Safety of non-therapeutic atomoxetine exposures--a national poison data system study

Hum Psychopharmacol. 2013 Sep;28(5):471-6. doi: 10.1002/hup.2334. Epub 2013 Jul 17.

Abstract

Aims: This study's objective is to assess the safety of non-therapeutic atomoxetine exposures reported to the US National Poison Database System (NPDS).

Methods: This is a retrospective database study of non-therapeutic single agent ingestions of atomoxetine in children and adults reported to the NPDS between 2002 and 2010.

Results: A total of 20 032 atomoxetine exposures were reported during the study period, and 12 370 of these were single agent exposures. The median age was 9 years (interquartile range 3, 14), and 7380 were male (59.7%). Of the single agent exposures, 8813 (71.2%) were acute exposures, 3315 (26.8%) were acute-on-chronic, and 166 (1.3%) were chronic. In 10 608 (85.8%) cases, exposure was unintentional, in 1079 (8.7%) suicide attempts, and in 629 (5.1%) cases abuse. Of these cases, 3633 (29.4 %) were managed at health-care facilities. Acute-on-chronic exposure was associated with an increased risk of a suicidal reason for exposure compared with acute ingestions (odds ratio 1.44, 95% confidence interval 1.26-1.65). Most common clinical effects were drowsiness or lethargy (709 cases; 5.7%), tachycardia (555; 4.5%), and nausea (388; 3.1%). Major toxicity was observed in 21 cases (seizures in nine (42.9%), tachycardia in eight (38.1%), coma in six (28.6%), and ventricular dysrhythmia in one case (4.8%)).

Conclusions: Non-therapeutic atomoxetine exposures were largely safe, but seizures were rarely observed.

Keywords: Strattera; atomoxetine; drug safety; poisoning; seizure; suicidal intent.

MeSH terms

  • Adolescent
  • Adrenergic Uptake Inhibitors / administration & dosage
  • Adrenergic Uptake Inhibitors / adverse effects*
  • Adult
  • Aged
  • Atomoxetine Hydrochloride
  • Child
  • Child, Preschool
  • Databases, Factual / trends*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Poison Control Centers / trends*
  • Propylamines / administration & dosage
  • Propylamines / adverse effects*
  • Retrospective Studies
  • Seizures / chemically induced
  • Seizures / epidemiology
  • Suicide, Attempted / trends*
  • United States / epidemiology
  • Young Adult

Substances

  • Adrenergic Uptake Inhibitors
  • Propylamines
  • Atomoxetine Hydrochloride