A review of the efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in children and adult patients with common comorbidities

Figures & data

Table 1 Incidence of comorbidities with ADHD in children

Comorbidity	Incidence	References
Anxiety	18%	Larson et al^Citation10
	25%–35%	Geller et al^Citation12
	25%–50%	Sciberras et al^Citation13
	27%	Bakken et al^Citation14
Binge eating	12%	Reinblatt et al^Citation15
Bipolar disorder	0%–20%	Taurines et al^Citation16
	7%–22%	Singh et al^Citation17
	5%	Bakken et al^Citation14
Conduct disorder/ODD	30%–50%	Dopheide and Pliszka^Citation3
	40%–60%	Biederman et al^Citation18
	24%	Bakken et al^Citation14
Depression	21%	Bakken et al^Citation14
	16%–26%	Gillberg et al^Citation19
Learning and language disorders	23%	Bakken et al^Citation14
	46%	Larson et al^Citation10
Obsessive compulsive disorder	2%	Jensen and Steinhausen^Citation8
Pervasive developmental disorders/ASD	12%	Jensen and Steinhausen^Citation8
	30%–50%	Reichow et al^Citation20
Substance abuse disorders	22%	Kollins^Citation21
Tic disorders/Tourette’s syndrome	7%	Bakken et al^Citation14
	20%–30%	Taurines et al^Citation16

Note: No data were found in the literature for ADHD and antisocial personality disorder in children (ie, <18 years of age).

Abbreviations: ADHD, attention-deficit hyperactivity disorder; ASD, autism spectrum disorder; ODD, oppositional defiant disorder.

Table 2 Incidence of comorbidities with ADHD in adults

Comorbidity	Incidence	Reference
Anxiety	25%–35%	Kessler et al^Citation9
Bipolar disorder	5%–20%	Perugi and Vannucchi^Citation26
	47%	Wingo and Ghaemi^Citation27
	19%	Kessler et al^Citation9
Depression	19%	Kessler et al^Citation9
	30%–50%	Kolar et al^Citation28
Substance use disorders	47%	Kollins^Citation21
	30%	Biederman^Citation29

Note: No data were found in the literature for the following comorbidities in adults (ie, ≥18 years of age): antisocial personality disorder, binge eating, conduct disorder/ODD, learning and language disorders, obsessive compulsive disorder, pervasive developmental disorders/ASD, and tic disorders/Tourette syndrome.

Abbreviations: ADHD, attention-deficit hyperactivity disorder; ASD, autism spectrum disorder; ODD, oppositional defiant disorder.

Table 3 Comorbidities and associated terms used in PubMed literature search

Antisocial personality disorder	Pervasive development disorder
Antisocial	Asperger
Personality	Autism
Anxiety	Autistic
Anxiety	Pervasive
Binge eating disorder	PDD
Binge	Rett
Bipolar disorder	Sleep disorder
Bipolar	Hypersomnia
Mania	Insomnia
Conduct disorder or oppositional defiance disorder	Sleep
Conduct	Sluggish cognitive tempo
Oppositional	Sluggish
Defiance	Tempo
ODD	SCT
Depression	Substance abuse disorder
Depression	Abuse
Learning disorder or language disorder	Dependence
Language	Substance
Learning	SUD
Dyslexia	Alcohol
Reading	Tic disorder
Obsessive compulsive disorder	Tic
Obsessive	Tourette
Compulsive
OCD

Notes: The search performed was for “atomoxetine” AND the “comorbidity term”; eg, (atomoxetine[Title/Abstract]) AND bipolar[Title/Abstract].

Abbreviations: OCD, obsessive compulsive disorder; ODD, oppositional defiant disorder; PDD, pervasive developmental disorder; SCT, sluggish cognitive tempo; SUD, substance use disorder.

