atomoxetine / Generic mfg. - LARVOL DELTA

Prescription Stimulant Therapy and Risk of Constipation in Adults With ADHD: A Propensity-Matched Multicenter Cohort Study (ACG 2026) - "The stimulant cohort included patients receiving amphetamine or amphetamine-like stimulants, excluding prior stimulant exposure and non-stimulant ADHD medication exposure. The non-stimulant cohort included patients receiving atomoxetine, guanfacine, clonidine, or viloxazine, excluding prior non-stimulant exposure and stimulant exposure... After matching, 36,501 patients were included in each cohort. At 1 year, constipation occurred in 617/33,224 stimulant users versus 832/32,541 non-stimulant users (1.9% vs 2.6%; RR 0.726, 95% CI 0.655â0.805; p< 0.001). Stimulant therapy was also associated with lower laxative/constipation medication use (5.3% vs 5.8%; RR 0.916, 95% CI 0.857â0.980; p=0.011) and ileus risk (0.04% vs 0.10%; RR 0.371, 95% CI 0.196â0.701; p=0.001)."

Clinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Psychiatry

IDENTIFYING MEANINGFUL PATIENT SAVINGS ON GENERICS: DIRECT-TO-CONSUMER PRICES VS COMMERCIAL INSURANCE (ISPOR 2026) - "DTC pharmacies such as MCCPDC meaningfully lower out-of-pocket costs for higher-cost generic prescriptions which could otherwise be difficult to afford. Commercially insured patients should consider DTC pharmacies when their copayment or coinsurance for a generic medication exceeds $15, and particularly when it exceeds $100."

Clinical • Reimbursement • US reimbursement • CNS Disorders • Depression • Endocrine Disorders • Erectile Dysfunction • Multiple Sclerosis

Severe atomoxetine overdose presenting with status epilepticus and wide-complex ventricular tachycardia. (PubMed, Am J Emerg Med) - "Severe atomoxetine overdose may cause convulsive status epilepticus, profound lactic acidosis, and life-threatening cardiac conduction disturbances. Early airway protection, seizure control, continuous electrocardiographic monitoring, and consideration of sodium bicarbonate therapy for marked QRS widening are critical management strategies."

Journal • ADHD (Impulsive Aggression) • Anesthesia • Attention Deficit Hyperactivity Disorder • Cardiovascular • CNS Disorders • Epilepsy • Hypotension • Metabolic Disorders • Psychiatry • Ventricular Tachycardia

Noradrenaline reuptake inhibitors (NRIs) for attention deficit hyperactivity disorder (ADHD) in adults. (PubMed, Int J Risk Saf Med) - "NRIs increased treatment discontinuation (RR 1.16, 95% CI [1.03, 1.30]) and non-serious adverse events (AEs) (RR 1.27, 95% CI [1.09, 1.49]), both with very low certainty. Atomoxetine increased serious AEs (RR 2.31, 95% CI [1.79, 2.97]; moderate certainty).ConclusionsThere is probably more harm (compared to placebo) with atomoxetine use in adults, with over two-fold increase in the number of people with serious (life-threatening) adverse events, a higher proportion of people with any adverse event amongst patients taking atomoxetine and higher withdrawal rates of people treated with atomoxetine or reboxetine."

Journal • Review • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Short-term heart rate variability is preserved in Parkinson's disease under atomoxetine. (PubMed, Brain Commun) - "Using Bayesian statistical inference, we demonstrated confidence in the preservation of HRV across measures in the time, frequency and non-linear domains. Our findings are in favour of a safe cardiovascular profile for atomoxetine in Parkinson's disease, further supporting noradrenergic modulation as a viable treatment strategy for neuropsychiatric symptoms in Parkinson's disease and related disorders."

