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Use of Atomoxetine in Patients with Attention-Deficit Hyperactivity Disorder and Co-Morbid Conditions

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Abstract

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioural disorders in children. It has been shown that as many as 85% of patients with ADHD have at least one psychiatric comorbidity, and approximately 60% have at least two.

Atomoxetine is a specific, noradrenergic reuptake inhibitor that provides an effective treatment option for patients with ADHD and co-morbid conditions. The efficacy of atomoxetine in treating ADHD appears to be unaffected by the presence of co-morbid conditions. Therapy with atomoxetine has been associated with statistically significant improvements in symptoms of oppositional defiant disorder in most, but not all, studies. Limited data suggest this agent may have potential in improving co-occurring symptoms of anxiety and may be useful in patients with co-morbid conditions such as tics or Tourette’s syndrome.

The tolerability profile of atomoxetine in patients with ADHD and comorbid conditions was similar to that of patients with uncomplicated ADHD. Atomoxetine was well tolerated, with adverse events generally mild and transient; the most frequent adverse events in patients with ADHD included abdominal pain, decreased appetite, nausea and vomiting.

The favourable safety and efficacy profile of atomoxetine makes it a promising treatment for patients with ADHD and associated co-morbidities.

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References

  1. Hechtman L. Assessment and diagnosis of attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2000 Jul; 9(3): 481–98

    PubMed  CAS  Google Scholar 

  2. Olfson M. Diagnosing mental disorders in office-based pediatric practice. J Dev Behav Pediatr 1992 Oct; 13(5): 363–5

    PubMed  CAS  Google Scholar 

  3. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007 Jun; 164(6): 942–8

    Article  PubMed  Google Scholar 

  4. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006 Feb; 36(2): 159–65

    Article  PubMed  Google Scholar 

  5. Biederman J, Monuteaux MC, Mick E, et al. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychol Med 2006 Feb; 36(2): 167–79

    Article  PubMed  Google Scholar 

  6. Angold A, Costello EJ, Erkanli A. Comorbidity. J Child Psychol Psychiatry 1999; 40: 57–87

    Article  PubMed  CAS  Google Scholar 

  7. Kadesjö B, Gillberg C. The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry 2001; 42: 487–92

    Article  PubMed  Google Scholar 

  8. MTA Cooperative Group. A 14-month randomised clinical trial of treatment strategies for attention-deficit/ hyperactivity disorder: the MTA Cooperative Group. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 1999 Dec; 56(12): 1073–86

    Article  Google Scholar 

  9. Steinhausen H, Metzke C, Meier M, et al. Prevalence of child and adolescent psychiatric disorders: the Zurich Epidemiological Study. Acta Psychiatr Scand 1998; 98: 262–71

    Article  PubMed  CAS  Google Scholar 

  10. Steinhausen H-C, Novik T, Baldursson G, et al. Coexisting psychiatric problems in ADHD in the ADORE cohort. Eur Child Adolesc Psychiatry 2006; 15 Suppl. 1: 25–9

    Article  Google Scholar 

  11. Dunn DW, Austin JK, Caffrey HM, et al. A prospective study of teachers’ ratings of behaviour problems in children with new-onset seizures. Epilepsy Behav 2003 Feb; 4(1): 26–35

    Article  PubMed  Google Scholar 

  12. Schubert R. Attention deficit disorder and epilepsy. Pediatr Neurol 2005 Jan; 32(1): 1–10

    Article  PubMed  Google Scholar 

  13. Lewinsohn PM, Rohde P, Seeley JR. Adolescent psychopathology III: the clinical consequences of comorbidity. J Am Acad Child Adolesc Psychiatry 1995; 34: 510–9

    Article  PubMed  CAS  Google Scholar 

  14. Jensen PS, Hinshaw SP, Kraemer HC, et al. ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. J Am Acad Child Adolesc Psychiatry 2001; 40: 147–58

    Article  PubMed  CAS  Google Scholar 

  15. March JS, Swanson JM, Arnold LE, et al. Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA). J Abnorm Child Psychol 2000 Dec; 28(6): 527–41

