Isolated atomoxetine (Strattera) ingestions commonly result in toxicity

Atomoxetine is a recently approved medication for attention deficit disorder. It is a selective norepinephrine reuptake inhibitor with an onset of action within 2 h, and a duration of effect up to 40 h in therapeutic doses. Experience in the overdose setting is limited. After brief training in systematic chart review, reviewers blinded to the purpose of the study completed a standardized data collection sheet. Two years after atomoxetine was released, poison center patient encounters were reviewed. Age, outcomes, and signs and symptoms were recorded. All patients were followed until the cessation of symptoms or 24 h. Seventeen cases of isolated atomoxetine were reviewed. The age range of these 6 patients was 9 months to 28 years old with a mean of 15.6 years. The range of amount ingested was 10-1200 mg. The onset of symptoms was delayed as long as 3 h in 3 patients. All neurological symptoms were preceded by tachycardia. Ten of 17 patients had tachycardia, 6/17 had emesis, and 3/17 had agitation that required benzodiazepines to control. All symptoms resolved within 30 h. Supratherapeutic ingestions of atomoxetine can result in transient tachycardia, vomiting, and cognitive disturbances.