Table 4 Search results for ADHD and comorbidities in children

References	Type of study	Age range	Main findings
Antisocial personality disorder
–	–	–	–
Anxiety
Kratochvil et al^Citation46,#	RCT	7–17 years	ATX plus PBO not significantly different from ATX and fluoxetine. Significant improvements in ADHD symptoms (ADHD-RS) and anxiety symptoms (MASC)
Geller et al^Citation12	RCT	8–17 years	ATX significantly improved ADHD symptoms (ADHD-RS) and anxiety (PARS)* ATX did not exacerbate comorbid anxiety
Binge eating disorders
–	–	–	–
Bipolar disorder
Chang et al^Citation47	Open-label	6–17 years	ATX improved ADHD symptoms ATX did not change symptoms of depression (CDRS) or of mania (YMRS) in Pts with ADHD and bipolar disorder
Hah and Chang^Citation48	Consecutive case series		Pts with ADHD and bipolar disorder treated with ATX and mood stabilizers Six of 7 Pts showed significant improvement in ADHD symptomsNo Pts had episodes of hypomania or mania
Conduct disorders and oppositional defiant disorder
Newcorn et al^Citation49	RCT	8–18 years	ATX produced clinically meaningful improvements in ADHD (ADHD-RS) and ODD (CPRS-R:S) symptoms Pts with ADHD plus ODD required more ATX than ADHD alone Pts with ADHD plus ODD remained more severely affected
Bangs et al^Citation50	RCT	6–12 years	ATX superior to PBO for ODD at 2 and 5, but not 8 weeks (SNAP-IV ODD) ATX superior to PBO for ADHD (SNAP-IV ADHD ratings; CGI scales for severity, improvement, and for the parent version) at 8 weeks
Biederman et al^Citation18	Meta-analysis of 3 RCTs	6–16 years	ATX improved ADHD symptoms in Pts with and without ODD (ADHD-RS; CGI-ADHD-S) ATX improved ODD (CPRS-R:S oppositional scores), and ODD improvement correlated with ADHD improvement
Dittmann et al^Citation51	RCT	6–17 years	ATX was superior to PBO for ADHD and CD/ODD symptoms (SNAP-IV ADHD and ODD subscales) Path analysis suggests ATX has a specific effect on CD/ODD
Dell’Agnello et al^Citation52	RCT	6–15 years	ATX was significantly superior to PBO in improving ADHD (SNAP-IV ADHD subscale; CGI-ADHD-S) and ODD (SNAP-IV ODD subscale) symptoms
Garg et al^Citation53	RCT	6–14 years	ATX and methylphenidate improved ADHD and ODD symptoms (VADPRS) in Pts with ADHD and comorbid ODD
Cheng et al^Citation54,#	Meta-analysis of 7 RCTs	Not stated	ATX superior to PBO in reducing ADHD (ADHD-RS-IV; CGI-S; CTRS-R:S) and ODD symptoms (Oppositional Index of CTRS-R:S) ATX produced smaller changes in ADHD symptoms in Pts with ADHD and ODD; ATX improved quality of life (CHQ)
Wehmeier et al^Citation55	Post hoc subgroup analyses of RCT	6–17 years	ATX improved quality of life and self-esteem, in Pts with ADHD and ODD (KINDL-R)
Waxmonsky et al^Citation56	Open-label	6–12 years	Switching to bid ATX with a slight increase in dose improved ODD, but not ADHD, symptoms (IOWA Connors Rating Scale) in children with both disorders
van Wyk et al^Citation57	Meta-analysis of 7 RCTs	6–16 years	ATX and methylphenidate produced similar results in Pts with ADHD and either with or without ODD
Wehmeier et al^Citation58	Post hoc subgroup analyses of RCT	6–12 years	ATX reduced severity of ADHD symptoms in Pts with or without ODD/CD (cb-CPT/MT); ATX had more pronounced effect on hyperactivity in Pts with comorbid ODD/CD
Ercan et al^Citation59	Retrospective chart review	Mean: 9.97±1.87 years	ATX improved symptoms of ADHD, but not ODD, in Pts with both (CGI)
Kaplan et al^Citation60	Post hoc subgroup analyses of RCT	7–13 years	ATX improved ADHD scores (ADHD-RS-IV; CGI-ADHD-S; CPRS-R:S) but not ODD scores (CPRS-R:S Oppositional subscore) in Pts with both ADHD and ODD
Hazell et al^Citation61	Open-label	6–15 years	ODD did not change relapse rate or latency in Pts with ADHD after ATX treatment end
Depression
Cheng et al^Citation54,#	Meta-analyses of 7 RCTs	Not stated	ATX superior to PBO in reducing ADHD (ADHD-RS-IV; CGI-S; CTRS-R:S) NNTs were similar for ATX in Pts with and without comorbid depression
Scott et al^Citation62	Retrospective chart review	5–17 years	No significant differences in treatment success or treatment failure with ATX with ADHD and comorbid depression
Bangs et al^Citation63	RCT	12–18 years	ATX superior to PBO in improving ADHD symptoms (ADHD-RS) ATX not different from PBO for symptoms of depression (CDRS-R) in Pts with ADHD comorbid MDD
Kratochvil et al^Citation46,#	RCT	7–17 years	Marked improvement in ADHD symptoms (ADHD-RS) and depression symptoms (CDRS-R) No difference between ATX + PBO and ATX + fluoxetine
Bakken et al^Citation14,#	Prospective, observational, longitudinal, open-label	6–17 years	ATX improved ADHD symptoms (PGI-ADHD-S) in Pts with ADHD with or without depression Depressive symptoms improved in 55% of these Pts
Learning and language disorders
