Real-World Dosing Patterns of Atomoxetine in Adults with Attention-Deficit/Hyperactivity Disorder.
OBJECTIVE
The aim was to investigate the dosing patterns of atomoxetine monotherapy in adult patients with attention-deficit/hyperactivity disorder (ADHD) in a retrospective analysis.


METHODS
Adult (≥ 18 years) patients with ADHD newly initiated on atomoxetine with ≥ 1 outpatient pharmacy claim for atomoxetine between January 2006 and December 2011 were selected from the Truven Health MarketScan(®) Commercial database. After a 30-day titration period, dosing patterns of atomoxetine monotherapy were analyzed in the 12 months following initiation. In addition, patient demographic and clinical characteristics were compared to identify characteristics associated with suboptimal versus recommended dosing.


RESULTS
Of the 12,412 adult patients with ADHD newly initiated on atomoxetine, 4548 (36.6%) were suboptimally dosed, whereas 3323 (26.7%) were treated at recommended dose. Overall, study patients were treated at a mean (standard deviation [SD]) dose of 68.5 (44.9) mg/day. The suboptimal dosing cohort included significantly more females (54% vs. 44%, P < 0.001) and had fewer patients with pre-index use of other ADHD medications (17% vs. 20%, P < 0.001) compared with the recommended dosing cohort.


CONCLUSIONS
Adult patients with ADHD receiving atomoxetine therapy in a real-world setting are often dosed suboptimally. Increasing the awareness on optimal dosing strategy among clinicians and patients is warranted to maximize the therapeutic benefits of atomoxetine among adult patients with ADHD.
Eli Lilly and Company, Indianapolis, IN, USA.
Samaneh
S
Kabul
Eli Lilly and Company, Indianapolis, IN, USA.
Carlos
C
Alatorre
Truven Health Analytics, Cambridge, MA, USA.
Leslie B
LB
Montejano
Truven Health Analytics, Cambridge, MA, USA.
Amanda M
AM
Farr
Eli Lilly and Company, Indianapolis, IN, USA.
David B
DB
Clemow
D000293:Adolescent; D000328:Adult; D000069445:Atomoxetine Hydrochloride / Q000008:administration & dosage*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D062313:Databases, Pharmaceutical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000008:administration & dosage*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States; D055815:Young Adult
D011619:Psychotropic Drugs; D000069445:Atomoxetine Hydrochloride
Adult; Atomoxetine; Attention-deficit disorder with hyperactivity; Dose-response relationship; Drug; Medication adherence