Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder.
BACKGROUND
Attention-deficit/hyperactivity disorder (ADHD) is a CNS disorder that has its onset in childhood, but often persists into adulthood. There is growing recognition that adult ADHD can result in multiple negative consequences for individuals. ADHD is also often associated with a number of comorbid psychiatric disorders. Atomoxetine (ATX), a nonstimulant, selective noradrenergic reuptake inhibitor, was approved in the United States in 2002 for the treatment of ADHD in children and adolescents, as well as adults. We review here the safety and efficacy of ATX in adults with ADHD, including data in special populations, functional outcomes, as well as provider and patient real-world perceptions.


METHODS
We searched the databases Embase, MEDLINE and PsycINFO using the terms 'ADHD' and 'adult' and 'ATX' capturing publications from January 1, 1998, to March 27, 2014. Only publications in English were considered.


RESULTS
ATX demonstrated significantly greater improvement than placebo (PBO) on the Conners Adult ADHD Rating Scale-Investigator rated:Screening Version (CAARS-Inv:SV) in all trials (N = 6; total score difference ranged from -3.5 to -5.5). For long-term trials using the CAARS-Inv:SV, ATX demonstrated significantly greater improvement than PBO in three of four trials (total score differences ranged from -0.1 to -6.0). In short-term studies, ATX showed significantly greater improvement than PBO on the Adult ADHD Quality-of-Life scale total score in three of three studies, but results were mixed on the Sheehan Disability Scale. Three studies of ATX have reported statistically significant improvement (compared with PBO) on the Behavior Rating Inventory of Executive Function-Adult Version Self Report scale. The most common adverse events (occurring in ≥ 10% of patients taking ATX) were nausea, dry mouth, decreased appetite, insomnia and fatigue.


CONCLUSIONS
ATX is an important treatment option for the right patient. ATX can provide long-term, consistent symptom relief and functional improvement for adults with ADHD.
a 1 Eli Lilly and Company, Lilly Corporate Center , Indianapolis, IN 46285, USA.
Daniel J
DJ
Walker
Oren
O
Mason
David B
DB
Clemow
Kathleen A
KA
Day
D018759:Adrenergic Uptake Inhibitors / Q000494:pharmacology; D000328:Adult; D000069445:Atomoxetine Hydrochloride / Q000494:pharmacology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001526:Behavioral Symptoms / Q000188:drug therapy / Q000209:etiology; D056344:Executive Function / Q000187:drug effects*; D006801:Humans; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000069445:Atomoxetine Hydrochloride
Atomoxetine; adult; attention-deficit/hyperactivity disorder; noradrenaline