Neuropediatrics 2006; 37 - TP111
DOI: 10.1055/s-2006-945705

ATOMOXETINE TREATMENT OF ADHD IN CHILDREN WITH COMORBID TOURETTE SYNDROME

T Spencer 1, FR Sallee 2, D Dunn 3, J McCracken 4, B Coffey 5, C Budman 6, R Ricardi 7, H Leonard 8, AJ Allen 9, D Gilbert 2, D Geller 10, S Linder 11, D Lewis 12, P Winner 13, R Kurlan 14, M Mintz 15, D Milton 9, P Feldman 9, D Kelsey 9
  • 1Massachusetts General Hospital, Boston, MA, United States
  • 2Cincinnati Children's Hospital, Cincinnati, OH, United States
  • 3Indiana University School of Medicine, Indianapolis, IN, United States
  • 4Neuropsychiatric Institute, Los Angeles, CA, United States
  • 5New York University Child Study Center, New York, NY, United States
  • 6 North Shore University Hospital, Long Island Jewish Health System, Manhasset, NY, United States
  • 7 Arizona Family Resource and Counseling Center, Phoenix, AZ, United States
  • 8 Rhode Island Hospital, Brown University, Providence, RI, United States
  • 9 Lilly Research Laboratories, Indianapolis, IN, United States
  • 10 McLean Hospital/Harvard Medical School, Belmont, MA, United States
  • 11 Dallas Pediatric Neurology Associates, Dallas, TX, United States
  • 12 Monarch Research Associates, Norfolk, VA, United States
  • 13 Premiere Research Institute, Palm Beach Neurology, West Palm Beach, FL, United States
  • 14 University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
  • 15 Bancroft NeuroHealth, Cherry Hill, NJ, United States

Objectives: This analysis examines changes in the severity of tics and symptoms of attention-deficit/hyperactivity disorder (ADHD) in patients with Tourette syndrome (TS) during treatment with atomoxetine.

Methods: Patients were 7–17 years old and met full criteria for both DSMIV ADHD and concurrent TS. They were randomly assigned to double-blind treatment with placebo (n=56) or atomoxetine (0.5–1.5mg/kg/day, n=61) for approximately 18 weeks.

Results: Relative to placebo, atomoxetine treatment was associated with significantly greater reduction of tic severity from baseline to endpoint, as measured by the Yale Global Tic Severity Scale total score and Clinical Global Impressions (CGI) severity of tic/neurological symptoms score but not the Tic Symptom Self-Report total score. Atomoxetine also produced significantly greater improvement on the ADHD Rating Scale total and subscale scores and CGI overall severity score but was associated with increased pulse rate, decreased body weight, and significantly higher rates of decreased appetite and nausea. No other clinically relevant treatment differences were seen in any other vital sign, adverse event, laboratory parameter, or electrocardiographic measure.

Conclusion: Use of atomoxetine appears safe and well tolerated in ADHD patients with comorbid TS. It does not seem to exacerbate tic symptoms, and may in fact decrease their severity.