Long-Term, Open-Label Study of the Safety and Efficacy of Atomoxetine in Adults With Attention-Deficit/Hyperactivity Disorder

Adler, Lenard A.; Spencer, Thomas; Milton, Denái R.; Moore, Rodney J.; Michelson, David

doi:10.4088/jcp.v66n0304

Cited by 145 publications

(49 citation statements)

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“…The NE reuptake inhibitors appear to decrease impulsivity (Wilens et al 1996;Mozes et al 2005;Adler et al 2005;Chamberlain et al 2007a;Evenden 1999;Robinson et al 2008b;Navarra et al 2008;Bari et al 2009), thereby opposing the hypothesis, but these drugs also boost PFC dopamine (Tanda et al 1994;Page and Lucki 2002;Bymaster et al 2002), which may be the factor that is activating PFC. The alpha2 agonist clonidine tends to decrease impulsivity (Leckman et al 1991;Pityaratstian 2005; Tourette's Syndrome Study Group 2002; Nair and Mahadevan 2009), which would be consistent with the NE/deactivation hypothesis as long as the principal effect of the drug is decreasing NE release (van Gaalen et al 1997) rather than increasing neurotransmission by agonizing postsynaptic alpha2 receptors.…”

Section: Impulsivity and Nementioning

confidence: 93%

“…In an open-label trial of reboxetine in children with hyperkinetic conduct disorder, there were decreases in associated symptoms such as impulsivity and aggressiveness (Mozes et al 2005). In a long-term open-label study of atomoxetine in adult ADHD, where subjects had been followed for up to 97 weeks, atomoxetine use was associated with reduction of symptoms (Adler et al 2005). In a double-blind, placebo-controlled study of adult ADHD, acute atomoxetine improved inhibitory control as measured by shorter stop-signal reaction times (Chamberlain et al 2007a).…”

Section: Impulsivity and Nementioning

confidence: 97%

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A neurochemical yin and yang: does serotonin activate and norepinephrine deactivate the prefrontal cortex?

Fitzgerald

2010

Psychopharmacology

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Section: Impulsivity and Nementioning

confidence: 93%

Section: Impulsivity and Nementioning

confidence: 97%

A neurochemical yin and yang: does serotonin activate and norepinephrine deactivate the prefrontal cortex?

Fitzgerald

2010

Psychopharmacology

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“…With a mean treatment length of 40 weeks, longer duration efficacy and safety data were added to the knowledge about ATX. 11 Until longer-term clinical trial data for ATX become available, examining emerging patterns of medication use may be informative for care of adult ADHD. Differences in treatment selection reflect not only marketing efforts but perceived medication successes and failures over time.…”

mentioning

confidence: 99%

Factors Associated With Initiation With Atomoxetine Versus Stimulants in the Treatment of Adults With ADHD: Retrospective Analysis of Administrative Claims Data

Brunt¹,

Johnston²,

Ye³

et al. 2006

JMCP

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ttention-deficit/hyperactivity disorder (ADHD) is characterized by problems regulating attention and controlling behavior across social settings.1 Though predominantly viewed as a childhood disorder, there is growing recognition that symptoms often persist into adulthood.2 While the etiology of ADHD remains a matter of debate, there is a wealth of literature as to its effects. Persons with ADHD experience academic and occupational underachievement relative to their peers, have impaired social relationships with higher rates of divorce, and have higher rates of traffic violations and accidents resulting in injury.3,4 Untreated ADHD in children is also associated with an increased risk for substance abuse problems later in life. 5Treatment options for ADHD include both behavioral and pharmacological therapies, with the latter more broadly applied and dominated by the use of psychostimulants. 6,7 In 2003, a nonstimulant therapy became widely available, offering another pharmacologic alternative to the stimulant (STIM) group. U.S. Food and Drug Administration (FDA) approval for adult use of atomoxetine (ATX, Strattera) was granted after 2 studies of 10 weeks duration, each of which showed improvements on the Conners Adult ADHD Rating Scales.7 ATX differs from STIMs both in the mechanism of action and in adverse effects. Like other nonstimulants used for ADHD such as tricyclic antidepressants and bupropion, 8 ATX can be safely used in patients with comorbid anxiety disorders, does not exacerbate tics, and lacks potential for abuse. 9New treatment choices create new challenges. Physicians must balance the risks and benefits of expanding treatment alternatives to optimally care for their patients. In the early days following the approval of a new medication, this task may be ABSTRACT OBJECTIVE: To determine which factors are associated with use of atomoxetine (ATX) relative to stimulant medications (STIMs) for treatment initiation in adults with attention-deficit/hyperactivity disorder (ADHD). A similar exploratory analysis of the use of ATX versus STIMs in children has been published previously.METHODS: This was an exploratory analysis using a retrospective observational cohort design applied to administrative pharmacy and medical claims from an integrated managed care database. Patients were identified if they had at least 1 administrative claim with a diagnosis for ADHD. Treatment "initiation" was defined as a new prescription for an ADHD medication preceded by 3 months without similar therapy. Two separate analyses were done, one comparing medication starts for ATX with those of any STIM, the other comparing starts of ATX with long-acting stimulants (LA-STIMs). Logistic regression analyses of prior-year administrative claims were used to compare the frequencies of differential predictors of the use of medication.RESULTS: There were 10,359 patients aged >18 years who initiated ATX or a STIM between April and December of 2003 and had at least 1 claim with a diagnosis for ADHD (International Classification of Diseases...

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“…Adding to the short-term data available on Strattera in adults with ADHD [22] is a long-term open-label study of subjects previously enrolled in one of two double-blind, acute-treatment studies [23]. The fi nal report of this 4-year study involving 384 adults with ADHD was recently published [24•].…”

Section: Fda-approved Medicationsmentioning

confidence: 98%

Update on adult attention-deficit/hyperactivity disorder

Hammerness¹,

Surman²,

Miller³

2008

Curr Neurol Neurosci Rep

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Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and highly morbid neurobehavioral disorder afflicting children, adolescents, and adults throughout the world. This article discusses the clinical assessment of adult ADHD, reviews the results of recent adult ADHD treatment studies with an emphasis on medications currently approved by the US Food and Drug Administration, and discusses the clinical management and monitoring of ADHD pharmacotherapy.

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Long-Term, Open-Label Study of the Safety and Efficacy of Atomoxetine in Adults With Attention-Deficit/Hyperactivity Disorder

Cited by 145 publications

References 0 publications

A neurochemical yin and yang: does serotonin activate and norepinephrine deactivate the prefrontal cortex?

A neurochemical yin and yang: does serotonin activate and norepinephrine deactivate the prefrontal cortex?

Factors Associated With Initiation With Atomoxetine Versus Stimulants in the Treatment of Adults With ADHD: Retrospective Analysis of Administrative Claims Data

Update on adult attention-deficit/hyperactivity disorder

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