Understanding Evening Irritability with Atomoxetine

Rationale: This is the primary strategy for managing wear-off effects. By dividing the total daily dose into two smaller doses (e.g., one in the morning, one in the late afternoon), you prevent the significant evening drop in medication levels. This maintains a more stable level of pharmacological support throughout the day and evening, directly addressing the root cause of the irritability.

Rationale: Starting with a low dose and increasing it gradually over weeks allows the nervous system to adapt to the medication. This can significantly reduce the incidence and severity of all initial side effects, including irritability. It's also important to remember that atomoxetine's full therapeutic benefits can take 4-8 weeks to emerge.

Rationale: Open communication is key. Patients and caregivers should be educated about the potential for mood changes and instructed to report any new or worsening irritability, hostility, or agitation. Keeping a simple "mood journal" noting the time of day symptoms occur can provide valuable data to help clinicians fine-tune the treatment plan.