Atomoxetine<i>versus</i>Methylphenidate in Paediatric Outpatients with Attention Deficit Hyperactivity Disorder: A Randomized, Double-Blind Comparison Trial

Wang, Yufeng; Zheng, Yi; Du, Yasong; Song, Dong Ho; Shin, Young-jeon; Cho, Soo C.; Kim, Bung N.; Ahn, Dong Hyun; Márquez-Caraveo, María Elena; Gao, Haitao; Williams, David Wynne; Levine, Louise R.

doi:10.1080/00048670601057767

Cited by 73 publications

(85 citation statements)

References 33 publications

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“…The only non-stimulant approved by the FDA for the treatment of ADHD is atomoxetine, a selective norepinephrine reuptake inhibitor (SNRI) 12 . While similar efficacy in the treatment of ADHD has been reported with the non-stimulant atomoxetine compared to the stimulant methylphenidate, a meta-analysis revealed a greater effect size for stimulants compared to atomoxetine 17,18 . Thus it is implied that the athlete must first have undergone a potentially unsuccessful therapeutic trial with atomoxetine, which may have arguably inferior results, prior to initiating stimulants 14 .…”

Section: Introductionmentioning

confidence: 70%

“…Presently only ∼50% of all children with ADHD are receiving treatment consistent with the guidelines from the American Academy of Child and Adolescent Psychiatry 40 . What if the child were diagnosed with ADHD and initiated on successful stimulant treatment prior to initiating athletics, should the now athlete with ADHD be forced to change to a potentially less effective non-stimulant treatment with reportedly increased adverse effects 17,18 ? In essence, is it appropriate that relevant national or international Therapeutic Use Exemption Committees (TUECs) function as medical arbiters instead of the treating physician?…”

Section: Discussionmentioning

confidence: 99%

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Attention-deficit/hyperactivity disorder (ADHD) in gymnastics: preliminary findings

Kaufman

Bajaj

Schiltz

2011

Apunts. Medicina de l'Esport

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Background: Athletic performance without benefit from performance-enhancing substances is essential in amateur sports; yet, prohibiting specific medications creates discrimination against competitors with a medical illness. To avoid such inequalities, the World Anti-Doping Agency (WADA) adopted international standards for therapeutic use exemptions (TUE). Attentiondeficit/hyperactivity disorder (ADHD) treatment within the athletic population is a unique challenge. Stimulants, first-line treatment for ADHD, are prohibited unless alternative, nonprohibited medications have first been tried and found ineffective. The world prevalence of ADHD is 5.3%; however, there are no ADHD prevalence studies in sports. This paper addresses ADHD in a boys' gymnastics team, implications for further research with a proposed surveyquestionnaire to measure prevalence of ADHD with behavioral effects of gymnastics, and ethical considerations. Method: Preliminary ADHD prevalence in a boys' gymnastics team is presented with complementary literature review and a proposed survey-questionnaire to estimate actual ADHD prevalence in gymnastics populations with behavioral effects. Results: The parents of boys in a gymnastic reported that 5 of 7 (71.4%) boys were either diagnosed with ADHD in the past or had been treated with stimulant or non-stimulant medications for inattentive/hyperactive/impulsive behaviours. Parents described gymnastics as effective behavioral therapy in controlling/improving ADHD symptoms, with this effect extending into other environments (home/classroom). Only one parent was aware of WADA stimulant prohibition. Conclusions: A surprisingly large ADHD prevalence is reported in one boys' gymnastic team. Further research is required to verify this high ADHD prevalence and behavioral effects in gymnastics. A proposed survey-questionnaire to measure both ADHD prevalence and behavioral effects in gymnastics is presented. © 2010 Consell Català de l'Esport. Generalitat de Catalunya. Published by Elsevier España, S.L. All rights reserved. * Corresponding author. E-mail address: kaufmakr@umdnj.edu (K.R. Kaufman). Documento descargado de http://www.apunts.org el 29/06/2011. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. Trastorno de déficit de atención/hiperactividad (TDAH) en gimnasia: resultados preliminares Resumen:Antecedentes: En el deporte amateur es esencial alcanzar un rendimiento deportivo sin el beneficio de sustancias que lo mejoren. Sin embargo, la prohibición de determinados fármacos genera una discriminación a los competidores con determinadas enfermedades. Para evitar esas desigualdades, la Agencia Mundial Antidopaje (AMA) aprobó las normas internacionales para la autorización de uso terapéutico (AUT). El tratamiento del trastorno de déficit de atención e hiperactividad (TDAH) supone un desafío único en el deporte. Los estimulantes, el tratamiento de primera línea para el TDAH, están prohibidos a menos que haya medicamentos alternativos que hayan sido pre...

