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Atomoxetine Improves Broad Measures of Functioning in Attention Deficit/Hyperactivity Disorder: Presented at CPA

By Alison Palkhivala

MONTREAL, CANADA -- November 20, 2007 -- Atomoxetine (Strattera(R)), a relatively new drug for the treatment of attention deficit/hyperactivity disorder (ADHD), not only improves symptoms of ADHD but also helps improve measures of academic and executive functioning, according to study results presented the results here at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).

"All the other drugs for ADHD are stimulants," said presenter and coauthor Hubert White, MD, Child/Adolescent Psychiatrist, Janeway Children's Health and Rehabilitation Centre, St John's, Newfoundland, Canada. "This is a nonstimulant [that is] non addictive, with no potential for abuse."

"Atomoxetine hasn't been out very long, and there haven't been many long-term studies done on this," Dr. White said in an interview on November 16. "So, what we wanted to do was to see if, at 12 months, what would be the result of using this in children who had ADHD."

The investigators enrolled 105 children aged 8 to 11 years diagnosed with ADHD and enrolled in an open-label study in which they were treated with atomoxetine for up to 1 year. Overall, 72 patients completed 12 months of therapy.

Patients were tested on several measures of academic, cognitive, and functional ability once a month for the duration of the trial. These measures were the ADHD Rating Scale IV: Parent Inventory (ADHRS), Clinical Global Impression Severity Scale (CGI-S), Woodcock-Johnson Tests of Achievement (WJIII), Behavior Rating Inventory of Executive Function (BRIEF), Behavior Assessment System for Children (BASC), and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P).

"Every single month there were improvements," said Dr. White. The mean reduction in ADHRS from baseline to the end of the study was 21.8. CGI-S improved by a mean of 2.3. The WJIII total raw score improved by a mean of 37.6, and the standard score improved by a mean of 1.6.

"There was definitely academic improvement on the total scores at 1 year compared to baseline," said Dr. White. "So, the drug works for ADHD symptoms, and the drug works as far as improving academic symptoms for these kids."

BRIEF score improved by a mean of 30.4, and WFIRS-P by a mean of 0.42. These were all statistically significant improvements at P <.05. Ten of 12 scores on the BASC were also significantly improved.

"It was nice to see that [atomoxetine] was effective, and it was effective over the 12 months," said Dr. White. "One thing that we saw but did not expect to see was that it was effective even over the first month."

The drug was also reasonably well tolerated. "A lot of the kids lost weight in the first month, but then after the first month, it appeared that their appetite came back, and they regained the weight," said Dr. White. Other common side effects were headache, vomiting, nausea, upper abdominal pain, fatigue, and somnolence.

The study was conducted in collaboration with Eli Lilly, Canada, which manufactures Strattera.


[Presentation title: Change in ADHD Symptoms During One Year of Atomoxetine Treatment. Poster P13]

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