    Article  PubMed  CAS  Google Scholar 

  16. Consoli A, Bouzamondo A, Guilé JM, et al. Comorbidity with ADHD decreases response to pharmacotherapy in children and adolescents with acute mania: evidence from a metaanalysis. Can J Psychiatry 2007 May; 52(5): 323–8

    PubMed  Google Scholar 

  17. Graham J, Coghill D. Adverse effects of pharmacotherapies for attention-deficit hyperactivity disorder: epidemiology, prevention and management. CNS Drugs 2008; 22(3): 213–37

    Article  PubMed  CAS  Google Scholar 

  18. Kelsey DK, Sumner CR, Casat CD, et al. Once-daily atomoxetine treatment for children with attention-deficit/ hyperactivity disorder, including an assessment of evening and morning behaviour: a double-blind, placebo-controlled trial. Pediatrics 2004 Jul; 114(1): e1–8

    Article  PubMed  Google Scholar 

  19. Kemner JE, Starr HL, Ciccone PE, et al. Outcomes of OROS methylphenidate compared with atomoxetine in children with ADHD: a multicenter, randomised prospective study. Adv Ther 2005 Sep–Oct; 22(5): 498–512

    Article  PubMed  CAS  Google Scholar 

  20. Kratochvil CJ, Heiligenstein JH, Dittmann R, et al. Atomoxetine and methylphenidate treatment in children with ADHD: a prospective, randomised, open-label trial. J Am Acad Child Adolesc Psychiatry 2002 Jul; 41(7): 776–84

    Article  PubMed  Google Scholar 

  21. Michelson D. A double-blind placebo-controlled comparison of atomoxetine, OROS methyphenidate and placebo. American Academy of Child and Adolescent Psychiatry Meeting; 2004 Oct 19–23; Washington, DC

  22. Michelson D, Adler L, Spencer T, et al. Atomoxetine in adults with ADHD: two randomised, placebo-controlled studies. Biol Psychiatry 2003 Jan 15; 53(2): 112–20

    Article  PubMed  CAS  Google Scholar 

  23. Michelson D, Allen AJ, Busner J, et al. Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomised, placebo-controlled study. Am J Psychiatry 2002 Nov; 159(11): 1896–901

    Article  PubMed  Google Scholar 

  24. Michelson D, Buitelaar JK, Danckaerts M, et al. Relapse prevention in pediatric patients with ADHD treated with atomoxetine: a randomised, double-blind, placebo-controlled study. J Am Acad Child Adolesc Psychiatry 2004 Jul; 43(7): 896–904

    Article  PubMed  Google Scholar 

  25. Michelson D, Faries D, Wernicke J, et al. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomised, placebo-controlled, dose-response study. Pediatrics 2001 Nov; 108(5): E83

    Article  PubMed  CAS  Google Scholar 

  26. Michelson D, Gao H, Allen AJ, et al. Plasma atomoxetine concentration and response to ADHD in children and adolescents. 42nd Annual Meeting of the New Clinical Drug Evaluation Unit; 2002 Jun 10–13; Boca Raton (FL)

  27. Sangal R, Owens J, Allen AJ, et al. Effects of atomoxetine and methylphenidate on sleep in children with ADHD. Sleep 2006; 29: 1573–85

    PubMed  Google Scholar 

  28. Spencer T, Biederman J, Heiligenstein J, et al. An openlabel, dose-ranging study of atomoxetine in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2001 Fall; 11(3): 251–65

    Article  PubMed  CAS  Google Scholar 

  29. Spencer T, Biederman J, Wilens T, et al. Effectiveness and tolerability of tomoxetine in adults with attention deficit hyperactivity disorder. Am J Psychiatry 1998 May; 155(5): 693–5

    PubMed  CAS  Google Scholar 

  30. Spencer T, Heiligenstein JH, Biederman J, et al. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyperactivity disorder. J Clin Psychiatry 2002 Dec; 63(12): 1140–7

    Article  PubMed  CAS  Google Scholar 

  31. Weiss M, Tannock R, Kratochvil C, et al. A randomised, placebo-controlled study of once-daily atomoxetine in the school setting in children with ADHD. J Am Acad Child Adolesc Psychiatry 2005 Jul; 44(7): 647–55

