Atomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorder
Abstract
BACKGROUND: To evaluate the effect of atomoxetine (ATX) on attention-deficit/hyperactivity disorder (ADHD) and comorbid social anxiety disorder in adults. METHODS: Randomized, double-blind, placebo-controlled, conducted in adults with ADHD and social anxiety disorder. Patients received 40-100 mg ATX (n=224) or placebo (n=218) for 14 weeks following a 2-week placebo lead-in period. Efficacy measures included the Conners' Adult ADHD Rating Scale: Investigator-Rated: Screening Version (CAARS:Inv:SV), Liebowitz Social Anxiety Scale (LSAS), Clinical Global Impression-Overall-Severity (CGI-O-S), State-Trait Anxiety Inventory (STAI), Social Adjustment Scale-Self Report (SAS), and Adult ADHD Quality of Life Scale-29 (AAQoL). Safety and tolerability were also assessed. RESULTS: ATX mean change (-8.7+/-10.0) from baseline (29.6+/-10.4) on CAARS:Inv:SV Total ADHD Symptoms score was significantly greater than placebo mean change (-5.6+/-10.2) from baseline (31.2+/-9.4; P<.001). ATX mean change (-22.9+/-25.3) from baseline (85.3+/-23.6) on LSAS Total score was significant compared to placebo mean change (-14.4+/-20.3) from baseline (82.1+/-21.3; P<.001). The visit-wise analysis revealed greater improvement on the CAARS:Inv:SV Total ADHD Symptoms score and LSAS Total score for ATX at every time point throughout the study (P values </=.012). Mean changes in CGI-O-S, STAI-Trait Anxiety scores, and AAQoL Total score were significantly greater for ATX compared to placebo. Mean change for both groups on STAI-State Anxiety scores was comparable. Improvement on SAS for ATX compared to placebo was not significant. Rates of insomnia, nausea, dry mouth, and dizziness were higher with ATX than with placebo. Discontinuation rates due to treatment-emergent adverse events were similar between groups. CONCLUSIONS: ATX monotherapy effectively improved symptoms of ADHD and comorbid social anxiety disorder in adults and was well tolerated.
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Atomoxetine has been associated with improvements in both ADHD and comorbid anxiety symptoms.
“For instance, atomoxetine has been associated with improvements in both ADHD and comorbid anxiety [111] and depressive [112] symptoms.”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [111]
Many studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated.
“Many studies have reported improvements in comorbid psychiatric symptoms when ADHD is effectively treated.”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [111]
Atomoxetine may be indicated in patients with comorbid substance use disorders, emotional dysregulation or social anxiety.
“Atomoxetine may be indicated in patients with comorbid substance use disorders, emotional dysregulation or social anxiety [295-297].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [297]
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- Authors
- Adler, L. A., Liebowitz, M., Kronenberger, W., Qiao, M., Rubin, R., Hollandbeck, M., Deldar, A., Schuh, K., & Durell, T.
- Affiliations
- VA NY Harbor Healthcare System (US)
- Medical Research Network (US)
- Indiana University Indianapolis (US)
- Eli Lilly (United States) (US)
- Corresponding author
- Durell, Todd
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2009-03
- Volume
- 26
- Issue
- 3
- Pages
- 212-221
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- OpenAlex
- W1996284827
- Cited by
- 176
- References
- 27
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 13 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 5 · 2019: 9 · 2018: 7 · 2017: 14 · 2016: 17 · 2015: 14 · 2014: 18 · 2013: 11 · 2012: 14
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- atomoxetine, attention deficit hyperactivity disorder, social anxiety disorder, comorbidities, adults, treatment-emergent adverse events, tolerability, quality of life, social adaptation
- MeSH terms
- Adolescent, Adult, Aged, Attention Deficit Disorder with Hyperactivity, Female, Humans, Male, Middle Aged, Phobic Disorders, Quality of Life, Surveys and Questionnaires, Comorbidity, Adrenergic Uptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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