title: Atomoxetine in the treatment of attention deficit hyperactivity disorder and suicidal ideation.
abstract: OBJECTIVE
  Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric childhood disorder. The most commonly used drugs in the treatment of ADHD are methylphenidate (MPH) and atomoxetine (ATX); the former of the two is prescribed in USA more than it is in Western Europe. Some of the most important safety concerns about ADHD drug treatment are sudden cardiac death and suicidal behavior. In this study, we present a series of cases of Italian children who had presented suicidal ideation during ADHD pharmacological therapy with ATX.
  
  
  METHODS
  Data were obtained from the ADHD Italian Register. The data assessed the use of MPH and ATX, which had been prescribed to patients who were aged < 18 years and diagnosed with ADHD. All patients enrolled in the ADHD Italian Register treated with ATX or MPH who experienced suicidal thoughts or thoughts of self-harming were considered and assessed.
  
  
  RESULTS
  We describe the clinical cases of seven Italian children (enrolled in the ADHD Italian Register) treated with ATX and affected by suicidal ideation, self-harming or other similar symptoms. Our results highlighted that all seven patients developed suicidal ideation or intentional self-harming during pharmaceutical treatment with ATX and, particularly, after the dose increase of the drug.
  
  
  CONCLUSIONS
  There is a need to improve our knowledge about the efficacy and safety of ATX, MPH and other drugs used in the treatment of ADHD both in children and adults during the post-marketing experience.
authors.affiliation: Second University of Naples, Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Department of Experimental Medicine, Section of Pharmacology L. Donatelli, Faculty of Medicine and Surgery , Via De Crecchio, 7, 80138 Naples , Italy +39 0815667669 ; +39 0815667652 ; annalisa.capuano@unina2.it.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
authors.forename: Cristina
authors.initials: C
authors.lastname: Scavone
authors.forename: Concetta
authors.initials: C
authors.lastname: Rafaniello
authors.forename: Romano
authors.initials: R
authors.lastname: Arcieri
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.forename: Pietro
authors.initials: P
authors.lastname: Panei
mesh_terms: D000293:Adolescent; D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069445:Atomoxetine Hydrochloride; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011437:Propylamines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012042:Registries; D016728:Self-Injurious Behavior / Q000453:epidemiology; D059020:Suicidal Ideation
chemical_list: D018759:Adrenergic Uptake Inhibitors; D011437:Propylamines; D000069445:Atomoxetine Hydrochloride
keywords: adverse drug reaction; atomoxetine; attention deficit hyperactivity disorder; suicidal ideation