title: Tolerability of atomoxetine for treatment of pediatric attention-deficit/hyperactivity disorder in the context of epilepsy.
abstract: To examine atomoxetine's tolerability in patients with epilepsy, we reviewed medical records of all patients with epilepsy who were treated with atomoxetine in a tertiary care pediatric psychopharmacology practice. Twenty-seven patients (10.1 ± 4.2 years, 63% male) with an average seizure frequency at baseline of 7 ± 24 per month (median: 0, range: 0-90) were found. Symptoms of attention-deficit/hyperactivity disorder in twenty-five patients (92.5%) had previously not responded to stimulants. Atomoxetine, average dose 35.2 ± 24.4 mg, was given for a median of 26 weeks (range: 4-141). Seventeen patients (63%) discontinued atomoxetine due to: inadequate response (n=7, 26%), worsening behavior such as increased irritability/activation (n = 7, 26%), nonadherence (n=1, 4%), emerging psychotic-like symptoms (n=1, 4%), and appetite decrease and tremor (n=1, 4%). There were no discontinuations because of seizure exacerbation. Atomoxetine dose, epilepsy etiology, seizure type, and comorbid psychiatric disorders did not predict discontinuation. No safety problems of sufficient magnitude to preclude prospective studies of atomoxetine in children with epilepsy were found.
authors.affiliation: Department of Neurology, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Alcy
authors.initials: A
authors.lastname: Torres
authors.forename: Jane
authors.initials: J
authors.lastname: Whitney
authors.forename: Sneha
authors.initials: S
authors.lastname: Rao
authors.forename: Claire
authors.initials: C
authors.lastname: Tilley
authors.forename: Rachel
authors.initials: R
authors.lastname: Lobel
authors.forename: Joseph
authors.initials: J
authors.lastname: Gonzalez-Heydrich
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D011437:Propylamines / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride