Taking Atomoxetine With Ketamine: What to Know
Strattera (Atomoxetine) — Norepinephrine reuptake inhibitor (non-stimulant ADHD)
Verdict at Tovani Health
Compatible; cardiovascular and modest serotonergic monitoring.
Atomoxetine and ketamine are compatible. Atomoxetine raises BP and HR similarly to stimulants, so the additive cardiovascular consideration applies. There is a theoretical serotonergic component because atomoxetine has minor serotonin reuptake activity at high doses, but clinical relevance is small.
If you take Strattera regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or modest dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Strattera interacts with ketamine
Atomoxetine selectively inhibits norepinephrine reuptake. Cardiovascular activation stacks with ketamine's. It is metabolized by CYP2D6, so poor metabolizers reach much higher exposures.
What we do at intake
Tell us your dose and whether you have ever had genetic CYP2D6 testing. Baseline EKG if any cardiac history.
Bottom line
Atomoxetine and ketamine are compatible. Atomoxetine raises BP and HR similarly to stimulants, so the additive cardiovascular consideration applies. There is a theoretical serotonergic component because atomoxetine has minor serotonin reuptake activity at high doses, but clinical relevance is small.
Frequently Asked Questions
Does atomoxetine have drug interactions with ketamine?
Atomoxetine and ketamine are compatible with monitoring. The main consideration is additive cardiovascular activation, since atomoxetine raises blood pressure and heart rate similarly to stimulants.
Can I take Strattera with ketamine therapy?
Yes, with monitoring. Strattera is compatible with KAP but we monitor blood pressure and heart rate, and we ask about your dose and any prior CYP2D6 genetic testing.
Does Strattera blunt ketamine's effect like stimulants do?
No. Neither stimulants nor atomoxetine reliably blunt ketamine's antidepressant response. The interaction we monitor is cardiovascular, not psychiatric.
Is atomoxetine safer than Adderall for ketamine therapy?
Both are compatible with monitoring. Atomoxetine has a similar cardiovascular profile to stimulants, but it is not a controlled substance and does not have the same abuse-liability considerations.
What should my KAP team know about my Strattera use?
Tell us your dose, how long you have been on it, and whether you have ever had CYP2D6 genetic testing. Baseline EKG is appropriate if you have any cardiac history.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Strattera (Atomoxetine) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Blood pressure safety of subanesthetic ketamine for depression: A report on 684 infusions. Riva-Posse P, Reiff CM, Edwards JA, et al.. Journal of Affective Disorders. 2018. PMID: 29525051
684-infusion case series documenting transient blood pressure elevation as the most common cardiovascular effect of subanesthetic ketamine; no serious adverse cardiovascular events.
- Pharmacodynamic Interactions Between Ketamine and Psychiatric Medications Used in the Treatment of Depression: A Systematic Review. Veraart JKE, Smith-Apeldoorn SY, Bakker IM, et al.. International Journal of Neuropsychopharmacology. 2021. PMID: 34170315
Systematic review of pharmacodynamic interactions between ketamine and psychiatric medications used in depression treatment.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 15, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.