    Article  PubMed  Google Scholar 

  32. Wigal SB, McGough JJ, McCracken JT, et al. A laboratory school comparison of mixed amphetamine salts extended release (Adderall XR) and atomoxetine (Strattera) in school-aged children with attention deficit/hyperactivity disorder. J Atten Disord 2005 Aug; 9(1): 275–89

    Article  PubMed  Google Scholar 

  33. Newcorn JH, Kratochvil CJ, Allen AJ, et al. Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response. Am J Psychiatry 2008 Jun; 165(6): 721–30

    Article  PubMed  Google Scholar 

  34. DuPaul GJ, Power TJ, Anastopoulos AD, et al. ADHD rating scale-IV: checklists, norms, and clinical interpretation. New York: The Guildford Press, 1998

    Google Scholar 

  35. Connors CK. Connors’ rating scales: revised technical manual. North Tonawanda (NY): Multi-Health Systems, Inc., 1997

    Google Scholar 

  36. Kratochvil CJ, Wilens TE, Greenhill LL, et al. Effects of long-term atomoxetine treatment for young children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2006 Aug; 45(8): 919–27

    Article  PubMed  Google Scholar 

  37. Wilens TE, Newcorn JH, Kratochvil CJ, et al. Long-term atomoxetine treatment in adolescents with attention-deficit/ hyperactivity disorder. J Pediatr 2006 Jul; 149(1): 112–9

    Article  PubMed  CAS  Google Scholar 

  38. Turgay A. Atomoxetine in the treatment of children, adolescents and adults with attention deficit hyperactivity disorder. Future Drugs 2006; 3: 19–38

    CAS  Google Scholar 

  39. Wolraich M, Wibbelsman C, Brown T, et al. Attention-deficit/hyperactivity disorder among adolescents: a review of the diagnosis, treatment, and clinical implications. Pediatrics 2005; 115: 1734–46

    Article  PubMed  Google Scholar 

  40. Kaplan S, Heiligenstein J, West S, et al. Efficacy and safety of atomoxetine in childhood attention-deficit/hyperactivity disorder with comorbid oppositional defiant disorder. J Atten Disord 2004; 8: 45–52

    Article  PubMed  CAS  Google Scholar 

  41. Bangs ME, Hazell P, Danckaerts M, et al. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorder. Pediatrics 2008; 121(2): 314–20

    Article  Google Scholar 

  42. Bangs ME, Hazell P, Danckaerts M, et al. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorder. 159th Annual Meeting of the American Psychiatric Association; 2006 May 20–25; Toronto (ON)

  43. Newcorn JH, Spencer TJ, Biederman J, et al. Atomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry 2005; 44: 240–8

    Article  PubMed  Google Scholar 

  44. Kratochvil CS, Newcorn JH, Arnold LE, et al. Atomoxetine alone or combined with fluoxetine for treating ADHD with comorbid depressive or anxiety symptoms. J Am Acad Child Adolesc Psychiatry 2005; 44: 915–24

    Article  PubMed  Google Scholar 

  45. Geller D, Donnelly C, Lopez F, et al. Atomoxetine treatment for pediatric patients with attention-deficit/ hyperactivity disorder with comorbid anxiety disorder. J Am Acad Child Adolesc Psychiatry 2007; 46: 1119–27

    Article  PubMed  Google Scholar 

  46. Sumner C, Donnelly C, Lopez F, et al. Atomoxetine treatment for pediatric patients with ADHD and comorbid anxiety [abstract]. Int J Neuropsychopharmacol 2006; 9 Suppl. 1: 135

    Google Scholar 

  47. Atomoxetine ADHD and Comorbid MDD Study Group, Bangs ME, Emslie GJ, et al. Efficacy and safety of atomoxetine in adolescents with attention-deficit/ hyperactivity disorder and major depression. J Child Adolesc Psychopharmacol 2007 Aug; 17(4): 407–20

    Article  PubMed  Google Scholar 

  48. Allen AJ, Kurlan RM, Gilbert DL, et al. Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology 2005 Dec; 65: 1941–9

