Ask about atomoxetine as an adult
A nonstimulant with solid evidence behind it, for when stimulants don't suit you or haven't helped enough.
High certaintyADHD evidence
Start with the time you have
1 minute
Type the one question about nonstimulant treatment you most want answered.
5 minutes
List what you want from an alternative and what made previous treatment hard.
15 minutes
Write your questions about timing, side effects and the review appointment.
A plan
Explore a nonstimulant option
- Review previous treatment and current needs.
- Ask about suitability and realistic expectations.
- Agree a clinician-led monitoring and review plan.
How sure the science is
High certainty, ADHD evidence
Enough good trials that more research is unlikely to change this number much. Measured in people with ADHD.
- 7 trials
- 1734 people
- adults
- self rated
- about 12 weeks
- measured on core ADHD symptoms
EBI re-estimation: 7 trials, 1734 adults; high certainty applies specifically to short term self-ratings; NICE NG87 1.7.15. See this row on the evidence map
The number, drawn
Why it matters
Atomoxetine is a nonstimulant medicine that affects noradrenaline signalling. EBI found a 0.368 SMD improvement in adults' self-rated symptoms versus placebo, with high certainty, but clinician-rated evidence was very low certainty. These findings concern about 12 weeks or trial endpoint, and do not establish long term benefit. NICE recommends it for adults who cannot tolerate, or have not been helped by, lisdexamfetamine and methylphenidate; more participants withdrew because of adverse effects than with placebo.
How to do it
- Ask whether a nonstimulant makes sense given your previous treatment and medical history.
- Bring a short account of what stimulants did for you, the side effects, or why they may not suit you.
- Ask how long the clinician expects it to take before you can judge whether it helps.
- Talk through possible unwanted effects and set up a review plan.
A clinician should decide whether it suits you, check interactions and plan monitoring. This adult estimate cannot be assumed to apply to children or to every outcome.
Putting it into practice
In real life
- Ask: 'What would count as enough benefit, and when would we review it?'
- Bring up your concerns about previous medicines, including effects that felt awkward to mention.
Watch out for
- Common mistakeNonstimulant does not mean free of side effects. Ask how you'll be monitored.
- Common mistakeSelf-ratings and clinician ratings got different certainty ratings. Talk about the benefits that matter in your own life.
Trusted guides
How we rated it
- Evidence grade
- A Moderate or high certainty evidence in people with ADHD, or an explicit ADHD guideline recommendation.
- The number
- Adults: small improvement in self-rated symptoms vs placebo over about 12 weeks (SMD 0.368) (BMJ / Gosling et al., 2025)
- Benefit
- 80/100 The benefit score is an editorial prioritization for the general list, weighted by certainty. It is not a prediction of what will happen for you.
- Effort
- Some effort
Sources
- Tier 1 guidelineEBI-ADHD: companion data to Gosling et al., BMJ 2025, commit 86eff22a9ffbBMJ / Gosling et al., 2025
- Tier 1 guidelineBenefits and harms of ADHD interventions: umbrella review and platform for shared decision makingBMJ, 2025
- Tier 1 guidelineAttention deficit hyperactivity disorder: diagnosis and management (NG87), recommendationsNICE, 2019
General information about ADHD, not a diagnosis or an individual treatment plan. Tailoring changes the order of suggestions; it does not assess you. Medication decisions belong with you and a qualified clinician.