title: A pilot study for augmenting atomoxetine with methylphenidate: safety of concomitant therapy in children with attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  This study examined augmenting atomoxetine with extended-release methylphenidate in children whose attention-deficit/hyperactivity disorder (ADHD) previously failed to respond adequately to stimulant medication.
  
  
  METHODS
  Children with ADHD and prior stimulant treatment (N = 25) received atomoxetine (1.2 mg/kg/day) plus placebo. After 4 weeks, patients who were responders (n = 4) were continued on atomoxetine/placebo while remaining patients were randomly assigned to either methylphenidate (ATX/MPH) (1.1 mg/kg/day) or placebo augmentation (ATX/PB) for another 6 weeks. Patients and sites were blind to timing of active augmentation. Safety measures included vital signs, weight, and adverse events. Efficacy was assessed by ADHD rating scales.
  
  
  RESULTS
  Categorical increases in vital signs occurred for 5 patients (3 patients in ATX/MPH, 2 patients in ATX/PBO). Sixteen percent discontinued the study due to AE, but no difference between augmentation groups. Atomoxetine treatment was efficacious on outcome measures (P <or= .001), but methylphenidate did not enhance response.
  
  
  CONCLUSIONS
  Methylphenidate appears to be safely combined with atomoxetine, but conclusions limited by small sample. With atomoxetine treatment, 43% of patients achieved normalization on ADHD ratings.
authors: Department of Child and Adolescent Psychiatry, Stony Brook School of Medicine, Stony Brook, New York 11794-8790, USA. gabrielle.carlson@stonybrook.edu
authors: Gabrielle A
authors: GA
authors: Carlson
authors: David
authors: D
authors: Dunn
authors: Douglas
authors: D
authors: Kelsey
authors: Dustin
authors: D
authors: Ruff
authors: Susan
authors: S
authors: Ball
authors: Lisa
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authors: Ahrbecker
authors: Albert J
authors: AJ
authors: Allen