title: Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder.
abstract: OBJECTIVE
  Pharmacological treatment of attention deficit hyperactivity disorder (ADHD) includes stimulant and non-stimulant medications. Our purpose in this study is to investigate efficacy, safety and tolerability of combined methylphenidate and atomoxetine pharmacotherapy.
  
  
  METHODS
  We included 12 patients of the 824 patients with ADHD using methylphenidate and atomoxetine combined therapy between the years 2010 and 2014. Kiddie-SADS, Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, Child Behavior Checklist, Clinic Global Impression Scale Severity and Impression (CGIS-S-I) scales were used.
  
  
  RESULTS
  Patients were between the ages of 7 and 17 years. Before combined pharmacotherapy the CGIS-S score mean was 5.08. Mean CGIS-S score after the combined pharmacotherapy was 3.08 (P = 0.03; -2,980). The most common side effects were irritability (n = 5, 41.6%), appetite reduction (n = 3, 25%), palpitations (n = 2, 16.7%), headache (n = 1, 8.3%).
  
  
  CONCLUSIONS
  Nine of these 12 patients showed significant improvement in their symptoms, combined therapy enhanced the effectiveness of monotherapy.
authors.affiliation: a Ege University Medical School, Child and Adolescent Psychiatry Department , Bornova, İzmir , Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Ozbaran
authors.affiliation: a Ege University Medical School, Child and Adolescent Psychiatry Department , Bornova, İzmir , Turkey.
authors.forename: Sezen
authors.initials: S
authors.lastname: Kose
authors.affiliation: a Ege University Medical School, Child and Adolescent Psychiatry Department , Bornova, İzmir , Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Yuzuguldu
authors.affiliation: a Ege University Medical School, Child and Adolescent Psychiatry Department , Bornova, İzmir , Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Atar
authors.affiliation: a Ege University Medical School, Child and Adolescent Psychiatry Department , Bornova, İzmir , Turkey.
authors.forename: Cahide
authors.initials: C
authors.lastname: Aydin
mesh_terms: D000293:Adolescent; D000069445:Atomoxetine Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride
keywords: atomoxetine; attention deficit hyperactivity disorder; combined therapy; methylphenidate; pharmacotherapy