For as long as she can remember, 29-year-old Vanessa Jaramillo has struggled to concentrate — a problem that affected her school years and later caused challenges at work.
The dog groomer from Georgia, USA, admits she often couldn’t keep on top of basic chores — dishes piled up in the sink and clothes were strewn across her bedroom floor.
She also battled severe social anxiety, struggled to maintain romantic relationships and at times was too afraid to even leave the house.
At 24, a psychiatrist diagnosed her with attention deficit hyperactivity disorder (ADHD) — a common condition characterised by difficulty concentrating, constant fidgeting and impulsive behaviour.
To Vanessa’s relief, she was told there was a medication that could help — a daily tablet called Strattera, also known as atomoxetine.
For decades, ADHD — which affects around 2.6 million people in the UK — has been treated with stimulant drugs such as amphetamines, first used in the early 20th century to keep Second World War pilots and long-haul truckers awake.
Research has shown, when used as a form of medical treatment, they boost energy levels and improve concentration in ADHD patients.
In the UK, the most commonly prescribed stimulant is Ritalin, also known as methylphenidate.
Vanessa Jaramillo, 29, has struggled to concentrate for as long as she can remember—a problem that affected her school years and later caused challenges at work
Vanessa also battled severe social anxiety, struggled to maintain romantic relationships and at times was too afraid to even leave the house
However, research shows that while often effective, stimulant drugs can cause a range of unpleasant side effects — including mood swings, rapid heartbeat, loss of appetite and, in children and adolescents, even stunted growth.
Experts say that, in an effort to avoid these effects, newly-diagnosed ADHD patients are increasingly being offered a different class of medication: non-stimulant drugs, such as Strattera.
They work by slowly boosting levels of a chemical in the brain called norepinephrine, which is linked to improved concentration. Experts say it was thought that non-stimulants had fewer side effects.
However, a growing number of Strattera patients, including Vanessa Jaramillo, are now reporting worrying complications.
Vanessa began taking Strattera in 2021, but for the first two years the tablets had little impact on her symptoms. Her psychiatrist responded by gradually increasing the dose — from 40 milligrams a day to eventually 80 milligrams.
Soon after starting the higher dose, Vanessa began experiencing severe nausea. It typically set in about two hours after taking the pill and only eased once she vomited. When that didn’t happen naturally, she says she would force herself to be sick.
‘It was the only way to stop the room from spinning,’ she says. When she told her psychiatrist about the vomiting, he reassured her that these issues would eventually fade.
But Vanessa says the symptoms did not improve. For more than 12 months, she continued to take Strattera and would vomit almost every day.
For decades, ADHD—which affects around 2.6 million people in the UK—has been treated with stimulant drugs such as amphetamines, but increasingly patients being offered a different class of medication: non-stimulant drugs, such as Strattera
And while Vanessa’s ADHD symptoms appeared to subside during this period, she says the nausea meant her quality of life was worse than before she began treatment.
‘I remember telling my psychiatrist that the side effects were psychologically breaking me,’ she says. ‘I told him that I couldn’t go on like this. It was so bad that I struggled to go to work.’
In 2022, with the help of her doctor, Vanessa decided to take herself off Strattera. The vomiting immediately ceased.
‘I really thought that the drug was going to help me and put an end to my years of suffering,’ she says. ‘But it was so disappointing that, if anything, my life got worse’.
Experts warn that nausea isn’t the only debilitating side effect of Strattera.
Studies have linked the drug to severe fatigue, mood swings, loss of appetite, stomach pain, hallucinations and priapism – painful erections lasting up to four hours – in men.
In rare cases, it has also been associated with dangerously high blood pressure.
And, disturbingly, children taking non-stimulants are more likely to experience thoughts of suicide than those on stimulants.
Last year, nearly 250,000 people in England were prescribed ADHD medication on the NHS—more than triple the number in 2015, when just 81,000 received the drugs
‘People often think that when they are given Strattera, they will not suffer from the same level of side effects as stimulant ADHD drugs,’ says Professor Katya Rubia, a cognitive neuroscientist at King’s College London. ‘But problems can be worse.’
Last year, nearly 250,000 people in England were prescribed ADHD medication on the NHS — more than triple the number in 2015, when just 81,000 received the drugs.
More than 60,000 of those patients were children. Experts say that, historically, the vast majority have been treated with stimulant medications.
However, in the past five years the number of non-stimulant ADHD drug prescriptions handed out on the NHS has increase by a fifth.
Experts say this is in large part because growing research shows the two classes of drugs are just as effective at combatting ADHD symptoms.
However, they add that patients have increasingly been given non-stimulants because it was wrongly assumed that these medicines have fewer side effects.
Non-stimulant ADHD medicines include Strattera as well as Kapvay and Qelbree. However, most NHS patients who are given non-stimulants now receive a generic version of Strattera — meaning it is cheaper — called atomoxetine.
Unlike stimulants, which are intended to work near-instantly, non-stimulants are designed to boost levels of brain chemical norepinephrine over a number of months.
Experts say it is still unclear why non-stimulants lead to such a wide variety of side effects, but it is thought to be the impact of raising norepinephrine levels.
Experts also warn that certain patients have a genetic mutation that puts them at a greater risk of suffering serious side effects — but will not know this until they begin treatment.
‘Around seven per cent of patients with ADHD will not break down the drug properly and will suffer from side effects ten times worse,’ says Professor Katya Rubia.
‘There are blood and saliva tests that GPs can carry out to see if patients are vulnerable to these particularly severe side effects.’
Vanessa Jaramillo says that, since stopping Strattera, her ADHD symptoms have returned. However, she say she has no plans to go back on the medication — or any other ADHD drug. She believes the side effects are worse than the condition itself.
A spokesperson for Eli Lilly, the manufacturer of Strattera said: ‘We take any reports about patient safety extremely seriously and actively monitor, evaluate, and report safety information for all our medicines.
‘The Strattera (atomoxetine) patient information leaflet warns that an increased heart rate, feeling or being sick and feeling sleepy are very common side effects.
‘Decreased interest in sex is also listed as a common side effect. We encourage patients to consult their doctor or other healthcare professional to discuss any possible side effects they may be experiencing.
‘Strattera currently accounts for less than one per cent of UK ADHD prescriptions as generic versions are now available at lower cost.’
