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Atomoxetine Improves Both Symptoms and Neuropsychological Functioning in Attention Deficit/Hyperactivity Disorder: Presented at CPA

By Alison Palkhivala

MONTREAL, CANADA -- November 21, 2007 -- The new, nonstimulant drug atomoxetine appears to improve not only symptoms of attention deficit/hyperactivity disorder (ADHD) but also measures of neuropsychological and executive functioning, according to a small study presented here at the 57th Annual Conference of the Canadian Psychiatric Association (CPA).

Atomoxetine is already known to produce clinical improvements in children with ADHD, said lead author Michel Maziade, MD, Director, Neuroscience and Mental Health Research Centre, Laval University, Quebec, Canada.

"I had [also] observed that there was a big improvement in [some aspects of] neuropsychological functioning, like memory, executive functions, and language," Dr. Maziade said.

His research team therefore conducted their study to determine whether atomoxetine has an effect on neuropsychological functioning using a direct neuropsychological battery of tests.

Dr. Maziade and colleagues conducted a 6-month followup study in which 21 children aged 6 to 11.5 years and diagnosed with ADHD received atomoxetine. The children were repeatedly rated using the following neuropsychological scales: The NEPSY Developmental Neuropsychological Assessment; ADHD Rating Scale IV (ADHRS) parent and teacher versions; Clinical Global Impression Severity (CGI-S) scale; Behaviour Rating Inventory of Executive Function (BRIEF) parent and teacher versions; Behaviour Assessment System for Children (BASC); Weiss Functional Impairment Rating Scale-Parent (WFIRS-P) report; and the Test of Everyday Attention (TEA-Ch).

The control group consisted of children without ADHD who also underwent testing but did not receive any treatment. Dr. Maziade presented the results in a poster session on November 16.

Overall, 16 of children with ADHD and all 20 of the control children completed the study. ADHD symptoms, as assessed by parents and teachers, began to diminish in children with ADHD within 1 month of starting atomoxetine and continued to diminish throughout the 6 months of the treatment.

Scores on the memory and learning components of the NEPSY questionnaire improved significantly among children with ADHD from baseline to the end of the study. Among control children, NEPSY scores in the Language domain improved significantly from baseline.

In the WFIRS-P report, overall score and scores on the "family", "learning in school", "life skills", and "child self concept" domains all improved significantly from baseline to 6 months in children with ADHD. Parents' reports using BREIF also improved significantly in ADHD children for all items from baseline at the 6 months evaluation. Teachers' ratings, however, were only significantly improved for the item "organization of materials".

"Although caution is warranted in interpreting the results of this small sample size pilot study, the data suggest that improvement after 6 months of atomoxetine treatment involves not only reduction in core ADHD symptoms, but also changes in neuropsychological, executive, and functional outcomes," the authors noted.

"Now, we are looking at the correlation between the improvement in neuropsychological functioning and improvement in [ADHD] symptoms," said Dr. Maziade.

This study conducted in collaboration with Eli Lilly Canada, Inc. Eli Lilly manufactures atomoxetine under the trade name Strattera(R).


[Presentation title: Neuropsychological Functioning in Atomoxetine-Treated Children With Attention Deficit/Hyperactivity Disorder. Poster P11]

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