Atomoxetine and Adult Attention-Deficit/Hyperactivity Disorder: The Effects of Comorbidity.
J Clin Psychiatry 2006;67(3):415-420
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: The objective of this study was
to determine if measures of broad clinical psychopathology or neuropsychological
performance could aid in the prediction of therapeutic
response to the highly selective norepinephrine
transporter inhibitor, atomoxetine, among adults with
attention-deficit/hyperactivity disorder (ADHD).
Method: We analyzed data from 2
double-blind, placebo-controlled, parallel design
studies of adult patients (Study I, N = 280; Study
II, N = 256) with DSM-IV-defined ADHD who were recruited by referral and advertising.
Subjects were randomly assigned to 10 weeks of
treatment with atomoxetine or placebo and were
assessed with Conners' Adult ADHD Rating Scales (CAARS), the General Well-Being
Schedule (GWB), the Sheehan Disability Scale, the
Stroop Color-Word Test (SCWT), and the Structured Clinical Interview for DSM-IV (SCID)
before and after treatment.
Results: Therapeutic improvement on
atomoxetine as evidenced by reduced CAARS scores was reliably predicted by the presence of a
lifetime comorbid diagnosis of depression or posttraumatic stress disorder at baseline, while
improvement on subscales of the GWB and Sheehan Disability Scale were predicted by these and
other SCID endorsements, such as alcohol and substance use, as well as demographics such as
age and gender. In light of the exploratory nature
of this work and the many comparisons that were examined in the corresponding regression
models, these findings should be regarded as
tentative pending replication and extension in another
Conclusion: From these findings, we
conclude that the variable responsiveness of individuals to atomoxetine cannot be largely
accounted for by differences in broad-spectrum psychopathology or neuropsychological
indicators of attentional capacity.