Wietecha et al^Citation64,#	RCT with open-label extension	10–16 years	ATX significantly better than PBO in improving ADHD symptoms (ADHD-RS) in Pts with ADHD and ADHD with comorbid dyslexia No difference between groups for ADHD symptoms ATX improved Phonological Loop and Central Executive components of WMTB-C
de Jong et al^Citation65	RCT	8–12 years	ATX was similarly effective against ADHD symptoms (ADHD-RS) in Pts with ADHD alone or ADHD and RD ATX improved visuospatial working memory (CBTT) and inhibition (SSRT) in Pts with ADHD and RD, but not with ADHD or RD alone Note age and IQ differences among groups
Sumner et al^Citation66	Open-label	10–16 years	ATX improved ADHD symptoms (ADHD-RS) and reading scores (K-TEA) in Pts with ADHD and with or without comorbid dyslexia Change in WMTB-C central executive score was significantly greater for the ADHD group Change in WMTB-C phonological loop score was significantly greater in the ADHD plus dyslexia group
Shaywitz et al^Citation67	Open-label, parallel design	10–16 years	ATX produced significant improvements in ADHD symptoms (ADHD-RS) in Pts with ADHD and those with ADHD and dyslexia Both groups showed improved reading scores (K-TEA) Weak correlation between improved ADHD and reading scores
Obsessive compulsive disorder
–	–	–	–
Pervasive developmental disorders/autism spectrum disorder
Arnold et al^Citation68	RCT	5–15 years (mental age ≥18 months)	ATX significantly superior to PBO against hyperactive symptoms of ADHD (ABC-H; CGI =1 or 2) in Pts with ADHD and ASD ATX superior (not significant) to PBO against inattentive symptoms of ADHD
Harfterkamp et al^Citation69	RCT	6–17 years	ATX superior to PBO for symptoms of ADHD (ADHD-RS) in Pts with ADHD and ASD
Harfterkamp et al^Citation70	Open-label extension	6–17 years	Continued ATX provided continuation of improvement in ADHD symptoms in Pts with ADHD and ASD
Troost et al^Citation71	Open-label prospective study	6–14 years	ATX improved ADHD symptoms in PDD Pts with ADHD symptoms (ADHD-RS; CPRS-R:S) ATX improved hyperactivity symptoms in ABC scale
Fernández-Jaén et al^Citation72	Open-label prospective study	Mean: 8.7±3.38 years	ATX improved ADHD symptoms in ADHD Pts with PDD symptoms (ADHD-RS; CPRS-R:S; CGI)
Jou et al^Citation73	Retrospective review of medical records	6–19 years	Pts with PDD showed improvement with ATX in conduct, hyperactivity, inattention, and learning (CGI)
Posey et al^Citation74	Open-label prospective study	6–14 years	Seventy-five percent of ADHD/PDD Pts receiving ATX “much improved” or “very much improved” on CGI ATX significantly improved ADHD symptoms on SNAP-IV and ABC-H
Charnsil^Citation75	Open-label study	7–15 years	Pts with severe ASD and symptoms of ADHD showed no significant improvement with ATX in hyperactive ADHD symptoms (ABC-H) ATX improved CGI scores
Sluggish cognitive tempo
Wietecha et al^Citation64,#	RCT	10–16 years	ATX improved K-SCT scores in Pts with ADHD alone or ADHD and dyslexia Positive correlation between improvements in ADHD-RS and in the K-SCT scores: K-SCT Parent subscale score vs ADHDRS-IV-Parent:Inv scores: correlation coefficient: 0.40–0.54, P<0.001 K-SCT Teacher subscale score vs ADHDRS-IV-Teacher-Version scores: correlation coefficient: 0.33–0.61, P<0.004 K-SCT Youth subscale score vs ADHDRS-Parent:Inv scores: correlation coefficient: 0.16–0.19, P≤0.032
Sleep disorders
Sangal et al^Citation76	Cross-over RCT	10.1±2.0 years	ATX improved ADHD symptoms (ADHD-RS) ATX showed significantly shorter latency to sleep vs methylphenidate ATX was associated with less difficulty in falling asleep, waking up, and less irritability (parent and children reports) vs methylphenidate
Substance use disorders
Thurstone et al^Citation77	Single-site RCT	13–19 years	ATX and PBO improved ADHD symptoms (DSM-IV ADHD symptom checklist) No difference in ADHD symptoms (DSM-IV ADHD symptom checklist) or nonnicotine substance use in ATX + MI/CBT vs PBO + MI/CBT groups
Bakken et al^Citation14,#	Open-label prospective study	6–17 years	ATX reduced symptoms of ADHD (PGI-ADHD-S) in Pts with ADHD No significant improvement in Pts with ADHD and SUD
Tic disorders/Tourette syndrome
Allen et al^Citation78	RCT	7–17 years	ATX significantly reduced ADHD symptoms (ADHD-RS) and tic severity (CGI-Tic/Neuro-S) ATX markedly reduced tics (YGTSS; Tic Symptom Self-Report) in Pts with ADHD and tic disorders
Spencer et al^Citation79	Post hoc subgroup analyses of RCT	7–17 years	ATX significantly superior to PBO against ADHD symptoms (ADHD-RS) ATX significantly superior to PBO in reducing tic severity (YGTSS; CGI-Tic/Neuro-S) in Pts with ADHD and Tourette syndrome
Bakken et al^Citation14,#	Prospective, observational, open-label study	6–17 years	ATX significantly improved ADHD symptoms (PGI-ADHD-S) Improved tic disorder in 65%, no change in 35% ATX did not worsen tics in Pts with ADHD and tic disorders

