title: Atomoxetine increases salivary cortisol in healthy volunteers.
abstract: It has been proposed that acute hypothalamo-pituitary-adrenal (HPA) axis challenge using noradrenergic drugs may be of utility in assessing the functional integrity of central noradrenaline pathways. Atomoxetine (formerly tomoxetine) is a highly selective noradrenaline reuptake inhibitor, which has recently been licensed for the treatment of attention deficit hyperactivity disorder (ADHD). The aim of this study was to assess the effects of acute atomoxetine on salivary cortisol levels for the first time.A total of 60 healthy male volunteers received 60 mg atomoxetine, 30 mg citalopram, or placebo per os in a double-blind parallel groups design (n = 20 per group). Salivary cortisol, blood pressure and pulse rates were recorded at baseline and at +1.0, +1.5, +2.5 and +3.5 hours after capsule administration.60 mg atomoxetine led to highly significant increases in salivary cortisol and a moderate increase in pulse rate, in the absence of significant effects on blood pressure. 30 mg citalopram had no significant effects on cortisol or cardiovascular parameters. These data support the utility of atomoxetine neuroendocrine challenge for evaluating central noradrenaline pathways, which may be of future use in neuropsychiatric patient studies. Furthermore, the effects of atomoxetine on HPA axis function may have clinical implications given the use of this agent in the treatment of ADHD.
authors: Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK. src33@cam.ac.uk
authors: Samuel R
authors: SR
authors: Chamberlain
authors: Ulrich
authors: U
authors: Müller
authors: Sarah
authors: S
authors: Cleary
authors: Trevor W
authors: TW
authors: Robbins
authors: Barbara J
authors: BJ
authors: Sahakian
mesh_terms: D000284:Administration, Oral; D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D000069445:Atomoxetine Hydrochloride; D001794:Blood Pressure / Q000187:drug effects; D002214:Capsules; D015283:Citalopram / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D010912:Pituitary-Adrenal Function Tests / Q000379:methods; D011437:Propylamines / Q000008:administration & dosage / Q000494:pharmacology*; D012016:Reference Values; D012463:Saliva / Q000378:metabolism*; D012469:Salivary Glands / Q000187:drug effects* / Q000378:metabolism; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000069445:Atomoxetine Hydrochloride; D002214:Capsules; D015283:Citalopram; D006854:Hydrocortisone; D011437:Propylamines; D017367:Selective Serotonin Reuptake Inhibitors