Ask about atomoxetine as an adult
High certaintyADHD evidence
A nonstimulant with solid evidence, if stimulants don't suit or help enough.
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.
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 An editorial priority for the general list, weighted by certainty. It does not predict 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.