Notes: Dashes indicate that no literature results were found on search.

# The source included more than 1 comorbidity, and appears more than once in the table. Thus, there are 37 articles, 4 of which appear 2 or more times.

* A post hoc correlation analysis of this RCT revealed that improvements in anxiety were directly correlated with improvements in symptoms of ADHD.¹⁰⁰

Abbreviations: ABC, Aberrant Behavior Checklist; ABC-H, Aberrant Behavior Checklist-Hyperactivity Scale; ADHD, attention-deficit hyperactivity disorder; ADHD-RS-IV, Attention-Deficit/Hyperactivity Disorder Rating Scale-IV; ADHDRS-IV-Parent:Inv, ADHD Rating Scale-IV-Parent-Version:Investigator-Administered and Scored; ADHDRS-IV-Teacher-Version, ADHD Rating Scale-IV-Teacher-Version; ADHD-RS, Attention-Deficit/Hyperactivity Disorder Rating Scale; ASD, autism spectrum disorder; ATX, atomoxetine; cb-CPT, computer-based continuous performance test; CBTT, Corsi Block Tapping Test; CD, conduct disorder; CDRS, Children’s Depression Rating Scale; CDRS-R, Children’s Depression Rating Scale-Revised; CGI, Clinical Global Impression; CGI-ADHD-S, Clinical Global Impression-Attention-Deficit Hyperactivity Disorder-Severity; CGI-S, Clinical Global Impression-Severity; CGI-Tic/Neuro-S, CGI Tic/Neurologic Severity Scale; CHQ, Child Health Questionnaire; CPRS-R:S, Conners’ Parent Rating Scale-Revised Short Form; CTRS-R:S, Conners’ Teacher Rating Scale-Revised Short Form; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; IQ, intelligence quotient; KINDL-R, Revidierter KINDer Lebensqualitätsfragebogen; K-SCT, Kiddie-Sluggish Cognitive Tempo; K-TEA, Kaufman Test of Educational Achievement; MASC, Multidimensional Anxiety Scale for Children; MDD, major depressive disorder; MI/CBT, motivational interviewing/cognitive behavioral therapy; MT, infrared motion tracking device; NNTs, numbers needed to treat; ODD, oppositional defiant disorder; PARS, Pediatric Anxiety Rating Scale; PBO, placebo; PDD, pervasive developmental disorder; PGI-ADHD-S, Physician Global Impression: ADHD Severity; Pts, patients; RCT, randomized clinical trial; RD, reading disorder; SNAP-IV, Swanson, Nolan, and Pelham Rating Scale-Revised; SSRT, Stop Signal Reaction Time; SUD, substance use disorder; VADPRS, Vanderbilt ADHD Diagnostic Parent Rating scale; WMTB-C, Working Memory Test Battery for Children; YGTSS, Yale Global Tic Severity Scale; YMRS, Young Mania Rating Scale.

