Medicine - Xagena

Health Canada has received 1 report of tics and 1 report of exacerbation of tics suspected of being associated with Strattera ( Atomoxetine ).

In the first case, a 7-year-old girl was prescribed Atomoxetine 25 mg/d for attention deficit hyperactivity disorder ( ADHD ). Subsequently, the dose was increased to 40 mg/d, and 7 to 10 days later the patient experienced new-onset motor tics. After a few days the dose was decreased to 25 mg/d by the parents. The tics persisted but were decreased in severity. The Atomoxetine was continued, Risperidone ( Risperdal ) was added to the regimen, and the tics disappeared.

The second case described exacerbation of tics in an 11-year-old boy who had been prescribed Atomoxetine for ADHD: the dose was 18 mg/d for 1 week initially and then was increased to 25 mg/d for 1 week, 40 mg/d for 3 weeks and then 60 mg/d.
His medical history included bipolar disorder, Gilles de la Tourette's syndrome and insomnia. Concomitant medications included Risperidone and Clonidine ( Catapresan ).
He had previously been taking extended-release Methylphenidate ( Concerta ) 36 mg/d that was reduced to 18 mg/d before being discontinued; the 60-mg dose of Atomoxetine overlapped with the 18-mg dose of extended-release Methylphenidate for 1-2 days. While receiving Atomoxetine 60 mg/d, the patient experienced dramatic worsening of vocal tics, which lasted 10-12 hours per day, and his ADHD was not well controlled.
His physician decreased the dose of Atomoxetine to 40 mg/d. The patient continued to experience tics and had not yet recovered at the time of reporting.

There has been a previous report of tics with the use of Atomoxetine, published in the Journal of Child and Adolescent Psychopharmacology ( 2005 ).

Source: Health Canada, 2006


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