Differences between children and adolescents in treatment response to atomoxetine and the correlation between health-related quality of life and Attention Deficit/Hyperactivity Disorder core symptoms: Meta-analysis of five atomoxetine trials
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OBJECTIVES: To explore the influence of age on treatment responses to atomoxetine and to assess the relationship between core symptoms of attention deficit/hyperactivity disorder (ADHD) and health-related quality of life (HR-QoL) outcomes. DATA SOURCES: Data from five similar clinical trials of atomoxetine in the treatment of children and adolescents with ADHD were included in this meta-analysis. STUDY SELECTION: Atomoxetine studies that used the ADHD Rating Scale (ADHD-RS) and the Child Health and Illness Profile Child Edition (CHIP-CE) as outcome measures were selected. INTERVENTIONS: Treatment with atomoxetine. MAIN OUTCOME MEASURES: Treatment group differences (atomoxetine vs placebo) in terms of total score, domains, and subdomains of the CHIP-CE were compared across age groups, and correlations between ADHD-RS scores and CHIP-CE scores were calculated by age. RESULTS: Data of 794 subjects (611 children, 183 adolescents) were pooled. At baseline, adolescents showed significantly (p < 0.05) greater impairment compared with children in the Family Involvement, Satisfaction with Self, and Academic Performance subdomains of the CHIP-CE. Treatment effect of atomoxetine was significant in both age groups for the Risk Avoidance domain and its subdomains. There was a significant age-treatment interaction with greater efficacy seen in adolescents in both the Risk Avoidance domain and the Threats to Achievement subdomain. Correlations between ADHD-RS and CHIP-CE scores were generally low at baseline and moderate in change from baseline and were overall similar in adolescents and children. CONCLUSIONS: Atomoxetine was effective in improving some aspects of HR-QoL in both age groups. Correlations between core symptoms of ADHD and HR-QoL were low to moderate.
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A meta-analysis of five clinical trials of atomoxetine showed large baseline impairments in QOL among adolescents with ADHD, particularly in self-esteem, family involvement, and academic achievement.
“A meta-analysis of five clinical trials (three randomized, double-blind, placebo-controlled trials; two open-label trials) of the nonstimulant medication atomoxetine (all treatment durations: 8–12 weeks) showed large baseline impairments in QOL among adolescents with ADHD when only placebo-controlled trials were assessed and when all trials were assessed (placebo-controlled+open-label); impairment”
From Participant-Perceived Quality of Life in a Long-Term, Open-Label Trial of Lisdexamfetamine Dimesylate in Adolescents with Attention-Deficit/Hyperactivity Disorder (2014) · cites this paper as Wehmeier et al. 2010
There is increasing recognition of the importance of evaluating the impact of therapy on QOL.
“There is increasing recognition of the importance of evaluating the impact of therapy on QOL (Spencer et al. 2008; Wehmeier et al. 2010)”
From Participant-Perceived Quality of Life in a Long-Term, Open-Label Trial of Lisdexamfetamine Dimesylate in Adolescents with Attention-Deficit/Hyperactivity Disorder (2014) · cites this paper as Wehmeier et al. 2010
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“methylphenidate, mixed amphetamine salts) or atomoxetine, which is a non-stimulant treatment option for ADHD [12], both in combination with behavioral therapy [13].”
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Schwartz, S., & Correll, C. U. (2014) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.11.005 · Cited by 166 · see citing works
Berek, M., Kordon, A., Hargarter, L., Mattejat, F., Slawik, L., Rettig, K., & Schäuble, B. (2011) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-5-26 · Cited by 15 · see citing works
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- Authors
- Wehmeier, P. M., Schacht, A., Escobar, R., Savill, N., & Harpin, V.
- Affiliations
- Eli Lilly (Germany) (DE)
- Eli Lilly (Spain) (ES)
- Eli Lilly (United Kingdom) (GB)
- Corresponding author
- Wehmeier, Peter M
- Venue
- Child and Adolescent Psychiatry and Mental Health
- Published
- 2010-12
- Volume
- 4
- Issue
- 1
- Pages
- 30-30
- ISSN
- 1753-2000 (ISSN-L)
- PMC
- PMC3012018
- OpenAlex
- W2098399548
- Cited by
- 21
- References
- 6
- Citations by year
- 2024: 1 · 2023: 1 · 2019: 1 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 5 · 2012: 2
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Child and Adolescent Psychiatry and Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- 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 › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- atomoxetine, attention deficit hyperactivity disorder, health-related quality of life, children, adolescents, age differences in treatment response, risk avoidance, academic performance
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