Table 5 Search results for ADHD and comorbidities in adults

References	Type of study	Age range	Main findings
Antisocial personality disorder
–	–	–	–
Anxiety
Social anxiety disorder
Adler et al^Citation80	Multicenter RCT		ATX significantly better than PBO Response rate better in ADHD (51%) than ADHD plus SAD (42%) CAARS:Inv:SV score improvement better in ADHD than ADHD + SAD
Adler et al^Citation81	Multicenter RCT		ATX significantly improved ADHD symptoms (CAARS:Inv:SV) and anxiety scores (LSAS; CGI-OS; STAI), and quality of life (AAQoL) compared to PBO in Pts with ADHD and SAD. SAS was markedly improved
Donnelly et al^Citation82	Post hoc subgroup analyses of RCT		ATX-mediated improvements in ADHD directly correlated with anxiety improvement in Pts with ADHD and SAD
Ravindran et al^Citation83	RCT	18–65 years	ATX not different from PBO in Pts with GSAD and without ADHD (LSAS)
Generalized anxiety disorder
Gabriel and Violato^Citation84	Open label	18–65 years	ATX as adjunctive to SSRIs or to SNRIs improved symptoms of ADHD (ASRS-v1.1; CGI-S) and anxiety (HAM-A) in Pts with ADHD and GAD
Young et al^Citation85,#	RCT	≥18 years	ATX improved ADHD scores, no change in anxiety (STAI) in Pts with ADHD and without anxiety
Binge eating disorders
–	–	–	–
Bipolar disorder
–	–	–	–
Conduct disorders and oppositional defiant disorder
–	–	–	–
Depression
Young et al^Citation85,#	RCT	≥18 years	ATX was significantly better than PBO in improving ADHD symptoms (CAARS-Inv:SV), but had no change on depressive symptoms (MADRS)
Durell et al^Citation86	RCT	18–30 years	ATX improved ADHD symptoms (CAARS-Inv:SV), but had no change on depressive symptoms (MADRS)
Learning and language disorders
–	–	–	–
Obsessive compulsive disorder
–	–	–	–
Pervasive developmental disorders/autism spectrum disorder
–	–	–	–
Sluggish cognitive tempo
–	–	–	–
Sleep disorders
–	–	–	–
Substance use disorders
Wilens et al^Citation87	RCT	≥18 years	ATX significantly superior to PBO in reducing ADHD symptoms (AISRS) ATX reduced cumulative days of heavy drinking ATX did not reduce latency to relapse of heavy drinking
Wilens et al^Citation88	Post hoc subgroup analyses of RCT	≥18 years	Significant correlation between improvements in ADHD symptoms and reductions in craving for alcohol in ATX, and not PBO, group PBO, but not ATX, group with relapse to alcohol had significant worsening of ADHD symptoms
Benegal et al^Citation89	Within-subject retrospective design with naturalistic follow-up	27.2±5.9 years	Pts with (72%) and without DSM-IV ADHD diagnosis ATX + TAU significantly improved ASRS-v1.1 scores, reduced turnaround time, increased abstinence periods, improved quality of life, and reduced cigarette smoking vs TAU
Adler et al^Citation90	Open-label	36.8±10.0 years	ATX improved ADHD symptoms (AISRS) and significantly reduced intensity, frequency, and length of cravings (BSCS) in Pts with ADHD and SUD
Levin et al^Citation91	Open-label	39.3±6.6 years	ATX improved ADHD symptoms (AARS-v1.1) but did not reduce cocaine use in Pts with ADHD and cocaine dependency
McRae-Clark et al^Citation92	RCT	18–65 years	ATX significantly superior to PBO in treating ADHD symptoms (CGI-I)
			ATX and PBO did not reduce cannabis use in Pts with ADHD and cannabis dependency

Note:

# Young et al⁸⁵ appears twice, as it addresses more than 1 comorbidity. Dashes indicate that no literature results were found on search.

