title: Atomoxetine once daily for 24 weeks in adults with attention-deficit/hyperactivity disorder (ADHD): impact of treatment on family functioning.
abstract: OBJECTIVE
  To assess the efficacy of atomoxetine (ATX) and impact of treatment on family functioning in adults with ADHD.
  
  
  METHODS
  Adults with attention-deficit/hyperactivity disorder (ADHD) having both a spouse/partner and child were randomized to placebo (n = 234) or ATX (n = 268) for 24 weeks. Attention-deficit/hyperactivity disorder measures included the Conners Adult ADHD Rating Scale total ADHD Symptoms score and Clinical Global Impression-ADHD-Severity. Marital measures included the Dyadic Adjustment Scale and the Family Assessment Measure Dyadic Relationship Scale (FAM III). Parenting measures included the Parenting Stress Index, Alabama Parenting Questionnaire, and Parenting Sense of Competence Scale (PSCS).
  
  
  RESULTS
  Improvement was greater with ATX over placebo at 24 weeks on the Conners Adult ADHD Rating Scale (-16.43 vs -8.65; P < 0.001, repeated measures) and Clinical Global Impression (P < 0.001, last observation carried forward). Baseline-to-end point changes in marital and parenting measures were significant but not between treatment groups. Post hoc analyses showed significant interaction of treatment and impairment for the FAM III Task Accomplishment (patient) and Role Performance (patient and spouse) items and PSCS efficacy. Further stratification by sex or presence of a child with ADHD yielded significant interaction and treatment differences for the FAM III Task Accomplishment and the FAM III and Dyadic Adjustment Scale affective expression items, PSCS total score, Alabama Parenting Questionnaire Corporal Punishment, and Parenting Stress Index attachment items.
  
  
  CONCLUSIONS
  Atomoxetine demonstrated significant ADHD symptom reduction over 24 weeks. Although both groups demonstrated baseline-to-end point changes on many marital and parenting measure items, there were no treatment differences. Maladaptive behaviors of long-standing ADHD may benefit from both medication and behavioral-psychosocial intervention.
authors.affiliation: Lilly USA, LLC, Lilly Corporate Center, Indianapolis, IN 46285, USA. wietechala@lilly.com
authors.forename: Linda
authors.initials: L
authors.lastname: Wietecha
authors.forename: Joel
authors.initials: J
authors.lastname: Young
authors.forename: Dustin
authors.initials: D
authors.lastname: Ruff
authors.forename: David
authors.initials: D
authors.lastname: Dunn
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
authors.forename: Keith
authors.initials: K
authors.lastname: Saylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology*; D002648:Child; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011437:Propylamines / Q000627:therapeutic use*; D018434:Sickness Impact Profile; D016896:Treatment Outcome
chemical_list: D011437:Propylamines; D000069445:Atomoxetine Hydrochloride