Randomized, Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents With Substance Use Disorder
Open accessAbstract
Objective To evaluate the effect of atomoxetine hydrochloride versus placebo on attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) in adolescents receiving motivational interviewing/cognitive behavioral therapy (MI/CBT) for SUD. Method This single-site, randomized, controlled trial was conducted between December 2005 and February 2008. Seventy adolescents (13 through 19 years of age) with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) ADHD, a DSM-IV ADHD checklist score greater than or equal to 22, and at least one nontobacco SUD were recruited from the community. All subjects received 12 weeks of atomoxetine hydrochloride + MI/CBT versus placebo + MI/CBT. The main outcome measure for ADHD was self-report DSM-IV ADHD checklist score. For SUD, the main outcome was self-report number of days used nontobacco substances in the past 28 days using the Timeline Followback interview. Results Change in ADHD scores did not differ between atomoxetine + MI/CBT and placebo + MI/CBT (F4,191 = 1.23, p = .2975). Change in days used nonnicotine substances in the last 28 days did not differ between groups (F3,100 = 2.06, p = .1103). Conclusions There was no significant difference between the atomoxetine + MI/CBT and placebo + MI/CBT groups in ADHD or substance use change. The MI/CBT and/or a placebo effect may have contributed to a large treatment response in the placebo group. Clinical Trials Registry Information-A Randomized, Placebo-Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents with Substance Use Disorder. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00399763.
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Thurstone et al. (2010) found no between-group difference in improvement for ADHD or substance use between atomoxetine and placebo, based on self-report and urinalysis.
“found no between-group difference in improvement for neither ADHD or substance use, both based on self-report and urinalysis [39].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [39]
The results of the reviewed randomized trials in adolescents with concurrent ADHD and SUD were equivocal, with contradictory findings between primary and secondary outcome measures for ADHD and SUD, overall negative findings for both ADHD and SUD, and a small sample size.
“Concerning pharmacotherapy, the results of the reviewed randomized trials in adolescents with concurrent ADHD and SUD were equivocal, with contradictory findings between the primary and secondary outcome measures pertaining to ADHD [37,38] and SUD [37], overall negative findings for both ADHD and SUD [39], and a small sample size [36].”
From Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review (2021) · cites this paper as [39]
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- Authors
- Thurstone, C., Riggs, P. D., Salomonsen-Sautel, S., & Mikulich-Gilbertson, S. K.
- Affiliations
- Denver Health Medical Center (US)
- University of Colorado Denver (US)
- Corresponding author
- Thurstone, Christian
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 49
- Issue
- 6
- Pages
- 573-582
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC2876346
- OpenAlex
- W2068014350
- Cited by
- 96
- References
- 32
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 10 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 13 · 2013: 5 · 2012: 12
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eli Lilly and Company
- National Institute on Drug Abuse (DA012845, U10DA013732, R01DA012845, R01DA022284, K12DA000357, R01DA021913)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- atomoxetine, attention deficit hyperactivity disorder, substance use disorders, adolescents, motivational interviewing, cognitive behavioral therapy, ADHD medication, placebo effect
- MeSH terms
- Atomoxetine Hydrochloride, Adolescent, Attention Deficit Disorder with Hyperactivity, Combined Modality Therapy, Double-Blind Method, Female, Humans, Interview, Psychological, Male, Motivation, Propylamines, Comorbidity, Cognitive Behavioral Therapy, Adrenergic Uptake Inhibitors, Substance-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders, Checklist
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