Journal • Cardiovascular • CNS Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

α6GABAA receptors as novel targets for ADHD therapy: A proof-of-concept study in MK-801-treated juvenile mice. (PubMed, Eur J Pharmacol) - "Atomoxetine, an approved ADHD medication, also attenuated ADHD-like phenotypes, although with sedative effects. The therapeutic-like effects of Compound 6 were abolished by intracerebellar microinjection of furosemide, an α6GABAA receptor antagonist, and were absent in Gabra6 (α6-encoding gene)-knockout mice, indicating that positive modulation of cerebellar α6GABAA receptors underlies the observed behavioral improvements. Together, these findings provide proof-of-concept that enhancing cerebellar α6GABAA receptor-mediated inhibition can ameliorate ADHD-relevant behavioral impairments and highlight α6GABAA receptor-selective PAMs as a potential pharmacotherapeutic strategy for ADHD."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Developmental deviations of association-network structural connectivity in youths with ADHD predict symptom and treatment outcomes. (PubMed, Nat Biomed Eng) - "Baseline deviations predicted 12-week treatment response to atomoxetine but not methylphenidate, and follow-up imaging revealed treatment-related reductions in deviation. Together, these findings identify structural connectivity deviation as a developmental biomarker with prognostic relevance for ADHD, supporting precision care through symptom monitoring and treatment stratification."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Cross-Cohort, Renal Compartment-Aware Transcriptomic Assessment of Lycii Fructus-Annotated Targets in Diabetic Kidney Disease. (PubMed, Curr Issues Mol Biol) - "Reference redocking reproduced carazolol in ADRB2 and atomoxetine in SLC6A2 (RMSD, 1.08 and 1.09 Å). Thus, the four genes are reproducible DKD-perturbed candidates carrying Lycii Fructus annotations, not evidence of a Lycii Fructus-specific mechanism; they warrant targeted pharmacological testing."

Journal • Diabetic Nephropathy • Nephrology • Renal Disease • ADRB2 • CASP8

Updates in treatment strategies in ADHD (WFSBP 2026) - "Lisdexamfetamine, a prodrug cleaved gradually by red blood cell enzymes, provides smoother pharmacokinetics and lower abuse potential due to slower peak concentrations...OROS-methylphenidate mimics twice-daily dosing through osmotic release, while transdermal methylphenidate bypasses first-pass metabolism and reduces appetite suppression. Serdexmethylphenidate and ion-exchange amphetamine preparations further improve duration and plasma stability...These mechanisms may improve emotional dysregulation and provide faster onset than atomoxetine...Investigational therapies include centanafadine, a triple DAT-NET-SERT inhibitor targeting emotional dysregulation; TAAR-1 agonists, which modulate dopamine and glutamate signaling; and metadoxine extended release, which restores GABA-glutamate balance and may preferentially benefit inattentive ADHD...DAT1 and SERT polymorphisms may predict stimulant or serotonergic treatment response, while COMT Val158Met variants influence..."

ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Mood Disorders • Psychiatry • Tic Disorders • Tourette Syndrome • COMT

Prevalence, Trends and Patterns of ADHD Medication Use Among Children, Adolescents and Young Adults in Quebec, Canada: A Repeated Cross-Sectional Population-Based Study From 2000 to 2022: Prévalence, tendances et profils d'utilisation des médicaments pour le TDAH chez les enfants, les adolescents et les jeunes adultes au Québec (Canada) : étude populationnelle transversale (PubMed, Can J Psychiatry) - "We estimated crude and age-adjusted prevalence rates along with their 99% confidence intervals according to sex, age (only for crude estimates), material and social deprivation, and ADHD medication type, namely stimulants (amphetamine-based and methylphenidate-based medications) and non stimulants (atomoxetine and guanfacine). The expansion of diagnostic criteria in 2013 and heightened awareness may have narrowed the disparity between the condition's prevalence and its management and may explain the increase in use observed in earlier years and the stabilization observed over the more recent years. The disparities between males and females, as well as between age groups, highlight the need for continuous monitoring of prescribing trends and support targeted equity evaluations to inform service planning and improve access where needed."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Pediatrics • Psychiatry

