Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESAtomoxetine Treatment in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder
Section snippets
Patient Sample
This study was conducted at 13 outpatient investigative sites in the United States. Patients were children and adolescents, 8 to 18 years of age, who met DSM-IV (American Psychiatric Association, 2000) criteria for ADHD by clinical assessment and confirmed by structured interview (behavioral module of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime versions (K-SADS-PL) (Kaufman et al., 1997). Patients were also required to have a symptom
Descriptive Characteristics of Youths With ADHD With and Without ODD
Of 297 children and adolescents randomly assigned to receive medication, 293 had complete information regarding the presence or absence of lifetime ODD. Of those, 115 (39.3%) met DSM-IV criteria for ODD and 178 (60.8%) did not. The high percentage of youths with ODD is consistent with the results of other studies (Biederman et al., 1991, Biederman et al., 2002). The proportions of patients in the ODD and non-ODD groups did not differ significantly with respect to age, sex, ADHD subtype, or
DISCUSSION
ODD is the most common comorbid disorder among youths with ADHD and among the most common conditions in pediatric psychiatry. Yet, there are few reports that specifically address the efficacy of pharmacological interventions in this patient population. Although this study was primarily designed to investigate the treatment of ADHD, it provided a unique opportunity to evaluate moderating effects of ODD symptoms, and the response of ODD symptoms to atomoxetine, as it incorporated measures of ODD
REFERENCES (37)
- et al.
A double-blind placebo controlled study of desipramine in the treatment of ADD: III. Lack of impact of comorbidity and family history factors on clinical response
J Am Acad Child Adolesc Psychiatry
(1993) - et al.
A double-blind placebo controlled study of desipramine in the treatment of ADD: I. Efficacy
J Am Acad Child Adolesc Psychiatry
(1989) - et al.
Atomoxetine increases extracellular levels of norepinephrine and dopamine in prefrontal cortex of rat: a potential mechanism for efficacy in attention deficit/hyperactivity disorder
Neuropsychopharmacology
(2002) - et al.
Bupropion hydrochloride in attention deficit disorder with hyperactivity
J Am Acad Child Adolesc Psychiatry
(1996) - et al.
Psychopharmacology and aggression. I: A meta-analysis of stimulant effects on overt/covert aggression-related behaviors in ADHD
J Am Acad Child Adolesc Psychiatry
(2002) - et al.
Novel halogenated analogs of tomoxetine are potent and selective inhibitors of norepinephrine uptake in brain
Neurochem Int
(1995) Assessment and diagnosis of attention-deficit/hyperactivity disorder
Child Adolesc Psychiatr Clin N Am
(2000)- et al.
An open trial of guanfacine in the treatment of attention-deficit hyperactivity disorder
J Am Acad Child Adolesc Psychiatry
(1995) - et al.
Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL): initial reliability and validity data
J Am Acad Child Adolesc Psychiatry
(1997) - et al.
Impact of comorbid oppositional or conduct problems on attention-deficit hyperactivity disorder
J Am Acad Child Adolesc Psychiatry
(1997)
Attention-deficit/hyperactivity disorder and the substance use disorders: the nature of the relationship, subtypes at risk, and treatment issues
Psychiatr Clin North Am
Nortriptyline in the treatment of ADHD: a chart review of 58 cases
J Am Acad Child Adolesc Psychiatry
Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR
Prevalence of ADHD and comorbid disorders among elementary school children screened for disruptive behavior
J Abnorm Child Psychol
Differential effect of environmental adversity by gender: Rutter's index of adversity in a group of boys and girls with and without ADHD
Am J Psychiatry
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders
Am J Psychiatry
Statistical Power Analysis for the Behavioral Sciences
Conners' Rating Scales: Revised Technical Manual
Cited by (147)
Affective Dysregulation in Children Is Associated With Difficulties in Response Control in Emotional Ambiguous Situations
2022, Biological Psychiatry: Cognitive Neuroscience and NeuroimagingCitation Excerpt :For example, as norepinephrine is discussed as a possible modulator of response selection processes (72–75), this could be investigated by administering atomoxetine, a norepinephrine reuptake inhibitor, or by examining changes in pupil diameter, which has been shown to be an indirect measure of norepinephrinergic changes (76,77). Interestingly, norepinephrine is thought to play a role in childhood mental disorders where irritability is present, such as ADHD and ODD (78–80). This study has limitations since we did not control for the level of general executive functioning (e.g., working memory) affecting emotion recognition (81).
