Atomoxetine for the Treatment of Attention-Deficit/Hyperactivity Disorder and Oppositional Defiant Disorder
Abstract
OBJECTIVE. In this study we examined the effectiveness of atomoxetine for the treatment of oppositional defiant disorder comorbid with attention-deficit/hyperactivity disorder. METHODS. Patients were aged 6 to 12 years and met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for attention-deficit/hyperactivity disorder with a Swanson, Nolan, and Pelham Rating Scale-Revised attention-deficit/hyperactivity disorder subscale score above age and gender norms; Clinical Global Impressions-Severity Scale score of ≥4; and Swanson, Nolan, and Pelham Rating Scale-Revised oppositional defiant disorder subscale score of ≥15. Patients were randomly assigned in a 2:1 ratio to receive 1.2 mg/kg per day of atomoxetine (n = 156) or placebo (n = 70) for 8 weeks. Treatment effect on oppositional defiant disorder and attention-deficit/hyperactivity disorder symptoms was measured by using the investigator-rated Swanson, Nolan, and Pelham Rating Scale-Revised. RESULTS. Repeated-measures analysis demonstrated a statistically significant difference favoring atomoxetine over placebo in the reduction of Swanson, Nolan, and Pelham Rating Scale-Revised oppositional defiant disorder total scores. There were significant pairwise treatment differences at weeks 2 and 5 but not at week 8 postbaseline. A last-observation-carried-forward analysis showed Swanson, Nolan, and Pelham Rating Scale-Revised scores at endpoint for the atomoxetine and placebo groups were significantly different for attention-deficit/hyperactivity disorder symptoms but not for oppositional defiant disorder symptoms. Atomoxetine was superior to placebo in a last-observation-carried-forward analysis of Clinical Global Impression-Improvement and Clinical Global Impression-Severity scores. CONCLUSIONS. This study confirms previous findings that patients with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder show statistically and clinically significant improvement in attention-deficit/hyperactivity disorder symptoms and global clinical functioning when treated with atomoxetine. It remains uncertain, however, whether atomoxetine exerts a specific and enduring effect on oppositional defiant disorder symptoms.
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Atomoxetine may not be as effective in patients with comorbid oppositional defiant disorder (ODD).
“Atomoxetine may not be as effective in patients with comorbid oppositional defiant disorder (ODD) [41].”
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- Authors
- Bangs, M. E., Hazell, P., Danckaerts, M., Hoare, P., Coghill, D. R., Wehmeier, P. M., Williams, D. W., Moore, R. J., Levine, L., & for the Atomoxetine ADHD/ODD Study Group
- Affiliations
- Eli Lilly (United States) (US)
- University of Newcastle Australia (AU)
- Universitair Ziekenhuis Leuven (BE)
- University of Edinburgh (GB)
- University of Dundee (GB)
- Eli Lilly (Germany) (DE)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2008-02-01
- Volume
- 121
- Issue
- 2
- Pages
- e314-e320
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2108685959
- Cited by
- 79
- References
- 25
- Citations by year
- 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2018: 1 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 6 · 2012: 5
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- atomoxetine, attention deficit hyperactivity disorder, oppositional defiant disorder, comorbidities, children with ADHD, stimulant medication, Clinical Global Impression Scale
- MeSH terms
- Atomoxetine Hydrochloride, Attention Deficit Disorder with Hyperactivity, Child, Double-Blind Method, Female, Humans, Male, Propylamines, Multivariate Analysis, Treatment Outcome, Adrenergic Uptake Inhibitors, Attention Deficit and Disruptive Behavior Disorders
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