THERAPEUTIC RESULTS OF ATOMOXETINE IN DUTCH ADHD CHILDREN NONRESPONDING TO STIMULANTS

Objectives: To describe the therapeutic results of treatment with atomoxetine in 19 ADHD children aged 6–15yrs (2 girls and 17 boys), who were nonresponders to stimulants (methylphenidate).

Methods: The study is an open label semistructured case series. The ADHD-Rating Scale IV (parent version) was used to ascertain the ADHD symptomatology before start atomoxetine and after 4 and 8 weeks treatment. Atomoxetine was given in a dosage of±0.5 mgr/kg once daily in the first week of treatment and thereafter±1.2 mgr/kg (recommended dosage).

Results: The mean ADHD-RS IV score before start atomoxetine was 36.9 (SD 9.8). After 4 weeks in 42% of the children a good improvement (=25% reduction of symptoms) was seen and after 8 weeks this was 58%; a moderate reduction (10–25%) of symptoms was seen in 16%, resp. 21%. Side effects of atomoxetine were noted in 11 of the 19 children. In all cases these side-effects wre but temporary and disappeared within 4 weeks after starting atomoxetine. In 9 of the 19 children Oppositional Defiant Disorder (ODD) was diagnosed (SNAP-IV score/parent version) as comorbidity; 4 of these 9 children responded well on atomoxetine and showed also reduction (=25%) of ODD symptomatology.

Conclusion: Atomoxetine appeared to be effective in reducing ADHD symptoms in children nonresponding to stimulants. This applies for the comorbid ODD symptomatology as well. Side-effects were not serious and were temporary within 4 weeks after starting atomoxetine.