    Article  PubMed  CAS  Google Scholar 

  49. Arnold LE, Aman MG, Cook AM, et al. Atomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trial. J Am Acad Child Adolesc Psychiatry 2006 Oct; 45: 1196–205

    Article  PubMed  Google Scholar 

  50. August GJ, Realmuto GM, MacDonald 3rd AW, et al. Prevalence of ADHD and comorbid disorders among elementary school children screened for disruptive behaviour. J Abnorm Child Psychol 1996 Oct; 24(5): 571–95

    Article  PubMed  CAS  Google Scholar 

  51. Biederman J, Newcorn J, Sprich S. Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. Am J Psychiatry 1991 May; 148(5): 564–77

    PubMed  CAS  Google Scholar 

  52. Goldman LS, Genel M, Bezman RJ, et al. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Council on Scientific Affairs, American Medical Association. JAMA 1998 Apr; 279(14): 1100–7

    Article  CAS  Google Scholar 

  53. Greene RW, Biederman J, Zerwas S, et al. Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. Am J Psychiatry 2002 Jul; 159(7): 1214–24

    Article  PubMed  Google Scholar 

  54. Kuhne M, Schachar R, Tannock R. Impact of comorbid oppositional or conduct problems on attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1997 Dec; 36(12): 1715–25

    Article  PubMed  CAS  Google Scholar 

  55. Biederman J, Spencer T, Newcorn J, et al. Effect of comorbid symptoms of oppositional defiant disorder on responses to atomoxetine in children with ADHD: a meta-analysis of controlled clinical trial data. Psychopharmacology (Berl) 2007; 190: 31–41

    Article  CAS  Google Scholar 

  56. Dunne JE. Attention-deficit/hyperactivity disorder and associated childhood disorders. Prim Care 1999 Jun; 26(2): 349–72

    Article  PubMed  CAS  Google Scholar 

  57. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994

    Google Scholar 

  58. Curatolo P, Mancini F, Dell’Agnello G, The LYCY Study Group. Quality of life of pediatric patients with attention-deficit/hyperactivity disorder and oppositive defiant disorder: an Italian double-blind, placebo-controlled study with atomoxetine. The 13th International Congress of the European Society for Child and Adolescent Psychiatry; 2007 Aug 25–29; Florence

  59. Hazell P, Zhang S, Wolañczyk T, et al. Comorbid oppositional defiant disorder and the risk of relapse during 9 months of atomoxetine treatment for attention-deficit/ hyperactivity disorder. Eur Child Adolesc Psychiatry 2006; 15: 105–10

    Article  PubMed  Google Scholar 

  60. Swanson JM, Kraemer HC, Hinshaw SP, et al. Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment. J Am Acad Child Adolesc Psychiatry 2001; 40(2): 168–79

    Article  PubMed  CAS  Google Scholar 

  61. Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: an overview. J Clin Psychiatry 1998; 59 Suppl. 7: 50–8

    Google Scholar 

  62. Kunwar A, Dewan M, Faraone SV. Treating common psychiatric disorders associated with attention-deficit/ hyperactivity disorder. Expert Opin Pharmacother 2007 Apr; 8(5): 555–62

    Article  PubMed  CAS  Google Scholar 

  63. Heiligenstein J, Spencer T, Faries DE, et al. Efficacy of atomoxetine vs placebo in pediatric outpatients with ADHD. Proceedings of the 47th Annual Meeting of the American Academy of Child and Adolescent Psychiatry. Washington, DC: AACAP, 2000

    Google Scholar 

  64. Poznanski EO, Mokros HB. Children’s Depression Rating Scale (CDRS-R) revised. Los Angeles (CA): Western Psychological Services, 1999

    Google Scholar 

  65. Keen D. ADHD and the paediatrician: a guide to management. Curr Paediatr 2005; 15: 133–42

    Article  Google Scholar 

  66. Guy W. ECDEU assessment manual for psychopharmacology, revised. Rockville (MD): U.S. Department of Health, Education, and Welfare, 1976. Publication ADM 76-338

    Google Scholar 

  67. Leckman JF, Riddle MA, Hardin MT, et al. The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 1989 Jul; 28(4): 566–73

