title: A randomized, double-blind study of continuation treatment for attention-deficit/hyperactivity disorder after 1 year.
abstract: BACKGROUND
  The efficacy of atomoxetine in maintaining symptom response following 1 year of treatment was assessed in children and adolescents (n = 163) with DSM-IV defined attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Subjects had previously responded to atomoxetine acutely and had completed 1 year of double-blind atomoxetine treatment. They were then randomly assigned in double-blind fashion to continued atomoxetine or placebo substitution for 6 months.
  
  
  RESULTS
  Atomoxetine was superior to placebo in preventing relapse (Wilcoxon test, p = .008) and in maintaining symptom response (ADHD Rating Scale IV score, p < .001). Among subjects assigned to discontinuation, the magnitude of symptom return was generally to a level of severity less than that observed at study entry.
  
  
  CONCLUSIONS
  Following 1 year of treatment with atomoxetine, continued treatment over the ensuing 6 months was associated with superior outcomes compared with placebo substitution. However, there was considerable variability between individuals in the magnitude of symptom return after drug discontinuation, suggesting that some subjects treated with atomoxetine for a year with good results may consolidate gains made during drug treatment and could benefit from a medication-free trial to assess the need for ongoing drug treatment.
authors.affiliation: University Medical Center St Radboud, Nijmegen, The Netherlands.
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: David
authors.initials: D
authors.lastname: Michelson
authors.forename: Marina
authors.initials: M
authors.lastname: Danckaerts
authors.forename: Christopher
authors.initials: C
authors.lastname: Gillberg
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
authors.forename: Alessandro
authors.initials: A
authors.lastname: Zuddas
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Faries
authors.forename: Shuyu
authors.initials: S
authors.lastname: Zhang
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011437:Propylamines / Q000627:therapeutic use*; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride