Atomoxetine Drug Properties for Repurposing as a Candidate Alzheimer’s Disease Therapeutic Agent
Authors:
Open Access
- 3 October 2025
- journal article
- review article
- Published by American Chemical Society (ACS) in ACS Pharmacology & Translational Science
- Vol. 8 (11) , 3757-3772
Abstract
Ongoing Alzheimer's disease (AD) drug development research addresses the need for therapeutic agents that can ameliorate cognitive symptoms and attenuate the course of AD synaptic deficits and neurodegeneration. There is growing interest in evaluating FDA-approved drugs for repurposing as candidate AD therapeutics. Such drugs have the advantage that data are available about their pharmaceutical properties, including doses, pharmacokinetics, pharmacodynamics, biomarkers, metabolism, and safety, to inform the design of clinical drug trials. Importantly, the suitability of such drugs with properties needed for AD requires evaluation. In the early stage of AD, degeneration of the locus coeruleus (LC) brain region results in the reduction of noradrenergic neurons and the loss of the neurotransmitter norepinephrine (NE) that regulates cognition and degeneration. Elevation of extracellular NE through inhibition of the NE transporter (NET) is hypothesized to ameliorate AD deficits. Notably, the NET reuptake inhibitor atomoxetine, an FDA-approved drug for the treatment of attention deficit hyperactivity disorder (ADHD), provides an attractive candidate as an AD therapeutic agent because it may attenuate cognitive decline in AD patients, positively impact AD biomarkers, and reduce neuropathology. The goal of this review is to assess atomoxetine for repurposing in AD based on its ability to improve cognition, regulate NE, impact AD biomarkers, and preserve LC neuronal function, with suitable pharmacokinetics, drug metabolism, and safety based on analysis of clinical and preclinical studies. Evidence for neuroprotective effects of atomoxetine in the early stage of AD at clinically safe doses with suitable pharmaceutical properties supports its candidacy as a repurposed drug for AD therapeutics.Keywords
Funding Information
- Epstein Family Foundation
This publication has 93 references indexed in Scilit:
- Alzheimer's disease drug development pipeline: 2025Alzheimer's & Dementia: Translational Research & Clinical Interventions, 2025
- Lower Locus Coeruleus Integrity Signals Elevated Entorhinal Tau and Clinical Progression in Asymptomatic Older IndividualsAnnals of Neurology, 2024
- The Role of Reactive Oxygen Species in Alzheimer's Disease: From Mechanism to Biomaterials TherapyAdvanced Healthcare Materials, 2024
- Donanemab in Early Symptomatic Alzheimer DiseaseJAMA, 2023
- Population pharmacokinetic‐pharmacodynamic analyses of amyloid positron emission tomography and plasma biomarkers for lecanemab in subjects with early Alzheimer's diseaseCPT: Pharmacometrics & Systems Pharmacology, 2022
- Locus coeruleus in the pathogenesis of Alzheimer's disease: A systematic reviewAlzheimer's & Dementia: Translational Research & Clinical Interventions, 2022
- Overview of Monoamine TransportersCurrent Protocols in Pharmacology, 2017
- A Randomized Clinical Trial of Atomoxetine for Mild Cognitive Impairment in Parkinson's DiseaseMovement Disorders Clinical Practice, 2016
- Atomoxetine for the treatment of executive dysfunction in Parkinson's disease: A pilot open‐label studyMovement Disorders, 2008
- Cholinesterase inhibitors for Alzheimer's diseaseCochrane Database of Systematic Reviews, 2006