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Atomoxetine + oxybutynin is an investigational combination therapy being developed for the treatment of obstructive sleep apnea (OSA). The combination consists of atomoxetine (80 mg), a selective norepinephrine reuptake inhibitor (sNRI), and oxybutynin (5 mg), an antimuscarinic agent. This therapy targets the underlying biological mechanisms of OSA by increasing the activity of upper airway dilator muscles during sleep. Specifically, atomoxetine counters the reduction in norepinephrine levels that occurs during non-rapid eye movement (NREM) sleep, while oxybutynin mitigates the increased muscarinic inhibition of pharyngeal muscles during rapid eye movement (REM) sleep. Originally researched by investigators at Brigham and Women's Hospital, the combination has demonstrated significant reductions in the apnea-hypopnea index (AHI) in clinical trials and is being further developed under the code name AD036.
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