CoChat
Sign Up
Cited by 64Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesDevelopmental and Educational Neuropsychology

Acute atomoxetine treatment of younger and older children with ADHD: A meta-analysis of tolerability and efficacy

Open access
Kratochvil, Christopher J, Milton, Denái R, Vaughan, Brigette S, Greenhill, Laurence L·2008·Child and Adolescent Psychiatry and Mental Health
DOI 10.1186/1753-2000-2-25PMC PMC2556311
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Atomoxetine is FDA-approved as a treatment of attention-deficit/hyperactivity disorder (ADHD) in patients aged 6 years to adult. Among pediatric clinical trials of atomoxetine to date, six with a randomized, double-blind, placebo-controlled design were used in this meta-analysis. The purpose of this article is to describe and compare the treatment response and tolerability of atomoxetine between younger children (6-7 years) and older children (8-12 years) with ADHD, as reported in these six acute treatment trials. METHODS: Data from six clinical trials of 6-9 weeks duration were pooled, yielding 280 subjects, ages 6-7 years, and 860 subjects, ages 8-12 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)-diagnosed ADHD. Efficacy was analyzed using the ADHD Rating Scale-IV (ADHD-RS), Conners' Parent Rating Scale-revised (CPRS-R:S), and the Clinical Global Impression of ADHD Severity (CGI-ADHD-S). RESULTS: Atomoxetine was superior to placebo in both age categories for mean (SD) change in ADHD-RS total, total T, and subscale scores; 3 CPRS-R:S subscales; and CGI-ADHD-S from baseline. Although there were no significant treatment differentials between the age groups for these efficacy measures, the age groups themselves, regardless of treatment, were significantly different for ADHD-RS total (younger: ATX = -14.2 [13.8], PBO = -4.6 [10.4]; older: ATX = -15.4 [13.2], PBO = -7.3 [12.0]; p = .001), total T (younger: ATX = -15.2 [14.8], PBO = -4.9 [11.2]; older: ATX = -16.4 [14.6], PBO = -7.9 [13.1]; p = .003), and subscale scores (Inattentive: younger: ATX = -7.2 [7.5], PBO = -2.4 [5.7]; older: ATX = -8.0 [7.4], PBO = -3.9 [6.7]; p = .043; Hyperactive/Impulsive: younger: ATX = -7.0 [7.2], PBO = -2.1 [5.4]; older: ATX = -7.3 [7.0], PBO = -3.4 [6.3]; p < .001), as well as the CGI-ADHD-S score (younger: ATX = -1.2 [1.3], PBO = -0.5 [0.9]; older: ATX = -1.4 [1.3], PBO = -0.7 [1.1]; p = .010). Although few subjects discontinued from either age group due to adverse events, a significant treatment-by-age-group interaction was observed for abdominal pain (younger: ATX = 19%, PBO = 6%; older: ATX = 15%, PBO = 13%; p = .044), vomiting (younger: ATX = 14%, PBO = 2%; older: ATX = 9%, PBO = 6%; p = .053), cough (younger: ATX = 10%, PBO = 6%; older: ATX = 3%, PBO = 9%; p = .007), and pyrexia (younger: ATX = 5%, PBO = 2%; older: ATX = 3%, PBO = 5%; p = .058). CONCLUSION: Atomoxetine is an effective and generally well-tolerated treatment of ADHD in both younger and older children as assessed by three recognized measures of symptoms in six controlled clinical trials. TRIAL REGISTRATION: Not Applicable.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/1753-2000-2-25

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Kaufman J Birmaher B Brent D Rao U Ryan N Kiddie-SADS-Present and Lifetime Version (K-SADS-PL), version 10 of October 1996 edn 1996 Pittsburgh, PA: University of Pittsburgh Press
  2. Kelsey D Sutton V Lewis DW Schuh K Sumner C Quintana H Morning-Versus Evening-Dosed Atomoxetine: Effects on Core ADHD Symptoms In Proceedings of the 158th Annual Meeting of the American Psychiatric Association: 21–26 May 2005; Atlanta

Cited by

Sorted by citations

Related

Authors
Kratochvil, C. J., Milton, D. R., Vaughan, B. S., & Greenhill, L. L.
Affiliations
  • Nebraska Medical Center (US)
  • Eli Lilly (United States) (US)
  • University of Nebraska Medical Center (US)
  • New York State Psychiatric Institute (US)
Corresponding author
Kratochvil, Christopher J
ORCID
Venue
Child and Adolescent Psychiatry and Mental Health
Publisher
Springer Science and Business Media LLC
Published
2008-09-15
Volume
2
Issue
1
Pages
25-25
ISSN
1753-2000 (ISSN-L)
DOI
10.1186/1753-2000-2-25
PMC
PMC2556311
OpenAlex
W1970632441
Cited by
64
References
22
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 9
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
Locations
  • Child and Adolescent Psychiatry and Mental Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DigitalCommons@UNMC (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Eli Lilly and Company
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
atomoxetine, attention deficit hyperactivity disorder, children with ADHD, age differences in treatment response, acute treatment, tolerability, efficacy, younger children, older children, ADHD Rating Scale-IV, Conners' Parent Rating Scale, stimulant medication, placebo response, adverse events, treatment discontinuation, hyperactivity/impulsivity, inattention

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review