Depression atomoxetine

Although purely speculative, atomoxetine may have uses in the treatment of depression and/or anxiety, either alone or in combination with other medications. 

SSRIs, SNRIs, or mirtazapine for treatment-resistant depression (use combinations ot antidepressants with atomoxetine with caution as this may theoretically activate bipolar disorder and suicidal ideation)... 

Mirtazapine, modafinil, atomoxetine (add A/ith caution and at lower doses since bupropion could theoretically raise atomoxetine levels) both for residual symptoms of depression and attention deficit disorder... 

R-(-)-atomoxetine, a 2-methylphenoxyphenylpropylamine, was marketed in 2003 as a nonstimulant treatment for attention-deficit hyperactivity disorder (ADHD) in both adults and children and for treatment of adult depression. The 2-methyl substitution (c.f., nisoxetine) (Fig. 21.8) confers selectivity for inhibiting NE reuptake (Table 21.6) (21,22,45). The R-enantiomer is 10 times more potent than the S-enantiomer as a NET reuptake inhibitor. Atomoxetine has a low propensity for anticholinergic and adverse cardiovascular effects. 

Atomoxetine is used as a safe and well-tolerated nonstimulant treatment of ADHD in both adults and children and of depression. Among children and adolescents aged 8 to 18 years, atomoxetine was superior to placebo in reducing symptoms of ADHD and in improving social and family functioning symptoms. Oral atomoxetine is promoted as an alternative to conventional ADHD therapy with methylphenidate, dextroamphetamine, and pemoline. It also can be a replacement for bupropion or for TCAs. Onset of action is approximately 7 days. 

Kratochviol CJ, Newcom JH, Arnold LE, Duesenberg D, EmsUe GJ, Quintana H, Sarkis EH, Wagner KD, Gao H, Michelson D, Biederman J. Atomoxetine alone or combined with fluoxetine for treating ADHD with comorbid depressive or anxiety s3miptoms. J Am Acad Child Ad-olesc Psychiatry (2005) 44, 915-24. 

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