Effect of Parent Training on Health-Related Quality of Life in Preschool Children With Attention-Deficit/Hyperactivity Disorder: A Secondary Analysis of Data From a Randomized Controlled Trial
2021, Journal of the American Academy of Child and Adolescent PsychiatryCitation Excerpt :It has been shown that reductions in core ADHD symptoms are associated with improved social skills and a greater academic outcome,2 which is likely to affect overall HRQoL positively. Earlier trials examining the effect of medication (atomoxetine and methylphenidate) have reported that a reduction in ADHD symptoms after end of treatment was associated with improved HRQoL.20,21,36 However, HRQoL might not be as sensitive an outcome as ADHD symptoms in the current trial with relatively short follow-up, and improvements in HRQoL may lag behind changes in ADHD.
Review of pharmacogenomics of psychiatric comorbidities in autism spectrum disorder
2023, PharmacogenomicsPersonalizing atomoxetine dosing in children with ADHD: what can we learn from current supporting evidence
2023, European Journal of Clinical Pharmacology
This work was sponsored by Eli Lilly and Company. The authors acknowledge Charles Bailey, M.D., Charles Casat, M.D., Joan Busner, M.D., Rakesh Jain, M.D., Anthony Dietrich, M.D., Richard Rubin, M.D., and Lesley Reese, B.A.., for their contributions.
Correspondence to Dr. Newcorn, Department of Psychiatry, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1230, New York, NY 10029; e-mail: [email protected].
Disclosure: Dr. Newcorn is an advisor for Celtech Pharmaceuticals, Eli Lilly and Company, Novartis Pharmaceuticals, and Ortho-McNeil Pharmaceuticals; he is a speaker for Eli Lilly and Company, Janssen Pharmaceutical, Novartis Pharmaceuticals, and Ortho-McNeil Pharmaceuticals; he receives grants from Eli Lilly and Company, Ortho Mc-Neil Pharmaceuticals, and Shire Pharmaceuticals; and he is a consultant for Eli Lilly and Company. Dr. Spencer is on the advisory boards of Eli Lilly and Company, GlaxoSmithKline, McNeil Pharmaceutical, Novartis Pharmaceutical, Pfizer Pharmaceutical, and Shire Laboratories, Inc.; he is a speaker for Eli Lilly and Company, GlaxoSmithKline, McNeil Pharmaceutical, Novartis Pharmaceutical, Shire Laboratories, and Wyeth Ayerst; and he receives research support from Eli Lilly and Company, GlaxoSmithKline, McNeil Pharmaceutical, Novartis Pharmaceutical, Pfizer Pharmaceutical, and Shire Laboratories Inc. Dr. Biederman is on the advisory boards of CellTech, Cephalon Pharmaceutical, Eli Lilly and Company, Janssen Pharmaceutical, Johnson & Johnson, McNeil Pharmaceutical, New River Pharmaceuticals, Novartis Pharmaceutical, Noven, Pfizer Pharmaceutical, Sanofi-Synthelabo, and Shire Laboratories Inc.; he is a speaker for Cephalon Pharmaceutical, Eli Lilly and Company, McNeil Pharmaceutical, Novartis Pharmaceutical, Pfizer Pharmaceutical, Shire Laboratories Inc., and Wyeth Ayerst; and he receives research support from Cephalon Pharmaceutical, Eli Lilly and Company, Janssen Pharmaceutical, Neurosearch Pharmaceuticals, Pfizer Pharmaceutical, Shire Laboratories Inc., and the Stanley Medical Institute. Dr. Michelson and Ms. Milton are employees and stakeholders of Eli Lilly and Company.