A double-blind, placebo-controlled study of atomoxetine in young children with ADHD

Christopher J Kratochvil, Brigette S. Vaughan, Julie A. Stoner, Joan M. Daughton, Brian D. Lubberstedt, Desiree W. Murray, Allan K. Chrisman, Melissa A. Faircloth, Nilda B. Itchon-Ramos, Scott H. Kollins, Lawrence A. Maayan, Laurence L. Greenhill, Lisa A. Kotler, Jane Fried, John S. March

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Abstract

OBJECTIVE: To evaluate the efficacy and tolerability of atomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in 5-and 6-year-old children. METHODS: This was an 8-week, double-blind, placebo-controlled randomized clinical trial of atomoxetine in 101 children with ADHD. Atomoxetine or placebo was flexibly titrated to a maximum dose of 1.8 mg/kg per day. The pharmacotherapist reviewed psychoeducational material on ADHD and behavioral-management strategies with parents during each study visit. RESULTS: Significant mean decreases in parent (P = .009) and teacher (P = .02) ADHD-IV Rating Scale scores were demonstrated with atomoxetine compared with placebo. A total of 40% of children treated with atomoxetine met response criteria (Clinical Global Impression-Improvement Scale indicating much or very much improved) compared with 22% of children on placebo, which was not significant (P=.1). Decreased appetite, gastrointestinal upset, and sedation were significantly more common with atomoxetine than placebo. Although some children demonstrated a robust response to atomoxetine, for others the response was more attenuated. Sixty-two percent of subjects who received atomoxetine were moderately, markedly, or severely ill according to the Clinical Global Impression-Severity Scale at study completion. CONCLUSIONS: To our knowledge, this is the first randomized controlled trial of atomoxetine in children as young as 5 years. Atomoxetine generally was well tolerated and reduced core ADHD symptoms in the children on the basis of parent and teacher reports. Reductions in the ADHD-IV Rating Scale scores, however, did not necessarily translate to overall clinical and functional improvement, as demonstrated on the Clinical Global Impression-Severity Scale and the Clinical Global Impression-Improvement Scale. Despite benefits, the children in the atomoxetine group remained, on average, significantly impaired at the end of the study.

Original languageEnglish (US)
Pages (from-to)e862-e868
JournalPediatrics
Volume127
Issue number4
DOIs
Publication statusPublished - Apr 1 2011

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Keywords

  • ADHD
  • Atomoxetine
  • Child
  • Pharmacotherapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Kratochvil, C. J., Vaughan, B. S., Stoner, J. A., Daughton, J. M., Lubberstedt, B. D., Murray, D. W., ... March, J. S. (2011). A double-blind, placebo-controlled study of atomoxetine in young children with ADHD. Pediatrics, 127(4), e862-e868. https://doi.org/10.1542/peds.2010-0825