scholarly journals Efficacy and Safety of Atomoxetine in the Treatment of Children and Adolescents with Attention Deficit Hyperactivity Disorder

2012 ◽  
Vol 6 ◽  
pp. CMPed.S7868 ◽  
Author(s):  
Michael R. Kohn ◽  
Tracey W. Tsang ◽  
Simon D. Clarke
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Hyperactivity Disorder ◽  
Randomized Controlled Studies ◽  
Adolescents And Adults ◽  
Stimulant Medications ◽  
Short And Long Term ◽  
Double Blinded

Several non-stimulant medications have been used in the treatment of attention deficit hyperactivity disorder (ADHD). Atomoxetine, was introduced in 2002. The safety and efficacy of atomoxetine in the treatment of ADHD for children, adolescents, and adults has been evaluated in over 4000 patients in randomized controlled studies and double blinded studies as well as in recent large longitudinal studies. This paper provides an updated summary of the literature on atomoxetine, particularly in relation to findings on the short- and long-term safety of atomoxetine in children and adolescents arising from recent large longitudinal cohort studies. Information is presented about the efficacy, safety, and tolerability of this medication.

scholarly journals PARENTAL PERCEPTIONS OF MEDICATION IMPACT ON BEHAVIOUR AND LEARNING IN CHILDREN WITH ATTENTION/DEFICIT-HYPERACTIVITY DISORDER

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e35-e35
Author(s):  
Jean-Francois Lemay ◽  
Julie-Anne Lemay ◽  
Hanna Kubas
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Parental Perceptions ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Long Term Treatment ◽  
Stimulant Medications ◽  
The Impact

Abstract BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that often negatively impacts behaviour, cognition, and learning. Stimulant medications are the most commonly used treatment for ADHD, with informant reports (e.g., parent questionnaires, surveys) frequently used to evaluate medication impact on behavioural and academic functioning in affected children. OBJECTIVES To determine parental perceptions of medication impact on behaviour and learning in a long-acting methylphenidate (LA-MPH) trial of their children with ADHD. DESIGN/METHODS A randomized controlled LA-MPH medication trial was conducted with children ages 8–12 with a diagnosis of ADHD. Trial began with one-week of baseline assessment, followed by a randomized three-week standard of care medication trial, and a one-week best dose assessment. Following the conclusion of the study (6 months to 2 years’ range post-treatment), families were asked to participate in a voluntary follow-up phone survey to evaluate parental perceptions on child’s behaviour and learning. RESULTS A total of 34/42 (81%) families participated (male to female ratio: 2.1/1). At the time of the follow-up survey, 53% (18/34) and 68% (23/34) of patients were having “difficulty” or “significant difficulty” with their behaviour and learning, respectively. Twenty-three patients (68%) were still on psycho-stimulant medications. Although parents of those 23 children said LA-MPH had in general “significant” or “very significant” impact on their child’s behaviour (87%) and learning (79%), these parents were still reporting challenges with behaviour (52%) and learning (61%) at follow-up. In addition, parents of children not on medication said that their current child’s behaviour and learning was still having the same or more challenging issues (82% and 73% respectively). CONCLUSION Overall, parents reported that medication significantly impacted their child’s behaviour and learning; however, long-term medication impact appears less effective. Thus, an ongoing relationship with families and paediatricians is recommended to better understand the impact of medication on behaviour and learning. Evaluating the effects of medication on behaviour and learning may ultimately lead to targeted intervention that help foster long-term treatment efficacy for children with ADHD.

scholarly journals Post hoc analyses of response rates to pharmacological treatments in children and adolescents with attention-deficit/hyperactivity disorder

2020 ◽  
Vol 34 (8) ◽  
pp. 874-882
Author(s):  
David R Coghill ◽  
Jeffrey H Newcorn ◽  
Jie Chen ◽  
Tamara Werner-Kiechle ◽  
Tobias Banaschewski
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Response Rates ◽  
Open Label ◽  
Stringent Criterion ◽  
Hyperactivity Disorder ◽  
End Point ◽  
Post Hoc

Introduction and objectives: Lack of consensus regarding how best to define treatment response hinders translation from trials to the clinic. These post hoc analyses examine three commonly used response criteria in six trials of lisdexamfetamine dimesylate (LDX) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: Data from four short-term randomised controlled trials (RCTs) and two long-term open-label studies were analysed. Children and adolescents with ADHD received either dose-optimised (30–70 mg/day) or fixed-dose (70 mg/day) LDX. The RCTs included osmotic-release oral system methylphenidate (OROS-MPH) or atomoxetine (ATX) as a head-to-head comparator or as a reference treatment. Three definitions of response were used in these analyses: reductions of ⩾30% or ⩾50% in ADHD Rating Scale IV (ADHD-RS-IV) total score plus a Clinical Global Impressions – Improvement (CGI-I) score of 1 or 2, or an ADHD-RS-IV total score of ⩽18. Results: At the end point, LDX response rates for the least stringent criterion of ⩾30% reduction in ADHD-RS-IV total score plus a CGI-I score of 1 or 2 ranged from 69.6% to 82.6%. The proportion achieving the more stringent criterion of a reduction in ADHD-RS-IV total score of ⩾50% plus a CGI-I score of 1 or 2 at the end point ranged from 59.8% to 74.8%. An ADHD-RS-IV total score of ⩽18 at the end point was achieved by 56.7–79.9% of participants. Response rates remained stable throughout the long-term open-label studies. Conclusions: Response rates were similar for the two more stringent response criteria. The less stringent criterion resulted in higher response rates and may include partial responders.

scholarly journals The Safety and Efficacy of Methylphenidate and Dexmethylphenidate in Adults with Attention Deficit/Hyperactivity Disorder

2010 ◽  
Vol 2 ◽  
pp. JCNSD.S4178 ◽  
Author(s):  
Michael A. Sopko ◽  
Harjeet Caberwal ◽  
Benjamin Chavez
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Case Reports ◽  
Data Extraction ◽  
Adult Population ◽  
Open Label ◽  
Safety And Efficacy ◽  
Hyperactivity Disorder ◽  
Double Blinded

Objective To review the literature on the safety and efficacy of methylphenidate, OROS-methylphenidate, methylphenidate ER, and dexmethylphenidate in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). To analyze the effects of different doses of methylphenidate, it's various formulations, and methylphenidate on efficacy and safety in this population. Data Sources Literature retrieval was performed through Pubmed/MEDLINE (Up to May 2010) using the terms methylphenidate, dexmethylphenidate, and attention-deficit hyperactivity disorder. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction Double-blinded, placebo-controlled clinical trials, as well as crossover and open-label trials found using the search criteria listed above were included for review. Case reports were not included in this review. Data Synthesis Attention-deficit/hyperactivity disorder (ADHD) is a psychiatric condition that is commonly seen in children and adolescents, that persists into adulthood for about 50% of patients. Methylphenidate and dexmethylphenidate are often prescribed to treat the symptoms associated with ADHD. The literature validating the safety and efficacy of methylphenidate and dexmethylphenidate in children and adolescents with ADHD is substantial. However, the literature specifically addressing the safety and efficacy of these medications in the adult population is less extensive and prescribing is often anecdotal based on child and adolescent data. Understanding the literature regarding methylphenidate and dexmethylphenidate and its effects in adults can enhance evidence-based medicine (EBM) and improve treatment outcomes Conclusion Methylphenidate and dexmethylphenidate are safe and effective medications to treat the symptoms of ADHD in adults. Based on the literature, increased doses are associated with better treatment response with moderate safety concerns. The different dosage forms available enable individualization of treatment.

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