Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder.
OBJECTIVE
To examine (1) moderating effects of oppositional defiant disorder (ODD) on attention-deficit/hyperactivity disorder (ADHD) treatment response and (2) responses of ODD symptoms to atomoxetine.


METHODS
Children and adolescents (ages 8-18) with ADHD were treated for approximately 8 weeks with placebo or atomoxetine (fixed dosing: 0.5, 1.2, or 1.8 mg/kg/day, b.i.d.) under randomized, double-blind conditions. Among patients with lifetime diagnostic information (n = 293), 39% were diagnosed with comorbid ODD and 61% were not. Treatment-group differences and differences between patients with and without comorbid ODD were examined post hoc for changes on the Attention-Deficit/Hyperactivity Disorder Rating Scale IV-Parent version, investigator-administered and -scored; Conners' Parent Rating Scale-Revised Short Form; Clinical Global Impressions Severity of ADHD Scale; and the parent-rated Child Health Questionnaire.


RESULTS
Youths with ADHD and comorbid ODD showed statistically significant improvement in ADHD, ODD, and quality-of-life measures. Treatment response was similar in youths with and without ODD, except that the comorbid group showed improvement compared with placebo at 1.8 mg/kg/day but not 1.2 mg/kg/day. In contrast, youths without ODD showed improvement at 1.2 mg/kg/day and no incremental benefit at 1.8 mg/kg/day.


CONCLUSIONS
Atomoxetine treatment improves ADHD and ODD symptoms in youths with ADHD and ODD, although the comorbid group may require higher doses.
Newcorn
Jeffrey H
JH
Department of Psychiatry, Mount Sinai School of Medicine, New York 10029, USA. jeffrey.newcorn@mssm.edu
Spencer
Thomas J
TJ
Biederman
Joseph
J
Milton
Denái R
DR
Michelson
David
D
D000293:Adolescent; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications* / Q000175:diagnosis; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D009638:Norepinephrine / Q000037:antagonists & inhibitors*; D011437:Propylamines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*
D011437:Propylamines; D000069445:Atomoxetine Hydrochloride; D009638:Norepinephrine