Discontinuing Atomoxetine Treatment

Clinical Considerations

• The American Academy of Child and Adolescent Psychiatry recommends obtaining the history of previous psychiatric symptoms and response to medication before discontinuing any medication, and developing a monitoring plan for a discontinuation trial 1
• Atomoxetine can be stopped immediately without a taper schedule, and patients should be monitored for return of ADHD symptoms over 2-4 weeks, as atomoxetine's therapeutic effects may persist briefly after discontinuation 1
• Functional impairment across multiple settings (work, home, social) should be tracked to determine if symptoms return 1
• Return of ADHD symptoms may take several weeks to become apparent, particularly for inattentive symptoms which are less immediately obvious than hyperactivity 1
• Functional decline in work performance, relationships, or daily activities may emerge gradually rather than immediately 1
• Untreated ADHD is associated with increased risk of accidents, substance abuse, and functional impairment, and if discontinuing atomoxetine due to inadequate efficacy, transition directly to a more effective medication (typically a stimulant) rather than leaving ADHD untreated 3
• When stopping atomoxetine, it is possible to transition directly to a more effective medication, such as a stimulant, without a taper 2