
Focus on eating nutrient-dense foods that provide a lot of calories and nutrients in a small serving. Examples include nuts, seeds, avocados, and full-fat dairy products.
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Consult Your Healthcare Provider
Perhaps the most crucial step in managing your experience with Strattera is to maintain open communication with your healthcare provider. If you are experiencing significant weight loss or any discomfort while taking Strattera, do not hesitate to reach out to your healthcare provider. They are your primary resource for guidance and support. Your healthcare provider can assess your specific situation, monitor your progress, and make necessary adjustments to your treatment plan if needed.
Other Side Effects of Strattera
In addition to weight loss, Strattera can cause other side effects, including:
Common Side Effects
- Nausea
- Vomiting
- Dry mouth
- Decreased appetite
- Dizziness
- Sexual side effects, such as erectile dysfunction
- Mood changes
- Insomnia
- Headache
- Fatigue
- Mild anxiety
Serious Side Effects
- Liver problems
- Changes in blood pressure and heart rate
- Urination problems
- Changes in behavior or mental health
- Severe drowsiness
- Priapism (a prolonged and often painful penile erection)
- Suicidal thoughts in children and adolescents
- Severe allergic reaction
It’s important to be aware of these potential side effects and to contact your doctor if you experience any concerning symptoms.
Precautions and Warnings
Strattera comes with certain precautions and warnings that should be carefully considered:
Suicidal Thoughts
Strattera has a boxed warning for the risk of suicidal thoughts in children and adolescents. This is a serious warning from the FDA. Patients should be monitored for any changes in behavior or mood.
Cardiovascular Issues
Prescribing atomoxetine in patients with hypertension, tachycardia, cardiovascular disease, or cerebrovascular disease requires caution. The medication can cause vascular changes, such as an increase in pulse and blood pressure.
Allergic Reactions
This medicine may cause serious allergic reactions, including anaphylaxis and angioneurotic edema, which can be life-threatening and require immediate medical attention.
Liver Problems
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
Drug Interactions
Do not take atomoxetine with or within 14 days of taking a drug with monoamine oxidase (MAO) inhibitor activity (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], procarbazine [Matulane®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]). If you do, you may develop serious side effects.
Alternatives to Strattera
If Strattera is not the right fit for you, there are other medications available to treat ADHD, including:
- Viloxazine (Qelbree)
- Serdexmethylphenidate/dexmethylphenidate (Azstarys)
- Methylphenidate (Concerta, Daytrana, Quillivant XR, Ritalin, others)
- Lisdexamfetamine (Vyvanse)
- Guanfacine (Intuniv)
- Dextroamphetamine (Dexedrine, Zenzedi)
- Dexmethylphenidate (Focalin, Focalin XR)
- Clonidine (Kapvay)
- Bupropion (Wellbutrin XL)
- Amphetamine/dextroamphetamine (Adderall, Adderall XR, Mydayis)
- Amphetamine (Evekeo, Dyanavel XR)
Dosage and Administration
The Strattera dosage your doctor prescribes will depend on several factors, including the severity of your condition, your age, body weight (in children), and other medical conditions you may have.
Adult Dosage
For treating ADHD in adults, Strattera’s typical starting dosage is 40 milligrams (mg) taken once daily in the morning. After at least 3 days, your doctor will likely increase this to the recommended dosage of 80 mg per day. You’ll either take the drug as a single dose in the morning or as two divided doses. The maximum dose is 100 mg per day.
Children’s Dosage
In children, the dosage of Strattera depends on the child’s body weight in kilograms (kg). The starting dose of Strattera for children who weigh 70 kg or less is 0.5 mg per kg of body weight (mg/kg). This starting dose is taken once daily in the morning. After at least 3 days, the doctor will likely increase the dose to the recommended dosage of 1.2 mg/kg per day. The maximum daily dosage of Strattera in children who weigh up to 70 kg is 1.4 mg/kg per day or 100 mg per day, whichever is less.