Selective Noradrenaline Reuptake Inhibitor (sNRI): Atomoxetine

This chapter provides a clear and practical overview of selective noradrenaline reuptake inhibitors (sNRI) with a focus on atomoxetine, the primary non-stimulant medication approved for ADHD management in this group. The chapter explains the neurochemical basis for using noradrenaline-enhancing treatments in ADHD, outlines how atomoxetine differs from stimulants and traditional SNRIs (Serotonin and Noradrenaline reuptake inhibitors), and describes its slow-onset, cumulative therapeutic profile. Clinical guidance is provided on dosing, common early side effects, withdrawal considerations, and the importance of educating families about expectations and safety monitoring—particularly regarding mood changes, anxiety, and the FDA black box warning. The chapter also highlights appropriate patient selection (especially inattentive ADHD presentations with co-occurring anxiety), and underscores the importance of avoiding unsafe medication combinations. Overall, this chapter offers a thoughtful, experience-based perspective on how atomoxetine can be a valuable option when stimulants are poorly tolerated or contraindicated.