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Section: Introductionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Attention-deficit/hyperactivity disorder (ADHD) in gymnastics: preliminary findings

Kaufman

Bajaj

Schiltz

2011

Apunts. Medicina de l'Esport

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“…[9][10][11][12][13] Some of the randomized controlled comparison studies for efficacy and safety of these two agents found MPH was superior while some others did not find any difference between two agents. 9,10,12,14,15 The metaanalyses of those studies also show similar contradictions. [16][17][18][19] Therefore, there is still a need for the studies comparing MPH and ATX which are two agents frequently used in the treatment of ADHD.…”

mentioning

confidence: 72%

“…Insomnia, headache and compulsive behaviors were seen in OROS-MPH group, and sedation, stomachache, and nervousness were seen in ATX group; however the rates of the adverse effects seen in two groups did not show any statistically significant differences which is consistent with the literature. 15 One study reported that ATX and MPH had similar adverse effect profiles, the rates of the patients who had adverse effects were similar, and gastrointestinal side effects and sedation were more common with ATX. 15 Another study from Turkey noted that the most frequent adverse effects due to ATX were anorexia, nausea, nervousness and weight loss while OROS-MPH most frequently led to anorexia, nervousness, insomnia, and headache.…”

Section: Crs-t-hpmentioning

confidence: 99%

Atomoxetine Versus Oros Methylphenidate in Attention Deficit Hyperactivity Disorder: A Six-Month Follow Up Study for Efficacy and Adverse Effects

Çetin¹,

Torun²,

Taner³

2015

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Attention deficit hyperactivity disorder (ADHD) is one of the most frequently seen neuropsychiatric disorders in childhood. The aim of this study is to compare the efficacy and the adverse effects of two FDA-approved agents, atomoxetine (ATX) and osmotic release oral system methylphenidate (OROS-MPH), in the treatment of ADHD. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This research was designed as a randomized, open label, prospective and follow-up study. The study was performed by 120 cases between ages 7-16 years who were diagnosed as ADHD for the first time and given prescription. The cases were divided into two by randomization. One group was given ATX (n=59) while the other was given OROS-MPH (n=61) were evaluated prospectively by clinical examination and Conner's Comprehensive Behavior Rating Scale-Teacher (CRS-T) at the 2 nd , 4 th , and 6 th months. Efficacy of treatment was regarded as a 40% reduction in CRS-T scores when compared to baseline values, and the adverse effects were questioned in every follow up visit. R Re es su ul lt ts s: : The efficacy was 55.7% in CRS-T hyperactivity score, 63.9% in the attention deficit score, and 55.7% in the behavior problems score in OROS-MPH group. Those values were 47.5%, 69.5% and 57.6% respectively in ATX group. Adverse effects were seen in 27.1% (n=16) of the patients in the ATX group, and in 31.1% (n=19) of the patients in the OROS-MPH group. Two groups were not found significantly different for the frequency of adverse effects as well as the efficacy of the medication, at the follow-up evaluations which were performed at 2 nd , 4 th and 6 th months. C Co on nc cl lu us si io on n: : In this study, ATX and OROS-MPH were compared for their efficacy and adverse effects for the treatment of ADHD, and two agents were found similar for their efficacies and adverse effect profiles. ATX and OROS-MPH have similar efficacies in the treatment of ADHD and adverse effect profiles are similar. K Ke ey y W Wo or rd ds s: : Attention deficit disorder with hyperactivity; atomoxetine; methylphenidate; adverse effects; efficiency Ö ÖZ ZE ET T A Am ma aç ç: : Dikkat eksikliği hiperaktivite bozukluğu (DEHB), çocukluk çağında en sık görülen nörop-sikiyatrik hastalıklardan biridir. Bu çalışmada, DEHB tedavisinde kullanılan FDA onaylı iki ajan olan atomoksetin (ATX) ile osmotik salınımlı metilfenidat (OROS-MPH)'ın etkinlik ve yan etki profillerinin karşılaştırılması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu araştırma randomize, açık uçlu ve prospektif bir izlem çalışması olarak dizayn edildi. Çalışma, DEHB tanısı konulan ve ilk kez ilaç tedavisi başlanan, yaşları 7-16 yıl arasındaki 120 hasta ile yapıldı. Hastalar, randomizasyonla ikiye ayrıldı. ATX (n=59) ve OROS-MPH (n=61) kullanan hastalar 2., 4. ve 6.aylarda Conner's Öğretmen Derecelendirme Ölçeği (CÖDÖ) ve klinik muayene ile değerlendirildi. Başlangıca göre 6. ayda CÖDÖ puanlarında %40 azalma etkinlik olarak kabul edildi ve...

