Use of atomoxetine in patients with attention-deficit hyperactivity disorder and co-morbid conditions.
Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioural disorders in children. It has been shown that as many as 85% of patients with ADHD have at least one psychiatric co-morbidity, and approximately 60% have at least two. Atomoxetine is a specific, noradrenergic reuptake inhibitor that provides an effective treatment option for patients with ADHD and co-morbid conditions. The efficacy of atomoxetine in treating ADHD appears to be unaffected by the presence of co-morbid conditions. Therapy with atomoxetine has been associated with statistically significant improvements in symptoms of oppositional defiant disorder in most, but not all, studies. Limited data suggest this agent may have potential in improving co-occurring symptoms of anxiety and may be useful in patients with co-morbid conditions such as tics or Tourette's syndrome. The tolerability profile of atomoxetine in patients with ADHD and co-morbid conditions was similar to that of patients with uncomplicated ADHD. Atomoxetine was well tolerated, with adverse events generally mild and transient; the most frequent adverse events in patients with ADHD included abdominal pain, decreased appetite, nausea and vomiting. The favourable safety and efficacy profile of atomoxetine makes it a promising treatment for patients with ADHD and associated co-morbidities.
Dell'Agnello
Grazia
G
Medical Department, Eli Lilly, 50019 Sesto Fiorentino, Florence, Italy. dell'agnello_grazia@lilly.com
Zuddas
Alessandro
A
Masi
Gabriele
G
Curatolo
Paolo
P
Besana
Dante
D
Rossi
Andrea
A
D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002986:Clinical Trials as Topic; D015897:Comorbidity; D006801:Humans; D011437:Propylamines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride
J Child Psychol Psychiatry. 1999 Jan;40(1):57-87
10102726
Epilepsy Behav. 2003 Feb;4(1):26-35
12609225
J Dev Behav Pediatr. 1992 Oct;13(5):363-5
1401121
J Am Acad Child Adolesc Psychiatry. 2002 Jul;41(7):776-84
12108801
J Clin Psychiatry. 2002 Dec;63(12):1140-7
12523874
Clin Toxicol (Phila). 2007;45(1):51-5
17357382
J Atten Disord. 2004 Oct;8(2):45-52
15801334
Pediatrics. 2004 Jul;114(1):e1-8
15231966
J Am Acad Child Adolesc Psychiatry. 1997 Aug;36(8):1046-55
9256584
JAMA. 1998 Apr 8;279(14):1100-7
9546570
J Atten Disord. 2005 Aug;9(1):275-89
16371674
Bipolar Disord. 2001 Aug;3(4):202-10
11552959
Can J Psychiatry. 2007 May;52(5):323-8
17542383
Am J Ment Defic. 1985 Mar;89(5):485-91
3993694
Arch Gen Psychiatry. 2004 Jul;61(7):731-6
15237085
Expert Opin Pharmacother. 2007 Apr;8(5):555-62
17376012
J Am Acad Child Adolesc Psychiatry. 2005 Jul;44(7):647-55
15968233
J Child Adolesc Psychopharmacol. 2005 Dec;15(6):996-1004
16379520
Am J Psychiatry. 2007 Jun;164(6):942-8
17541055
J Am Acad Child Adolesc Psychiatry. 2006 Aug;45(8):919-927
16865034
J Am Acad Child Adolesc Psychiatry. 2001 Feb;40(2):168-79
11211365
J Child Adolesc Psychopharmacol. 2006 Oct;16(5):599-610
17069548
J Child Adolesc Psychopharmacol. 2005 Apr;15(2):325-30
15910217
Paediatr Drugs. 2008;10(1):39-47
18162007
J Child Adolesc Psychopharmacol. 2006 Jun;16(3):365-70
16768644
J Am Acad Child Adolesc Psychiatry. 2005 Sep;44(9):915-24
16113620
