Atomoxetine therapy for children and adolescents with attention deficit hyperactivity disorder
Introduction: Atomoxetine is a specific noradrenergic reuptake inhibitor that has just been approved for the treatment of attention deficit hyperactivity disorder (ADHD) in children (6 years of age and older), adolescents, and adults. Up until now, stimulants have been the only approved medications for ADHD, although a variety of non-stimulant medications have been studied. This is the first non-stimulant to receive an indication for ADHD, and the first medication of any kind to be labeled for the treatment of ADHD in adults. Atomoxetine is metabolized by the cytochrome P450 2D6 pathway. Ninety percent to 95% of individuals are extensive metabolizers, and, in these individuals, the half-life is approximately 4 to 5 hours. However, results of initial studies using twice-daily dosing suggested that effects persist longer than the halflife would indicate, which raises the question of whether once-daily dosing would be feasible. This review will discuss the two main publications in children and adolescents, the data from which formed the basis for this medication’s approval. The first study was a dose-ranging study examining three different doses of atomoxetine administered twice daily versus placebo. The second was a study of atomoxetine administered once daily versus placebo.