Atomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorder

Mark E. Bangs, Philip Hazell, Marina Danckaerts, Peter Hoare, David R. Coghill, Peter M. Wehmeier, David W. Williams, Rodney J. Moore, Louise Levine, Atomoxetine ADHD Odd Study Grp

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    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.

    Original languageEnglish
    Pages (from-to)E314-E320
    Number of pages7
    JournalPediatrics
    Volume121
    Issue number2
    DOIs
    Publication statusPublished - Feb 2008

    Keywords

    • ADHD
    • adolescents
    • atomoxetine
    • DEFICIT-HYPERACTIVITY DISORDER
    • CONDUCT PROBLEMS
    • MIDDLE CHILDHOOD
    • CHILDREN
    • COVARIATION
    • COMORBIDITY
    • SYMPTOMS
    • ODD/CD
    • AD/HD

    Cite this

    Bangs, M. E., Hazell, P., Danckaerts, M., Hoare, P., Coghill, D. R., Wehmeier, P. M., Williams, D. W., Moore, R. J., Levine, L., & Atomoxetine ADHD Odd Study Grp (2008). Atomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorder. Pediatrics, 121(2), E314-E320. https://doi.org/10.1542/peds.2006-1880