Atomoxetine in the pharmacotherapy of hyperkinetic syndrome

Atomoxetine is a relatively new medication used in the treatment of attention deficit hyperactivity disorder (hyperkinetic disorder in the ICD-10 classification) in children, adolescents and adults. The drug is a selective noradrenaline reuptake inhibitor. Since atomoxetine does not belong to psychostimulants, it is particularly useful in clinical situations associated with the risk of dependence as well as in patients experiencing severe psychostimulant-induced adverse reactions, such as emotional lability or tics, and those refusing psychostimulant therapy. Importantly, it is effective in patients with attention deficit hyperactivity disorder and coexisting conditions, such as active psychoactive substance dependence, anxiety disorders and tics. The drug has a recognised position in the international standards for the treatment of hyperkinetic syndrome, with multiple studies supporting its efficacy. The paper presents a characteristics of the drug, indications and contraindications for its use, the most common adverse reactions and precautions as well as a literature review on its efficacy in the treatment of attention deficit hyperactivity disorder, including comparison with other drugs most commonly used in this indication. Benefits and risks associated with the use of atomoxetine as well as its place in the treatment standards for attention deficit hyperactivity disorder, advantage over other methods of treatment, and restrictions on its use were also discussed. The paper further discusses practical considerations associated with inclusion and dosing of the drug as well as with specific clinical situations.