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Atomoxetine Improves Multiple Symptoms in ADHD With Comorbid Anxiety: Presented at AACAP

By Paula Moyer

SAN DIEGO, CA -- November 2, 2006 -- Patients with attention deficit/hyperactivity disorder (ADHD) and comorbid anxiety get some relief from both conditions when they are treated with atomoxetine (Strattera), according to investigators speaking here at the 53^rd annual meeting of the American Academy of Child and Adolescent Psychiatry (AACAP).

"Atomoxetine was efficacious in treating ADHD symptoms in children and adolescents with these 2 conditions," said principal investigator Daniel Geller, MBBS, researcher, pediatric psychopharmacology research program, Massachusetts General Hospital, Cambridge, Massachusetts. "It did not exacerbate comorbid anxiety."

Dr. Geller and his co-investigators conducted the study because of their concern that 25% to 50% of patients with ADHD have comorbid anxiety disorders, Dr. Geller said in a presentation on October 26^th. Therefore, they conducted a study involving 176 patients with ADHD who also had comorbid anxiety.

Patients were randomized to receive either atomoxetine or placebo for 12 weeks; for patients on active treatment, the targeted dose was 1.2 mg/kg/day, with increases up to 1.8 mg/kg/day in patients who did not respond to the targeted treatment.

The treatment measures were the Multidimensional Anxiety Scale for Children (MASC), the Life Participation Scale for ADHD-Revised (LPS-ADHD-R), the Child Health Questionnaire-Parent Completed Full Length (CHQ-PF50), and the Clinical Global Impression-Severity scale (CGI-S).

Among the original patients, 132 completed the study, 66 in each group. Treated patients had a significantly greater improvement on the MASC, a decrease of 4.6 points, compared with those on placebo, who had a decrease of 2.1 points (P = .009). Similarly, on the LPS-ADHD-R, treated patients had an increase of 9.5 points and those on placebo has an increase of 3.1 points (P = .002). Treated patients also had significantly greater improvements on the CHQ-PF50 Psychosocial subscale, an increase of 6.9 points compared with an increase of 3.3 points in the placebo group (P = .019). And on the CGI-S, treated patients had a decrease of 0.9 points and those on placebo had a decrease of 0.4 points (P = .002).

Decreased appetite was the only adverse effect experienced by significantly more by treated patients than those on placebo, which occurred in 14.3% of treated patients and in 3.8% of those on placebo (P = .025).

"The results provide evidence of the effect of atomoxetine in treating anxiety symptoms in this population," the investigators reported. "Patient-reported improvements in anxiety symptoms were consistent with investigator-reported improvements in children with ADHD and comorbid anxiety."

The study was funded by Eli Lilly and Company, which manufactures Strattera.


[Presentation title: Atomoxetine Treatment for Pediatric Patients With ADHD and Comorbid Anxiety. Abstract C9]

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