Effects of atomoxetine and methylphenidate on quality of life and self-esteem in adults with ADHD. (PubMed, Front Psychiatry) - "Correlation analysis showed that symptom severity, assessed with the DIVA 5 test, was inversely proportional to levels of self-esteem (Spearman rho = -0.3269; p = 0.0131) and quality of life (Spearman rho = -0.3758; p = 0.0040) and that RSES and AAQoL-29 scores were positively correlated (Spearman rho = 0.6357; p = 0.0000). Our study confirms that pharmacological therapy in adult ADHD not only improves core symptoms but also promotes improvement in self-esteem and personal efficacy, essential components for the recovery of psychological and social well-being."

HEOR • Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Sleep and Stroop Performance with Adjunctive Melatonin in Pharmacotherapy-stable Pediatric ADHD: A Prospective Open-label Study. (PubMed, Indian J Psychol Med) - "Thirty-three participants (ADHD; Children's Sleep Habits Questionnaire [CSHQ] score ≥41) on stable methylphenidate or atomoxetine were enrolled; 32 completed follow-up. Pre- and post-improvements in parent-reported sleep scores and Stroop performance were observed over 6 weeks of melatonin use; given the single-arm design, causal attribution is not possible. Randomized controlled trials with objective sleep measures and parallel cognitive assessment forms are warranted."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Pediatrics • Psychiatry • Sleep Disorder

Real-World Medication Regimen Change in Adults with ADHD: A Large Claims Database Study. (PubMed, Biol Pharm Bull) - "Using a Japanese claims database, we assembled a cohort of adults who initiated ADHD medication with methylphenidate, atomoxetine, guanfacine, or polytherapy (combination therapy) at initiation. Landmark analysis yielded consistent differences between regimens. Initial ADHD pharmacotherapy showed heterogeneity in Japanese adults and included initial polytherapy, with initial regimen instability differing substantially depending on the starting regimen."

Journal • Real-world evidence • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Dissociation and Hallucinations Induced by Fluoxetine and Atomoxetine Combination in a Child. (PubMed, Am J Ther) - No abstract available

Journal

STEAM: Study of the Effects of Atomoxetine on Motivation (clinicaltrials.gov) - P4 | N=40 | Not yet recruiting | Sponsor: University of Oxford

New P4 trial

Asymmetric Kinetic Resolution of 2-Aryl Oxetanes by Dinuclear Titanium Radical Catalysis. (PubMed, Angew Chem Int Ed Engl) - "The resulting oxetanes serve as versatile chiral platforms and enable concise, modular, and enantio-retentive access to pharmaceutically relevant targets, including (S)-Atomoxetine, (S)-Nisoxetine, and (S)-Fluoxetine. Mechanistic studies support a Curtin-Hammett-type stereochemical model in which diastereomeric Ti-oxetane intermediates, differentiated by an unusual ligand-substrate C-H···π interaction, display distinct stability/reactivity relationships during C─O bond homolysis. Beyond establishing a broadly useful kinetic resolution of 2-aryl oxetanes, this work reveals an unusual mode of attractive ligand-substrate recognition in salen-titanium radical catalysis."

Journal

Atomoxetine in a Patient With Gilbert's Syndrome: Hepatic Monitoring and Pharmacogenomic Considerations. (PubMed, J Clin Psychopharmacol) - No abstract available

Biomarker • Journal • Hepatology

The effect of atomoxetine and methylphenidate on emotional dysregulation in children with attention deficit/hyperactivity disorder: a multicenter randomized clinical trial. (PubMed, J Child Psychol Psychiatry) - P4 | "ATX and MPH both alleviate ED in children with ADHD, and these effects are not solely accounted for by improvements in ADHD symptoms. Increased amygdala-centered FC may be associated with medication-related ED improvements."

