Atomoxetine has been shown to be safe and effective in the treatment of attention-deficit/hyperactivity disorder (ADHD). The purpose of this post hoc analysis was to examine response trajectories of pediatric patients treated with atomoxetine. Data were pooled from 7 atomoxetine double-blind, placebo-controlled clinical trials conducted in pediatric patients between November 1998 and June 2004. Growth mixture modeling was applied to the investigator-rated ADHD rating scale (ADHDRS-Inv) and Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S) scores in the randomized acute phase (6-9 weeks) to explore whether there were groups of patients who differed in their response to atomoxetine. Classification and regression tree analyses were performed to identify predictors that can help categorize subjects to different response profiles. Patients (N = 925) were mostly male (73%) and of the combined subtype (74%). Most patients had a response pattern characterized by gradual, modest improvement, while a smaller group experienced early, robust improvement.
FaraoneSVBuitelaarJ. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur Child Adolesc Psychiatry. 2010;19:353-364.
2.
ArnoldLE. Methylphenidate vs. amphetamine: comparative review. J Attention Disord. 2000;3:200-211.
3.
KutcherSAmanMBrooksSJ. International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions. Eur Neuropsychopharmacol. 2004;14:11-28.
4.
PliszkaSRCrismonMLHughesCW. The Texas Children’s Medication Algorithm Project: revision of the algorithm for pharmacotherapy of attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2006;45:642-657.
5.
BiedermanJSpencerTWilensT. Evidence-based pharmacotherapy for attention-deficit hyperactivity disorder. Int J Neuropsychopharmacol. 2004;7:77-97.
6.
WeissMTannockRKratochvilC. A randomized, placebo-controlled study of once-daily atomoxetine in the school setting in children with ADHD. J Am Acad Child Adolesc Psychiatry. 2005;44:647-655.
7.
SpencerTHeiligensteinJHBiedermanJ. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyper-activity disorder. J Clin Psychiatry. 2002;63:1140-1147.
8.
MichelsonDFariesDWernickeJ; Atomoxetine ADHD Study Group. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics. 2001;108:E83.
9.
NewcornJHSuttonVKWeissMDSumnerCR. Clinical responses to atomoxetine in attention-deficit/hyper-activity disorder: the Integrated Data Exploratory Analysis (IDEA) study. J Am Acad Child Adolesc Psychiatry. 2009;48:511-518.
10.
SangalRBOwensJAllenAJSuttonVSchuhKKelseyD. Effects of atomoxetine and methylphenidate on sleep in children with ADHD. Sleep. 2006;29:1573-1585.
11.
SauerJMPonslerGDMattiuzEL. Disposition and metabolic fate of atomoxetine hydrochloride: the role of CYP2D6 in human disposition and metabolism. Drug Metab Dispos. 2003;31:98-107.
12.
BlockSLKelseyDCouryD. Once-daily atomoxetine for treating pediatric attention-deficit/hyperactivity disorder: comparison of morning and evening dosing. Clin Pediatr (Phila). 2009;48:723-733.
13.
KelseyDKSumnerCRCasatCD. Once-daily atomoxetine treatment for children with attention-deficit/hyperactivity disorder, including an assessment of evening and morning behavior: a double-blind, placebo-controlled trial. Pediatrics. 2004;114:e1-e8.
14.
DuPaulGJPowerTJAnastopoulosADReidR. ADHD Rating Scale-IV: Checklists, Norms, and Clinical Interpretations. New York, NY: Guilford Press; 2014.
15.
National Institutes of Mental Health. Clinical Global Impressions. Psychopharmacol Bull. 1985;21:839-943.
16.
GuyW. ECDEU Assessment Manual for Psychopharma-cology, Revised. Bethesda, MD: US Department of Health, Education, and Welfare; 1976.
17.
MuthénB. Latent variable analysis: growth mixture modeling and related techniques for longitudinal data. In: KaplanD, ed. Handbook of Quantitative Methodology for the Social Sciences. Thousand Oaks, CA: Sage; 2004:345-368.
18.
BreimanLFriedmanJHOlshenRAStoneCJ. Classification and Regression Trees. New York, NY: Chapman & Hall; 1984.
19.
ConnersCKSitareniosGParkerJDEpsteinJN. The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol. 1998;26:257-268.
20.
LandgrafJMAbetzLWareJE. The CHQ User’s Manual. 1st ed. Boston, MA: Health Institute, New England Medical Center; 1996.
21.
SaylorKBuermeyerCSuttonVFariesDKhanSSchuhK. The Life Participation Scale for Attention-Deficit/Hyperactivity Disorder–Child Version: psychometric properties of an adaptive change instrument. J Child Adolesc Psychopharmacol. 2007;17:831-842.
22.
MichelsonDAllenAJBusnerJ. Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study. Am J Psychiatry. 2002;159:1896-1901.
23.
Strattera [US Package Insert].Indianapolis, IN: Eli Lilly and Company; 2014.
24.
NewcornJHKratochvilCJAllenAJ. Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: acute comparison and differential response. Am J Psychiatry. 2008;165:721-730.
