A pilot study for augmenting atomoxetine with methylphenidate: Safety of concomitant therapy in children with attention-deficit/hyperactivity disorder

被引：32

作者：

Carlson G.A. ^{[1
]}

Dunn D. ^{[2
]}

Kelsey D. ^{[3
]}

Ruff D. ^{[3
]}

Ball S. ^{[3
]}

Ahrbecker L. ^{[3
]}

Allen A.J. ^{[3
]}

机构：

[1] Department of Child and Adolescent Psychiatry, Stony Brook School of Medicine, Stony Brook

[2] Department of Psychiatry, Indiana University School of Medicine, Indianapolis

[3] Lilly Research Laboratories, Eli Lilly and Company, Indianapolis

来源：

Child and Adolescent Psychiatry and Mental Health | / 1卷 / 1期

关键词：

Methylphenidate; ADHD Symptom; Study Phase; Atomoxetine; Stimulant Medication;

D O I：

10.1186/1753-2000-1-10

中图分类号：

学科分类号：

摘要：

Background: This study examined augmenting atomoxetine with extended-release methylphenidate in children whose attention-deficit/ hyperactivity disorder (ADHD) previously failed to respond adequately to stimulant medication. Methods: Children with ADHD and prior stimulant treatment (N = 25) received atomoxetine (1.2 mg/kg/day) plus placebo. After 4 weeks, patients who were responders (n = 4) were continued on atomoxetine/ placebo while remaining patients were randomly assigned to either methylphenidate (ATX/MPH) (1.1 mg/kg/day) or placebo augmentation (ATX/ PB) for another 6 weeks. Patients and sites were blind to timing of active augmentation. Safety measures included vital signs, weight, and adverse events. Efficacy was assessed by ADHD rating scales. Results: Categorical increases in vital signs occurred for 5 patients (3 patients in ATX/MPH, 2 patients in ATX/PBO). Sixteen percent discontinued the study due to AE, but no difference between augmentation groups. Atomoxetine treatment was efficacious on outcome measures (P ≤ .001), but methylphenidate did not enhance response. Conclusion: Methylphenidate appears to be safely combined with atomoxetine, but conclusions limited by small sample. With atomoxetine treatment, 43% of patients achieved normalization on ADHD ratings. © 2007 Carlson et al; licensee BioMed Central Ltd.

引用

共 19 条

[1]

Biederman J., Spencer T., Wilens T., Evidence-based pharmacotherapy for attention-deficit hyperactivity disorder, Int J Neuropsychopharmacol, 7, 1, pp. 77-97, (2004)

[2]

Faraone S.V., Biederman J., Neurobiology of Attention-Deficit Hyperactivity Disorder, Biol Psychiatry, 44, pp. 951-958, (1998)

[3]

Bhatara V., Feil M., Hoagwood K., Vitiello B., Zima B., National trends in concomitant psychotropic medication with stimulants in pediatric visits: Practice versus knowledge, J Attent Disord, 7, 4, pp. 217-226, (2004)

[4]

Safer D.J., Zito J.M., dosReis S., Concomitant psychotropic medications for youths, Am J Psychiatry, 160, pp. 438-449, (2003)

[5]

Carlson G.A., Rapport M.D., Kelly K., Grayson P., Pataki C.S., Methylphenidate and desipramine in hospitalized children with comorbid behavior and mood disorders: Separate and combined effects on behavior and mood, J Child Adolesc Psychopharmacol, 5, pp. 191-204, (1995)

[6]

Pataki C.S., Carlson G.A., Kelly K.L., Rapport M.D., Biancaniello T.M., Side effects of methylphenidate and desipramine alone and in combination in children, J Am Acad Child Adolesc Psychiatry, 32, pp. 1065-1072, (1993)

[7]

Brown T.E., Atomoxetine and stimulants in combination for treatment of attention deficit hyperactivity disorder: Four case reports, J Child Adolesc Psychopharmacol, 14, 1, pp. 129-136, (2004)

[8]

Spencer T., Biederman J., Wilens T., Harding M., O'Donnell D., Griffin S., Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle: A literature review, J Am Acad Child Adolesc Psychiatry, 35, pp. 409-432, (1996)

[9]

DuPaul G.J., Power T.J., Anastopoulos A.D., Reid R., ADHD Rating Scale-IV: Checklists, Norms, and Clinical Impressions, (1998)

[10]

Ethical principles for medical research involving human subjects. World Medical Association, First Adopted in 1964

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