Atomoxetine monotherapy compared with combination therapy for the treatment of ADHD: a retrospective chart review study.
OBJECTIVE
To analyze Clinical Global Impression-Severity (CGI-S) in ADHD patients treated with atomoxetine (ATX) monotherapy versus ATX combination therapy with another ADHD-indicated medication.


METHODS
This was a 2-site retrospective observational chart review study of child and adult ADHD patients, not necessarily treatment naïve, but treated ≥50 days post baseline with an endpoint assessment. To adjust for measured confounders, monotherapy (n = 77) versus combination (n = 108) cohort comparisons were performed using propensity score stratification and adjusted ANCOVA.


RESULTS
There were no significant baseline cohort differences after propensity stratification. CGI-S scores after a mean 264 days of treatment were not statistically significantly different between cohorts, with no cohort differences observed in any assessed symptom subcategory. The cohorts were similar in discontinuation due to any reason, adverse event, and lack of efficacy.


CONCLUSIONS
ATX combination therapy showed no evidence of additional benefit over ATX monotherapy in the treatment of ADHD in a community-based setting.
a Medical, Lilly USA, LLC , Indianapolis , IN , USA.
David B
DB
Clemow
b Attention MD , Grand Rapids , MI , USA.
Oren W
OW
Mason
c Sarkis Family Psychiatry , Gainesville , FL , USA.
Elias H
EH
Sarkis
d Statistics, Eli Lilly and Company , Indianapolis , IN , USA.
Dustin D
DD
Ruff
e Developmental and Behavioral Pediatrics, Progressions , Walnut Creek , CA , USA.
Brad D
BD
Berman
f Dartmouth College , Geisel School of Medicine , Lebanon , NH , USA.
Craig L
CL
Donnelly
g Children's National Medical Center, George Washington University , Washington , DC , USA.
Adelaide S
AS
Robb
h Boca Raton , FL , USA.
Donna S
DS
Holland
d Statistics, Eli Lilly and Company , Indianapolis , IN , USA.
Kory J
KJ
Schuh
a Medical, Lilly USA, LLC , Indianapolis , IN , USA.
Janet M
JM
Barnes
a Medical, Lilly USA, LLC , Indianapolis , IN , USA.
Andre B
AB
Araujo
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D000328:Adult; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D004359:Drug Therapy, Combination; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome
D018759:Adrenergic Uptake Inhibitors; D000069445:Atomoxetine Hydrochloride
ADHD; atomoxetine; combination therapy; polypharmacy; stimulant