Atomoxetine Treatment for Pediatric Patients With Attention-Deficit/Hyperactivity Disorder With Comorbid Anxiety Disorder

Geller, Daniel; Donnelly, Craig L.; López, Frank A.; Rubin, Richard L.; Newcorn, Jeffrey H.; Sutton, Virginia K.; Bakken, Rosalie; Paczkowski, Martin; Kelsey, Douglas K.; Sumner, Calvin R.

doi:10.1097/chi.0b013e3180ca8385

Cited by 178 publications

(129 citation statements)

References 37 publications

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“…So far, the highest reported ES in any published atomoxetine trial has been achieved in a study population with ADHD and comorbid anxiety disorders (ES of 1.0) [38]. The prevalence of anxiety syndromes (except for simple phobias) was as high as 34% in the MTA study [29].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder

Svanborg

Thernlund

Gustafsson³

et al. 2009

Eur Child Adolesc Psychiatry

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder

Svanborg

Thernlund

Gustafsson³

et al. 2009

Eur Child Adolesc Psychiatry

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“…In clinical studies, reboxetine and atomoxetine were effective in the treatment of panic disorder and comorbid anxiety disorder, respectively (Versiani et al, 2002;Geller et al, 2007), suggesting their anxiolytic properties. Although their therapeutic effects are generally thought to be primarily attributable to inhibition of norepinephrine reuptake in the brain (Hajós et al, 2004;Simpson and Plosker, 2004), inhibition of GIRK channels may also contribute to improvement of anxiety symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Their clinical efficacy is hypothesized to be linked mainly with potent inhibition of presynaptic norepinephrine transporters (Wong et al, 2000;Hajós et al, 2004;Simpson and Plosker, 2004). Furthermore, recent studies have suggested that the drugs are potentially useful for the treatment of several other psychiatric conditions, including anxiety disorders, eating disorders, substance use disorders, and narcolepsy (Kadhe et al, 2003;Hajós et al, 2004;Szerman et al, 2005;McElroy et al, 2007;Geller et al, 2007;Wilens et al, 2008). However, the molecular mechanisms underlying the various effects of NRIs have not yet been sufficiently clarified.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of G-Protein-Activated Inwardly Rectifying K+ Channels by the Selective Norepinephrine Reuptake Inhibitors Atomoxetine and Reboxetine

Kobayashi

Washiyama

Ikeda

2010

Neuropsychopharmacol

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Atomoxetine and reboxetine are commonly used as selective norepinephrine reuptake inhibitors (NRIs) for the treatment of attentiondeficit/hyperactivity disorder and depression, respectively. Furthermore, recent studies have suggested that NRIs may be useful for the treatment of several other psychiatric disorders. However, the molecular mechanisms underlying the various effects of NRIs have not yet been sufficiently clarified. G-protein-activated inwardly rectifying K + (GIRK or Kir3) channels have an important function in regulating neuronal excitability and heart rate, and GIRK channel modulation has been suggested to be a potential treatment for several neuropsychiatric disorders and cardiac arrhythmias. In this study, we investigated the effects of atomoxetine and reboxetine on GIRK channels using the Xenopus oocyte expression assay. In oocytes injected with mRNA for GIRK1/GIRK2, GIRK2, or GIRK1/GIRK4 subunits, extracellular application of atomoxetine or reboxetine reversibly reduced GIRK currents. The inhibitory effects were concentrationdependent, but voltage-independent, and time-independent during each voltage pulse. However, Kir1.1 and Kir2.1 channels were insensitive to atomoxetine and reboxetine. Atomoxetine and reboxetine also inhibited GIRK currents induced by activation of cloned A 1 adenosine receptors or by intracellularly applied GTPgS, a nonhydrolyzable GTP analogue. Furthermore, the GIRK currents induced by ethanol were concentration-dependently inhibited by extracellularly applied atomoxetine but not by intracellularly applied atomoxetine. The present results suggest that atomoxetine and reboxetine inhibit brain-and cardiac-type GIRK channels, revealing a novel characteristic of clinically used NRIs. GIRK channel inhibition may contribute to some of the therapeutic effects of NRIs and adverse side effects related to nervous system and heart function.

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“…Although methylphenidate initially might have been a reasonable treatment choice for the patient's ADHD symptoms, atomoxetine was selected because of the concurrent nature of his anxiety symptoms. Atomoxetine is an effective treatment option for both ADHD and anxiety symptoms when anxiety disorders interact with ADHD [7]. There is a growing view that pharmacotherapy in children with ADHD reduces the risk of unintentional injuries, and recent studies have supported this view [11,12].…”

Section: Tarda Bmentioning

confidence: 82%

“…Based on physical and mental examination via psychometric assessment scales and DSM-5 diagnostic criteria, he was diagnosed with ADHD and Generalized Anxiety Disorder [6]. Atomoxetine was selected for medical treatment since the patient expressed a combination of anxiety and ADHD symptoms [7]. The drug was initially administered at a dose of 0.5 mg/kg/day and titrated to 1 mg/kg/day a week later.…”

Section: Case Reportmentioning

confidence: 99%

Osteogenesis imperfecta and attention deficit hyperactivity disorder: A rare combination

Karayağmurlu¹,

Karayağmurlu²,

Gökçen³

2017

Med-Science

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Osteogenesis Imperfecta (OI) is a rare, autosomally inherited disorder of the connective tissue matrix that is characterized by bone fractures, deafness, and blue sclera. The impairment of Type 1 collagen production causes frequent fractures and increased bone fragility as well as reduced bone mass. Attention Deficit Hyperactivity Disorder (ADHD) is a chronic neurobehavioral disorder developed during childhood that is characterized by inattention, hyperactivity, impulsivity and, consequently, high risk for unintentional injury. This study will examine the case of a 6-year-old male admitted to the researchers' clinic who has been diagnosed with OI and ADHD and has experienced reccurent traumatic injury. While in the clinic, the patient also expressed symptoms of anxiety such as insomnia, restlessness and irritability. This case has beenpresented since associations of both d,sorder is rare. Aside from the fact that these disorders are injury-related and, thus, require additional attention by clinicians, the simultaneous nature of these diseases is also important in that their interaction may provide opportunity for early diagnosis and necessary intervention.

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Atomoxetine Treatment for Pediatric Patients With Attention-Deficit/Hyperactivity Disorder With Comorbid Anxiety Disorder

Cited by 178 publications

References 37 publications

Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder

Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder

Inhibition of G-Protein-Activated Inwardly Rectifying K+ Channels by the Selective Norepinephrine Reuptake Inhibitors Atomoxetine and Reboxetine

Osteogenesis imperfecta and attention deficit hyperactivity disorder: A rare combination

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