Case Report

Atomoxetine-Induced Myocardial Infarction

Authors: Ali Seifi, MD, Heidi Griffith, MD, Sahar Avestimehr, MD, Haitham Dib, MD

Abstract

Atomoxetine (Strattera®, Eli Lilly and Co.) is the first non-stimulant drug in the United States (US) to be approved for the treatment of attention deficit hyperactivity disorder (ADHD). In the past, physicians have been concerned about the safety of a variety of ADHD medications. As a result, non-stimulant drugs were developed with claims of fewer side effects and limited abuse potential. The data regarding this new group of drugs and its effect on the cardiovascular system is limited. We report a case of atomoxetine induced myocardial infarction (MI) in a young woman.


Key Points


* Atomoxetine can induce myocardial infarction in patients with attention deficit hyperactivity disorder (ADHD).


* Before prescribing atomoxetine, the patient's cardiovascular system should be monitored and continue to be monitored while taking the medication.


* Careful monitoring of the cardiovascular system can decrease the morbidity and mortality of atomoxetine.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. El Menyar AA. Drug induced myocardial infarction secondary to coronary artery spasm in teenagers and young adults. J Postgrad Med 2006;52:51–56.
 
2. Lynch J, Regan C, Stump G, et al. Hemodynamic and cardiac neurotransmitter-releasing effects in conscious dogs of attention- and wake-promoting agents: a comparison of d-amphetamine, atomoxetine, modafinil, and a novel quinazolinone H3 inverse agonist. J Cardiovasc Pharmacol2009;53:52–59.
 
3. Thompson J, Thompson JR. Acute myocardial infarction related to methylphenidate for adult attention deficit disorder. J Emerg Med 2010;38:18–21.
 
4. Donnelly C, Bangs M, Trzepacz P, et al. Safety and tolerability of atomoxetine over 3 to 4 years in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatry 2009;48:176–185.
 
5. Vitiello B. Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function. Child Adolesc Psychiatr Clin N Am 2008;17:459–474, xi.
 
6. Jiao X, Velez S, Ringstad J, et al. Myocardial infarction associated with adderal XR and alcohol use in a young man. J Am Board Fam Med 2009;22:197–201.