Atomoxetine and Stimulant Medications in Children and Adolescents with Persistent Symptoms of Attention Deficit Hyperactivity Disorder despite Monotherapy

Abstract

A 10-year-old, 30-kg boy with attention deficit hyperactivity disorder (ADHD) is taking osmoticrelease oral system methylphenidate (Concerta) 36 mg once daily in the morning. Because his ADHD symptoms are only partially controlled with this monotherapy, several attempts have been made to increase the dose. However, each increase has resulted in intolerable gastrointestinal adverse effects. Today, his mother has dropped off a new prescription for atomoxetine 18 mg once daily for 2 weeks, to be followed by 25 mg once daily for an additional 2 weeks. The atomoxetine is to be added to the existing methylphenidate therapy. Is this a safe and effective drug combination? Are there any special precautions related to using this combination? How should the therapy be monitored?