Clinical • Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

MCOS: Atomoxetine in Melanocortin Obesity Syndrome (clinicaltrials.gov) - P2 | N=20 | Recruiting | Sponsor: Icahn School of Medicine at Mount Sinai | Not yet recruiting ➔ Recruiting | Trial primary completion date: Jul 2028 ➔ Mar 2028

Enrollment open • Trial primary completion date • Genetic Disorders • Obesity • MC4R

Detrimental effects of atomoxetine on visual signal detection in rats: comparison with ADHD psychomotor stimulant drugs. (PubMed, Psychopharmacology (Berl)) - "As well as demonstrating baseline-dependent effects of amphetamine on visual attention, the findings for methylphenidate and atomoxetine suggest important, apparently opposing effects on visual signal detection performance produced via blockade of the DA and NA transporters. The deleterious effects of atomoxetine on performance were especially noteworthy in view of its use as a treatment in ADHD."

Journal • Preclinical • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

A pharmacometric framework for norepinephrine transporter occupancy and dose equivalence across psychotropic medications. (PubMed, J Psychopharmacol) - "These findings suggest that variability in NET engagement across psychotropic medications may not be fully captured by conventional class-based classifications. The proposed framework offers a mechanism-informed approach to comparative pharmacological analysis and introduces a conceptual noradrenergic activity index. This approach may be useful for hypothesis generation in future studies integrating pharmacokinetic-pharmacodynamic modeling with in vivo imaging and clinical outcomes."

Journal

A Retrospective Study Examining Predictors of Treatment Response in Over 1,300 Children and Adolescents with Attention-deficit Hyperactivity Disorder. (PubMed, Clin Psychopharmacol Neurosci) - "Using the combination therapy of methylphenidate (MPH) and atomoxetine (ATX) as the reference category, ATX monotherapy showed a significantly lower likelihood of responding to treatment. Higher ATX dosage was significantly associated with treatment response in this group. Knowing the factors affecting treatment response can be used to predict prognosis."

Journal • Retrospective data • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • Autism Spectrum Disorder • Behavior Disorders • CNS Disorders • Developmental Disorders • Genetic Disorders • Mental Retardation • Psychiatry • Urinary Incontinence

Hepatic Safety Profile of Atomoxetine and Methylphenidate in Patients with ADHD: Disproportionality Analysis Using EudraVigilance Database Data. (PubMed, Pharmaceuticals (Basel)) - "Specifically, ATX was associated with significantly higher reporting frequencies than MPH for the AEs of DILI, hepatitis, and jaundice (6.42 [4.45-9.06]; 6.48 [2.95-14.24]; and 2.19 [1.12-4.27], respectively). This analysis, based on the EudraVigilance database, suggests that both drugs are associated with hepatobiliary adverse drug reactions, with a higher overall reporting frequency observed for ATX."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Hepatology • Inflammation • Liver Failure • Psychiatry

Comparative Risks of Pregnancy Complications in Women Prescribed Psychostimulants or Atomoxetine During Pregnancy Following Pre-Pregnancy Stimulant Use. (PubMed, Psychiatr Res Clin Pract) - "This study highlighted differential risk profiles between stimulant and non-stimulant therapies, contributing evidence that informs future research on perinatal safety. The distinct risk profiles identified for stimulant and atomoxetine therapies underscore the need for personalized treatment decisions during pregnancy."

Journal • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Psychiatry

Utility of ADHD Medications in Children and Adolescents with Trauma-Related Presentations: A Systematic Scoping Review. (PubMed, J Child Adolesc Psychopharmacol) - "Stimulants have been shown to benefit wider long-term psychiatric outcomes, although smaller studies demonstrated a more consistent improvement in specific trauma-related symptoms with alpha-2 agonists. Rather than following a rigid medication sequence, clinicians should adopt a trauma-informed approach that prioritizes or combines treatments based on whether ADHD or trauma is the primary driver of functional impairment. However, because the current evidence is predominantly low quality and lacks controlled trials, these findings must be interpreted with caution."

Journal • Review • ADHD (Impulsive Aggression) • Attention Deficit Hyperactivity Disorder • CNS Disorders • Mood Disorders • Pediatrics • Post-traumatic Stress Disorder • Psychiatry