Am J Psychiatry. 2008 Jun;165(6):721-30
18281409
Ann Pharmacother. 2005 Jun;39(6):1045-8
15870137
J Pediatr. 2006 Jul;149(1):112-9
16860138
Dev Med Child Neurol. 2007 Jul;49(7):498-502
17593120
Acta Psychiatr Scand. 1998 Oct;98(4):262-71
9821446
Am J Psychiatry. 2004 Apr;161(4):757
15056530
J Clin Psychiatry. 2002;63 Suppl 12:50-5
12562062
J Am Acad Child Adolesc Psychiatry. 2005 Mar;44(3):240-8
15725968
Drug Saf. 2003;26(10):729-40
12862507
Psychol Med. 2006 Feb;36(2):159-65
16420712
Psychopharmacology (Berl). 2007 Jan;190(1):31-41
17093981
J Abnorm Child Psychol. 2000 Dec;28(6):527-41
11104315
Am J Psychiatry. 1998 May;155(5):693-5
9585725
Am J Psychiatry. 2002 Jul;159(7):1214-24
12091202
Neurology. 2005 Dec 27;65(12):1941-9
16380617
Arch Gen Psychiatry. 1999 Dec;56(12):1073-86
10591283
Dev Med Child Neurol. 2004 Jul;46(7):444-7
15230456
Health Technol Assess. 2006 Jul;10(23):iii-iv, xiii-146
16796929
Child Adolesc Psychiatr Clin N Am. 2000 Jul;9(3):481-98
10944652
J Child Psychol Psychiatry. 2001 May;42(4):487-92
11383964
J Child Adolesc Psychopharmacol. 2001 Fall;11(3):251-65
11642475
J Abnorm Child Psychol. 1996 Oct;24(5):571-95
8956085
J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):510-9
7751265
CNS Spectr. 2008 Sep 01;13(9):E1
18849901
Psychol Med. 2006 Feb;36(2):167-79
16420713
Am J Psychiatry. 1995 Feb;152(2):271-3
7840364
J Child Adolesc Psychopharmacol. 2007 Aug;17(4):407-20
17822337
Dev Med Child Neurol. 2003 Jan;45(1):50-4
12549755
Pediatr Neurol. 2005 Jan;32(1):1-10
15607597
J Clin Psychiatry. 1998;59 Suppl 7:50-8
9680053
Pediatrics. 2005 Jun;115(6):1734-46
15930238
J Am Acad Child Adolesc Psychiatry. 2004 Jul;43(7):896-904
15213591
Am J Psychiatry. 1991 May;148(5):564-77
2018156
Eur Child Adolesc Psychiatry. 2006 Dec;15 Suppl 1:I25-9
17177012
Bipolar Disord. 2006 Aug;8(4):373-81
16879138
J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921
17581453
CNS Drugs. 2008;22(3):213-37
18278977
J Atten Disord. 2008 Jan;11(4):470-81
17934184
Biol Psychiatry. 2003 Jan 15;53(2):112-20
12547466
Am J Manag Care. 2004 Jul;10(4 Suppl):S117-24
15352538
J Affect Disord. 1998 Nov;51(2):137-44
10743846
J Child Adolesc Psychopharmacol. 2006 Oct;16(5):611-9
17069549
Pediatrics. 2008 Feb;121(2):e314-20
18245404
J Am Acad Child Adolesc Psychiatry. 2006 Oct;45(10):1196-1205
17003665
J Am Acad Child Adolesc Psychiatry. 2004 Sep;43(9):1068-9
15322408
J Am Acad Child Adolesc Psychiatry. 2001 Feb;40(2):147-58
11211363
Sleep. 2006 Dec;29(12):1573-85
17252888
J Pediatr. 2006 Jun;148(6):831-4
16769398
Prim Care. 1999 Jun;26(2):349-72
10318752
Am J Psychiatry. 2002 Nov;159(11):1896-901
12411225
J Am Acad Child Adolesc Psychiatry. 2008 Feb;47(2):209-218
18176331
Arch Dis Child. 2005 Feb;90 Suppl 1:i26-9
15665154
J Am Acad Child Adolesc Psychiatry. 1989 Jul;28(4):566-73
2768151
J Am Acad Child Adolesc Psychiatry. 2007 Sep;46(9):1119-1127
17712235
Adv Ther. 2005 Sep-Oct;22(5):498-512
16418159
J Am Acad Child Adolesc Psychiatry. 1997 Dec;36(12):1715-25
9401333
Drug Saf. 2008;31(4):345-54
18366245
J Child Adolesc Psychopharmacol. 2002 Spring;12(1):11-25
12014591
J Affect Disord. 1998 Nov;51(2):153-64
10743848
Eur Child Adolesc Psychiatry. 2006 Mar;15(2):105-10
16523251
Pediatrics. 2001 Nov;108(5):E83
11694667
Int J Psychiatry Med. 2007;37(4):415-24
18441629