Atomoxetine Discontinuation Protocol

Monitoring and Special Considerations

• The American Academy of Child and Adolescent Psychiatry recommends developing a monitoring plan after stopping atomoxetine to assess for return of ADHD symptoms, as return of symptoms may take weeks to months to emerge after discontinuation 1, 2
• Schedule follow-up appointments to assess symptom recurrence and determine if retreatment is necessary, considering that most other psychotropic medications require gradual tapering to avoid withdrawal symptoms or rebound worsening of symptoms 1, 2
• The American Academy of Pediatrics suggests that extended-release guanfacine and extended-release clonidine should always be tapered rather than suddenly discontinued due to risk of rebound hypertension 3
• When discontinuing atomoxetine in patients taking multiple medications for ADHD or comorbid conditions, consider which medication to discontinue first based on the disorder that is more likely to go into remission or which is less severe 1
• Ensure adequate follow-up monitoring is arranged to detect any unexpected return of symptoms after discharge, especially in inpatient or partial hospital settings with short lengths of stay 1, 2