Synonyms: ATX, Strattera
Therapy Type: Small Molecule
Target Type: Other Neurotransmitters
Condition(s): Alzheimer's Disease
U.S. FDA Status: Alzheimer's Disease (Discontinued)
Status in Select Countries: Approved in North America, European Union, and may other countries for treatment of Attention-Deficity Hyperactivity Disorder (ADHD)
Company: Eli Lilly & Co.
Approved for: ADHD in US
Atomoxetine is a norepinephrine uptake inhibitor. It blocks a norepinephrine transporter and boosts noradrenaline levels in the brain. A "stimulant" medication, it is widely used around the world to treat attention-deficit hyperactivity disorder in children. Several lines of research implicate loss of noradrenaline in Alzheimer's disease (see, e.g., conference story), hence atomoxetine's value as an add-on medication was investigated.
Between 2003 and 2006, Eli Lilly conducted a six-month Phase 2/3 trial at eight sites in the United States to evaluate the effectiveness of 25-80 mg/day of atomoxetine in 92 patients with mild to moderate Alzheimer's disease who were on stable doses of standard acetyl cholinesterase inhibitor therapy. Cognition as measured by the ADAS-Cog was the primary outcome of this trial. Atomoxetine in these patients was reported to be generally safe, though with an increase in heart rate; however, it did not benefit cognition in these patients (Mohs et al., 2009).
- Mohs RC, Shiovitz TM, Tariot PN, Porsteinsson AP, Baker KD, Feldman PD. Atomoxetine augmentation of cholinesterase inhibitor therapy in patients with Alzheimer disease: 6-month, randomized, double-blind, placebo-controlled, parallel-trial study. Am J Geriatr Psychiatry. 2009 Sep;17(9):752-9. PubMed.
- Dolder CR, Davis LN, McKinsey J. Use of psychostimulants in patients with dementia. Ann Pharmacother. 2010 Oct;44(10):1624-32. PubMed.
- Aarsland D, Ballard C, Rongve A, Broadstock M, Svenningsson P. Clinical trials of dementia with lewy bodies and Parkinson's disease dementia. Curr Neurol Neurosci Rep. 2012 Oct;12(5):492-501. PubMed.