Atomoxetine (Strattera) and Ketamine Therapy | Tovani Health
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 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 Strattera have the same blunting effect as stimulants?
Neither stimulants nor atomoxetine reliably blunt ketamine's antidepressant response. The interaction we monitor is cardiovascular.
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.