Atomoxetine Alone or Combined With Fluoxetine for Treating ADHD With Comorbid Depressive or Anxiety Symptoms - 21/08/11
, Jeffrey H. Newcorn, M.D., L. Eugene Arnold, M.D., David Duesenberg, M.D., Graham J. Emslie, M.D., Humberto Quintana, M.D., Elias H. Sarkis, M.D., Karen Dineen Wagner, M.D., Ph.D., Haitao Gao, Ph.D., David Michelson, M.D., Joseph Biederman, M.D.ABSTRACT |
Objective |
Symptoms of depression and anxiety are commonly comorbid with attention-deficit/hyperactivity disorder (ADHD). The authors assessed the safety and effectiveness of atomoxetine monotherapy compared with combined atomoxetine/fluoxetine therapy in a population of children and adolescents with ADHD and concurrent symptoms of depression or anxiety.
Method |
Patients were randomized to treatment with fluoxetine (n = 127) or placebo (n = 46) under double-blind conditions for 8 weeks, with concomitant atomoxetine use the last 5 weeks.
Results |
At end point, reductions in ADHD, depressive, and anxiety symptoms were marked for both treatment groups (p < .001 for the relevant scale in each symptom cluster). Some differences between treatment groups for depressive symptoms were significant, but the magnitudes of the differences were small and likely of limited clinical importance. Completion rates for the two groups were similar, as were discontinuation rates for adverse events. The combination group had greater increases in blood pressure and pulse than did the monotherapy group.
Conclusions |
In pediatric patients with ADHD and comorbid symptoms of depression or anxiety, atomoxetine monotherapy appears to be effective for treating ADHD. Anxiety and depressive symptoms also improved, but the absence of a placebo-only arm does not allow us to conclude that these effects are specifically the result of treatment with atomoxetine. Combined atomoxetine/fluoxetine therapy was well tolerated.
Le texte complet de cet article est disponible en PDF.Key Words : attention-deficit/hyperactivity disorder, anxiety, depression, atomoxetine
Plan
| Disclosure: Dr. Kratochvil is a recipient of grants for research support from Eli Lilly, GlaxoSmithKline, Cephalon, and McNeil; a consultant for Eli Lilly, Organon, AstraZeneca, and Pfizer; and on the speaker’s bureau of Eli Lilly. Dr. Newcorn is a recipient of grants for research support from Eli Lilly, McNeil, and Shire; a consultant for Eli Lilly and Novartis; a member of the advisory boards of Eli Lilly, McNeil, Novartis, and Shire; and on the speaker’s bureaus of Eli Lilly, McNeil, Novartis, Bristol-Myers Squibb, UCB, Cephalon, and Sanofi-Aventis. Dr. Arnold is a recipient of grants for research support from Eli Lilly, Shire, Noven Pharmaceuticals, Targacept, Sigma-Tau Research, and Novartis; a consultant for Noven, Shire, and Sigma-Tau Research; on the speaker’s bureaus of McNeil, Novartis, and Shire; and on the Expert Advisory Board of Shire. Dr. Duesenberg is a recipient of grants for research support from Eli Lilly, Johnson & Johnson, Abbott, Bristol-Myers Squibb, Shire, and Organon; a consultant for and on the speaker’s bureaus of Eli Lilly and Shire. Dr. Emslie is a recipient of grants for research support from Eli Lilly and Organon; a consultant for Eli Lilly, GlaxoSmithKline, Forest Laboratories, Pfizer, and Wyeth-Ayerst; and on the speaker’s bureau of McNeil. Dr. Quintana is a recipient of grants for research support from Eli Lilly, Pfizer, Abbott, Janssen-Otsaki, and AstraZeneca and a consultant for Osler Institute and Lexicor Medical Technology. Dr. Sarkis is a recipient of grants for research support from Cephalon, Eli Lilly, GlaxoSmithKline, Organon, Jansen, Targacept, Abbott, and Shire; a speaker for Eli Lilly, Forest, McNeil, Shire, Cephalon, Janssen, Novartis, and GlaxoSmithKline; and a consultant for Eli Lilly and Novartis. Dr. Wagner is a recipient of grants for research support from Abbott, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Johnson & Johnson, Organon, Pfizer, and the NIMH, and a consultant for Abbott, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Laboratories, GlaxoSmithKline, Janssen, Jazz Pharmaceuticals, Novartis, Ortho-McNeil, Otskua, Pfizer, UCB Pharma, Wyeth-Ayerst, and the NIMH Advisory Council. Drs. Gao and Michelson are employees and shareholders of Eli Lilly. Dr. Biederman is a recipient of grants for research support from Shire, Eli Lilly, Pfizer, Cephalon, Janssen, Neurosearch, Stanley Medical Institute, Lilly Foundation, Prechter Foundation, McNeil, Abbott, Bristol-Myers Squibb, and New River Pharmaceutics; on the speaker’s bureaus of Eli Lilly, Pfizer, Novartis, Wyeth Ayerst, Shire, McNeil, and Cephalon; and a member of the advisory boards of Eli Lilly, CellTech, Shire, Novartis, Noven, McNeil, Janssen, Johnson & Johnson, Pfizer, Cephalon, New River Pharmaceuticals, and Sanofi-Synthelabo. Research funded by Eli Lilly and Company. The authors acknowledge Drs. J. Aranda, L. Beckett, J. Busner, J. Ferguson, C. Foley, S. Hatti, S. Hoopes, R. Lipetz, P. Londborg, R. Ricardi, M. Rosenthal, A. Sood, C. Thomason, K. Toups, R. Moore, P. Nash, K. Baker, and Ms. E. Agostinelli for their contributions |
Vol 44 - N° 9
P. 915-924 - septembre 2005 Retour au numéro
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