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These aren't drugs that I'd choose to take when a proven therapy like the use of a CPAP exist, the list of potential serious adverse reactions isn't trivial at

These aren't drugs that I'd choose to take when a proven therapy like the use of a CPAP exist, the list of potential serious adverse reactions isn't trivial at all. Most amusingly insomnia is a known risk of atomoxetine. I understand that this might be a viable option for people who simply cannot tolerate CPAP therapy, have tried alternatives and found them lacking, and aren't surgical candidates... but I certainly hope it never becomes a first line treatment. My concern would also be that insurance companies will see this as a much cheaper option and try to force it on people who would otherwise tolerate CPAP therapy.

derefr 1y ago
> Most amusingly insomnia is a known risk of atomoxetine. Given that atomoxetine is an sNRI, and norepinephrine modulates both alertness and muscle tone, I would bet dollars to doughnuts that what this treatment is doing is mostly helping people who have inadequate muscle tone in their pharynx at night due to inadequate NE levels, restore that muscle tone, and thereby keep their airways unblocked. These people aren't going to get insomnia from having their NE levels increased — because insomnia in sNRI use is a symptom of excess NE, while in these people, NE is just being brought up to a neurotypical level. (In other words, the same logic that explains why [correctly dosed] dopaminergic stimulants don't make people with ADHD manic — but applied to NE dysfunction rather than DA dysfunction.)