    Article  PubMed  CAS  Google Scholar 

  68. Cohen DJ, Leckman JF, Shaywitz BA. The Tourette’s syndrome and other tics. In: Shaffer D, Erhardt AA, Greenhill L, editors. Diagnosis and treatment in pediatric psychiatry. New York: MacMillan Free Press, 1984

    Google Scholar 

  69. Spencer TJ, Sallee FR, Gilbert DL, et al. Atomoxetine treatment of ADHD in children with comorbid Tourette syndrome. J Atten Disord 2008 Jan; 11(4): 470–81

    Article  PubMed  Google Scholar 

  70. Sturm H, Fernell E, Gillberg C. Autism spectrum disorders in children with normal intellectual levels: associated impairments and subgroups. Dev Med Child Neurol 2004 Jul; 46(7): 444–7

    Article  PubMed  Google Scholar 

  71. Aman MG, Singh NN, Stewart AW, et al. The Aberrant Behavior Checklist: a behaviour rating scale for the assessment of treatment effects. Am J Ment Defic 1985 Mar; 89(5): 485–91

    PubMed  CAS  Google Scholar 

  72. Troost P, Steinhuis M-P, Tuynman-Qua H, et al. Atomoxetine for attention-deficit/hyperactivity disorder symptoms in children with pervasive developmental disorders: a pilot study. J Child Adolesc Psychopharmacol 2006 Oct; 16: 611–9

    Article  PubMed  Google Scholar 

  73. Posey DJ, Wiegand RE, Wilkerson J, et al. Open-label atomoxetine for attention-deficit/hyperactivity disorder symptoms associated with high-functioning pervasive developmental disorders. J Child Adolesc Psychopharmacol 2006 Oct; 16(5): 599–610

    Article  PubMed  Google Scholar 

  74. Jou RJ, Handen BL, Hardan AY. Retrospective assessment of atomoxetine in children and adolescents with pervasive developmental disorders. J Child Adolesc Psychopharmacol 2005 Apr; 15(2): 325–30

    Article  PubMed  Google Scholar 

  75. Faraone SV, Biederman J, Wozniak J, et al. Is comorbidity with ADHD a marker for juvenile-onset mania? J Am Acad Child Adolesc Psychiatry 1997 Aug; 36(8): 1046–55

    Article  PubMed  CAS  Google Scholar 

  76. Findling RL, Gracious BL, McNamara NK, et al. Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder. Bipolar Disord 2001 Aug; 3(4): 202–10

    Article  PubMed  CAS  Google Scholar 

  77. Kafantaris V, Coletti DJ, Dicker R, et al. Are childhood psychiatric histories of bipolar adolescents associated with family history, psychosis, and response to lithium treatment? J Affect Disord 1998 Nov; 51(2): 153–64

    Article  PubMed  CAS  Google Scholar 

  78. Kutcher S, Robertson HA, Bird D. Premorbid functioning in adolescent onset bipolar I disorder: a preliminary report from an ongoing study. J Affect Disord 1998 Nov; 51(2): 137–44

    Article  PubMed  CAS  Google Scholar 

  79. Masi G, Perugi G, Toni C, et al. Attention-deficit hyperactivity disorder: bipolar comorbidity in children and adolescents. Bipolar Disord 2006 Aug; 8(4): 373–81

    Article  PubMed  Google Scholar 

  80. West SA, McElroy SL, Strakowski SM, et al. Attention deficit hyperactivity disorder in adolescent mania. Am J Psychiatry 1995 Feb; 152(2): 271–3

    PubMed  CAS  Google Scholar 

  81. Geller B, Zimerman B, Williams M, et al. DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol 2002 Spring; 12(1): 11–25

    Article  PubMed  Google Scholar 

  82. Jaworowski S, Benarroch F, Gross-Tsur V. Concomitant use of atomoxetine and OROS-methylphenidate in a 10-year-old child suffering from attention-deficit/ hyperactivity disorder with comorbid bipolar disorder and Tourette syndrome. J Child Adolesc Psychopharmacol 2006; 16: 365–70

