Fluoxetine Monotherapy in Attention-Deficit/Hyperactivity Disorder and Comorbid Non-Bipolar Mood Disorders in Children and Adolescents

Abstract

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for developing comorbid non-bipolar mood disorders. Fluoxetine monotherapy is an established treatment for pediatric mood disorders; however its efficacy in ADHD and comorbid mood disorder is unknown. Therefore, we evaluated 30 children who met DSM-IV criteria for ADHD and comorbid non-bipolar mood disorders in a prospective, 6-12-week open-label, study of fluoxetine monotherapy. Fluoxetine was associated with significant decreases in the severity of depressive symptoms, and also, associated with significant decreases on subscales of inattention/overactivity and aggression/defiant symptoms-47% of participants were much or very much improved without observed adverse effects.

Disorder-dissociated effects of fluoxetine on brain function of working memory in attention deficit hyperactivity disorder and autism spectrum disorder

“…Based on evidence for decreased serotonin levels in ADHD (Barrickman et al 1991;Gammon & Brown, 1993;Quintana et al 2007), we hypothesized that increased serotonin levels under fluoxetine would increase frontal brain activation in ADHD, as observed previously in pharmaco-fMRI studies of verbal WM and serotonin agonists in healthy adults (Allen et al 2006;Rose et al 2006). Although there is some evidence for higher platelet levels of serotonin in ASD (Hranilovic et al 2007), the poor binding of serotonin to 5-HT receptors in the frontal lobe suggests that this may be ineffective at eliciting frontal activation (Murphy et al 2006;Nakamura et al 2010).…”

Chronic Fluoxetine Bidirectionally Modulates Potentiating Effects of Serotonin on the Hippocampal Mossy Fiber Synaptic Transmission

“…The robust effect of chronic fluoxetine on the open-field activity observed in the present study may be related to therapeutic effects of SSRIs on panic disorder with agoraphobia, although the lack of significant changes in the anxiety-related behaviors argues against this idea. It has been reported that SSRI can improve symptoms of attention-deficit hyperactivity disorder (ADHD) (Quintana et al, 2007). Polymorphisms of the 5-HT 4 receptor gene are associated with ADHD (Li et al, 2006).…”

Efficacy and safety of atomoxetine for attention-deficit/hyperactivity disorder in children and adolescents—meta-analysis and meta-regression analysis

“…Addition of fluoxetine to atomoxetine (compared to atomoxetine alone) was associated with greater reduction in ADHD-RS-IV inattentive symptoms (not total or hyperactivity/impulsive symptoms) but was only marginally significant (p=0.059; Kratochvil et al 2005). Fluoxetine alone reduced inattentive symptoms, but not hyperactive symptoms, in ADHD with comorbid depression (Quintana et al 2007). …”