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“…The selective inhibitor of the NE transporter atomoxetine (tomoxetine or LY139603) has also been reported to alleviate ADHD symptoms [98] . All these medications have achieved much better therapeutic efficacy with less adverse effects [99] than MPH and amphetamines, although there is controversy regarding the long-term effectiveness [100,101] . …”

Section: N Ew Insights To Develop a Primate Model Of Adhdmentioning

confidence: 99%

Prefrontal cortical α2A-adrenoceptors and a possible primate model of attention deficit and hyperactivity disorder

Sun

Luo

et al. 2015

Neurosci. Bull.

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Attention deficit and hyperactivity disorder (ADHD), a prevalent syndrome in children worldwide, is characterized by impulsivity, inappropriate inattention, and/or hyperactivity. It seriously afflicts cognitive development in childhood, and may lead to chronic under-achievement, academic failure, problematic peer relationships, and low self-esteem. There are at least three challenges for the treatment of ADHD. First, the neurobiological bases of its symptoms are still not clear. Second, the commonly prescribed medications, most showing short-term therapeutic efficacy but with a high risk of serious side-effects, are mainly based on a dopamine mechanism. Third, more novel and effi cient animal models, especially in nonhuman primates, are required to accelerate the development of new medications. In this article, we review research progress in the related fi elds, focusing on our previous studies showing that blockade of prefrontal cortical α 2A -adrenoceptors in monkeys produces almost all the typical behavioral symptoms of ADHD.Keywords: prefrontal cortex; α 2A -adrenoceptors; cognitive functions; attention defi cit and hyperactivity disorder; animal models ·Review· IntroductionAttention deficit and hyperactivity disorder (ADHD) is one of the most prevalent childhood neurodevelopmental conditions, affecting 3-5% of grade-school children worldwide [1] . It is characterized by i nappropriate levels of inattention, i mpulsivity, and/or hyperactivity [2][3][4] . These symptoms develop in childhood, and can persist into adolescence and adulthood [5] . ADHD seriously affects cognitive development [6][7][8] , and, without appropriate treatment, has consequences for the risk of anxiety, substance abuse, and depression in adulthood [ 2, 5, 9] .T he neurobiological bases o f ADHD symptoms are still not clear [10] . Clarifying them can help better understand the biological vulnerabilities that may underlie ADHD in a specifi c patient and how to modulate the responses to treatment, thereby contributing to better and more effective therapy.It has been suggested that the symptoms involve a dopaminergic mechanism in the prefrontal cortex (PFC) and striatum [11, 12] . Experimentally decreased dopamine (DA) release in the PFC results in ADHD-like symptoms [13, 14] .To date, DA dysregulation is thought to be central to the neurobiology of ADHD, and its pharmacological treatment, such as m ethylphenidate (MPH, i.e. Ritalin) [15][16][17] , levels the DA c oncentration in the synapse and extrasynaptic space in the PFC as a blocker of the DA transporter. MPH ameliorates inappropriate inattention [18][19][20] , decreases impulsivity [21] , and enhances inhibitory control [22] . However, as MPH is a prescription psychostimulant, there are strong concerns over drug dependence, paranoia, schizophrenia, and behavioral sensitization that might be caused by longterm therapy, similar to other stimulants [23][24][25].Converging evidence indicates that the pathophysiology of ADHD has multiple origins [26][27][28][29][30][31][32] ; for i...

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AtomoxetineversusMethylphenidate in Paediatric Outpatients with Attention Deficit Hyperactivity Disorder: A Randomized, Double-Blind Comparison Trial

Abstract: This study suggests that atomoxetine is non-inferior to methylphenidate in the improvement of ADHD symptoms in paediatric outpatients. Although both of the drugs were well tolerated, atomoxetine was associated with a higher incidence of TEAEs than methylphenidate.

Cited by 73 publications

References 33 publications

Attention-deficit/hyperactivity disorder (ADHD) in gymnastics: preliminary findings

Attention-deficit/hyperactivity disorder (ADHD) in gymnastics: preliminary findings

Atomoxetine Versus Oros Methylphenidate in Attention Deficit Hyperactivity Disorder: A Six-Month Follow Up Study for Efficacy and Adverse Effects

Prefrontal cortical α2A-adrenoceptors and a possible primate model of attention deficit and hyperactivity disorder

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