Switching from Adderall to Atomoxetine

Discontinuation and Initiation

Adderall can be discontinued abruptly without tapering when switching to another ADHD medication, and amphetamines like Adderall should be discontinued or decreased when problematic, with behavioral therapies considered as adjunctive treatment, according to the American Heart Association, as published in Circulation 1
There is no washout period required between stopping Adderall and starting atomoxetine, as these medications work through different mechanisms, as stated in Pharmacology and Therapeutics 2

Expect 6-12 weeks until full therapeutic effects are observed with atomoxetine, which is significantly longer than stimulants, and patients should be counseled about the delayed therapeutic onset to maintain adherence during the transition period, as reported in Pharmacology and Therapeutics 2
Atomoxetine provides "around-the-clock" symptom control without the need for multiple daily dosing, and it is an uncontrolled substance with negligible abuse potential, making it particularly useful for patients with comorbid substance use disorders, according to Pharmacology and Therapeutics 2

Check blood pressure and pulse at baseline and regularly during treatment, as atomoxetine can cause increases in both parameters, as recommended by the American Heart Association, as published in Circulation 1
Assess efficacy using standardized ADHD rating scales when possible, as suggested by the guideline society, although the specific society is not mentioned in the non-ignored references, but is mentioned in Praxis Medical Insights: Practical Summaries of Clinical Guidelines 3