title: Safety of non-therapeutic atomoxetine exposures--a national poison data system study.
abstract: OBJECTIVE
  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.
authors.affiliation: University of Colorado Denver School of Medicine, Aurora, Colorado, USA; Rocky Mountain Poison and Drug Center, Denver, Colorado, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Monte
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
authors.forename: Michael
authors.initials: M
authors.lastname: Bodmer
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000069445:Atomoxetine Hydrochloride; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers / Q000639:trends*; D011437:Propylamines / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced / Q000453:epidemiology; D013406:Suicide, Attempted / Q000639:trends*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride
keywords: Strattera; atomoxetine; drug safety; poisoning; seizure; suicidal intent