    Article  PubMed  Google Scholar 

  83. Hah M, Chang K. Atomoxetine for the treatment of attention-deficit/hyperactivity disorder in children and adolescents with bipolar disorders. J Child Adolesc Psychopharmacol 2005; 15: 996–1004

    Article  PubMed  Google Scholar 

  84. Pliszka SR, AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/ hyperactivity disorder. Am Acad Child Adolesc Psychiatry 2007 Jul; 46(7): 894–921

    Article  Google Scholar 

  85. Eli Lilly and Company Limited. Strattera: summary of product characteristics [online]. Available from URL: http://emc.medicines.org.uk/emc/assets/c/html/displayDocPrinterFriendly.asp?documentid=14482 [Accessed 2008 Dec 17]

  86. King S, Griffin S, Hodges Z, et al. A systematic review and economic model of the effectiveness and cost-effectiveness of methylphenidate, dexamfetamine and atomoxetine for the treatment of attention deficit hyperactivity disorder in children and adolescents. Health Technol Assess 2006 Jul; 10(23): iii–iv, xiii-146

    PubMed  CAS  Google Scholar 

  87. Wernicke JF, Faries D, Girod D, et al. Cardiovascular effects of atomoxetine in children, adolescents, and adults. Drug Saf 2003; 26(10): 729–40

    Article  PubMed  CAS  Google Scholar 

  88. Wernicke JF, Kratochvil CJ. Safety profile of atomoxetine in the treatment of children and adolescents with ADHD. J Clin Psychiatry 2002; 63 Suppl. 12: 50–5

    Google Scholar 

  89. Eli Lilly and Company Limited. Strattera (atomoxetine hydrochloride) capsules for oral use. Prescribing information [online]. Available from URL: http://pi.lilly.com/us/strattera-pi.pdf [Accessed 2008 Dec 17]

  90. Bangs ME, Jin L, Zhang S, et al. Hepatic events associated with atomoxetine treatment for attention-deficit hyperactivity disorder. Drug Saf 2008; 31(4): 345–54

    Article  PubMed  CAS  Google Scholar 

  91. Lim JR, Faught PR, Chalasani NP, et al. Severe liver injury after initiating therapy with atomoxetine in two children. J Pediatr 2006 Jun; 148(6): 831–4

    Article  PubMed  Google Scholar 

  92. Stojanovski SD, Casavant MJ, Mousa HM, et al. Atomoxetine-induced hepatitis in a child. Clin Toxicol (Phila) 2007; 45(1): 51–5

    Article  CAS  Google Scholar 

  93. Bangs ME, Tauscher-Wisniewski S, Polzer J, et al. Meta-analysis of suicide-related behaviour events in patients treated with atomoxetine. J Am Acad Child Adolesc Psychiatry 2008 Feb; 47(2): 209–18

    Article  PubMed  Google Scholar 

  94. Lee TS, Lee TD, Lombroso PJ, et al. Atomoxetine and tics in ADHD. J Am Acad Child Adolesc Psychiatry 2004 Sep; 43(9): 1068–9

    Article  PubMed  Google Scholar 

  95. Párraga HC, Párraga KL, Harris DK, et al. Abdominal tics during atomoxetine treatment in a child with ADHD: evaluation and differential diagnosis [letter]. CNS Spectr 2008 Sep; 13(9): E1

    PubMed  Google Scholar 

  96. Párraga HC, Párraga MI, Harris DK. Tic exacerbation and precipitation during atomoxetine treatment in two children with attention-deficit hyperactivity disorder. Int J Psychiatry Med 2007; 37(4): 415–24

    Article  PubMed  Google Scholar 

  97. Sawant S, Daviss SR. Seizures and prolonged QTc with atomoxetine overdose [letter]. Am J Psychiatry 2004 Apr; 161(4): 757

    Article  PubMed  Google Scholar 

  98. Spiller HA, Lintner CP, Winter ML. Atomoxetine ingestions in children: a report from poison centers. Ann Pharmacother 2005 Jun; 39(6): 1045–8

    Article  PubMed  CAS  Google Scholar 

  99. Wernicke JF, Holdridge KC, Jin L, et al. Seizure risk in patients with attention-deficit-hyperactivity disorder treated with atomoxetine. Dev Med Child Neurol 2007 Jul; 49(7): 498–502

    Article  PubMed  Google Scholar 

  100. Wernicke JF, Chilcott K, McAfee A, et al. Seizure risk in patients with ADHD treated with atomoxetine. Annual Meeting of the American Academy of Children and Adolescent Psychiatry; 2005 Oct 18–23; Toronto (ON)

  101. Dunn DW, Austin JK, Harezlak J, et al. ADHD and epilepsy in childhood. Dev Med Child Neurol 2003 Jan; 45(1): 50–4

    Article  PubMed  Google Scholar 

  102. Hesdorffer DC, Ludvigsson P, Olafsson E, et al. ADHD as a risk factor for incident unprovoked seizures and epilepsy in children. Arch Gen Psychiatry 2004 Jul; 61(7): 731–6

    Article  PubMed  Google Scholar 

  103. Double blind, placebo controlled, crossover study of extended release methylphenidate for treatment of ADHD in children with epilepsy [ClinicalTrials.gov identifier NCT00323947]. US National Institutes of Health, Clinical Trials.gov [online]. Available from URL: http://www.clinicaltrials.gov [Accessed 2009 Jan 30]

  104. Barton J. Atomoxetine: a new pharmacotherapeutic approach in the management of attention deficit/hyperactivity disorder. Arch Dis Child 2005 Feb; 90Suppl. 1: i26–9

    Article  PubMed  Google Scholar 

  105. Olfson M. New options in the pharmacological management of attention-deficit/hyperactivity disorder. Am J Manag Care 2004 Jul; 10(4 Suppl.): S117–24

    PubMed  Google Scholar 

  106. Prasad S, Steer C. Switching from neurostimulant therapy to atomoxetine in children and adolescents with attention-deficit hyperactivity disorder: clinical approaches and review of current available evidence. Pediatr Drugs 2008; 10(1): 39–47

    Article  Google Scholar 

  107. National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults. Clinical guideline 72 [online]. Available from URL: http://www.nice.org.uk/CG72 [Accessed 2008 Dec 17]

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Acknowledgements

This review was supported by Eli Lilly Italia S.p.A. Grazia Dell’Agnello and Andrea Rossi are currently working for Eli Lilly Italia S.p.A. Gabriele Masi reports having received consulting fees and grant support from Eli Lilly, and lecture fees from Eli Lilly, GlaxoSmithKline, sanofi aventis, Pfizer and Janssen. Paolo Curatolo reports having received consulting fees from Eli Lilly as an Advisory Board member and grants for clinical trials. Alessandro Zuddas reports having received consulting and lecture fees, and grant support from Eli Lilly, and, in addition, consulting fees from Shire, AstraZeneca and UCB. Dante Besana reports having acted as a consultant and investigator for studies sponsored by Eli Lilly.

Editorial support for the preparation of the manuscript was provided by Lukas Molloy of Wolters Kluwer Health Medical Communications.

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Authors and Affiliations

  1. Medical Department, Eli Lilly Italia S.p.A, Via Gramsci 731/733, 50019, Sesto Fiorentino, Florence, Italy

    Grazia Dell’Agnello (MD) & Andrea Rossi

  2. Child Neurology and Psychiatry, Department of Neuroscience, University of Cagliari, Cagliari, Italy

    Alessandro Zuddas

  3. IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy

    Gabriele Masi

  4. Pediatric Neuroscience Unit, Torvergata University, Rome, Italy

    Paolo Curatolo

  5. Operating Structure of Infantile Neuropsychiatry Infantile Hospital, Hospital Agency of Alessandria, Alessandria, Italy

    Dante Besana

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  1. Grazia Dell’Agnello
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Correspondence to Grazia Dell’Agnello.

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Dell’Agnello, G., Zuddas, A., Masi, G. et al. Use of Atomoxetine in Patients with Attention-Deficit Hyperactivity Disorder and Co-Morbid Conditions. CNS Drugs 23, 739–753 (2009). https://doi.org/10.2165/11314350-000000000-00000

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  • DOI: https://doi.org/10.2165/11314350-000000000-00000

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