Abbreviations: AAQoL, Adult ADHD Quality of Life Scale-29; AARS, Adult ADHD Rating Scale; ADHD, attention-deficit hyperactivity disorder; AISRS, ADHD Investigator Symptom Rating Scale; ASRS-v1.1, Adult ADHD Self-Report Scale-v1.1; ATX, atomoxetine; BSCS, Brief Substance Craving Scale; CAARS:Inv:SV, Conners’ Adult ADHD Rating Scale:Investigator-Rated:Screening Version; CGI-I, Clinical Global Impression-Global Improvement; CGI-OS, Clinical Global Impression-Overall Severity; CGI-S, Clinical Global Impression-Severity; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; GAD, generalized anxiety disorder; GSAD, generalized social anxiety disorder; HAM-A, Hamilton Anxiety Scale; LSAS, Liebowitz Social Anxiety Scale; MADRS, Montgomery–Åsberg Depression Rating Scale; PBO, placebo; Pts, patients; RCT, randomized controlled trial; SAD, social anxiety disorder; SAS, Social Adjustment Scale; SNRI, selective noradrenergic reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; STAI, State-Trait Anxiety Inventory; SUD, substance use disorder; TAU, treatment-as-usual.

LarsonKRussSAKahnRSHalfonNPatterns of comorbidity, functioning, and service use for US children with ADHD, 2007Pediatrics2011127346247021300675

 PubMed Web of Science ®Google Scholar

GellerDDonnellyCLopezFAtomoxetine treatment for pediatric patients with attention-deficit/hyperactivity disorder with comorbid anxiety disorderJ Am Acad Child Adolesc Psychiatry20074691119112717712235

 PubMed Web of Science ®Google Scholar

SciberrasELycettKEfronDMensahFGernerBHiscockHAnxiety in children with attention-deficit/hyperactivity disorderPediatrics2014133580180824753534

 PubMed Web of Science ®Google Scholar

BakkenRJPaczkowskiMKramerHPEffects of atomoxetine on attention-deficit/hyperactivity disorder in clinical pediatric treatment settings: a naturalistic studyCurr Med Res Opin200824244946018179733

 PubMed Web of Science ®Google Scholar

ReinblattSPLeoutsakosJMMahoneEMForresterSWilcoxHCRiddleMAAssociation between binge eating and attention-deficit/hyperactivity disorder in two pediatric community mental health clinicsInt J Eat Disord201548550551125130278

 PubMed Web of Science ®Google Scholar

TaurinesRSchmittJRennerTConnerACWarnkeARomanosMDevelopmental comorbidity in attention-deficit/hyperactivity disorderAtten Defic Hyperact Disord20102426728921432612

 PubMedGoogle Scholar

SinghMKDelBelloMPKowatchRAStrakowskiSMCo-occurrence of bipolar and attention-deficit hyperactivity disorders in childrenBipolar Disord20068671072017156157

 PubMed Web of Science ®Google Scholar

DopheideJAPliszkaSRAttention-deficit-hyperactivity disorder: an updatePharmacotherapy200929665667919476419

 PubMed Web of Science ®Google Scholar

BiedermanJSpencerTJNewcornJHEffect of comorbid symptoms of oppositional defiant disorder on responses to atomoxetine in children with ADHD: a meta-analysis of controlled clinical trial dataPsychopharmacology (Berl)20071901314117093981

 PubMed Web of Science ®Google Scholar

GillbergCGillbergICRasmussenPCo-existing disorders in ADHD – implications for diagnosis and interventionEur Child Adolesc Psychiatry200413Suppl 1I80I9215322959

 PubMedGoogle Scholar

JensenCMSteinhausenHCComorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide studyAtten Defic Hyperact Disord201571273824942707

 PubMedGoogle Scholar

ReichowBVolkmarFRBlochMHSystematic review and meta-analysis of pharmacological treatment of the symptoms of attention-deficit/hyperactivity disorder in children with pervasive developmental disordersJ Autism Dev Disord201343102435244123468071

 PubMed Web of Science ®Google Scholar

KollinsSHADHD, substance use disorders, and psychostimulant treatment: current literature and treatment guidelinesJ Atten Disord200812211512518192623

 PubMed Web of Science ®Google Scholar

KesslerRCAdlerLBarkleyRThe prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey ReplicationAm J Psychiatry2006163471672316585449

 PubMed Web of Science ®Google Scholar

PerugiGVannucchiGThe use of stimulants and atomoxetine in adults with comorbid ADHD and bipolar disorderExpert Opin Pharmacother201516142193220426364896

 PubMed Web of Science ®Google Scholar

WingoAPGhaemiSNA systematic review of rates and diagnostic validity of comorbid adult attention-deficit/hyperactivity disorder and bipolar disorderJ Clin Psychiatry200768111776178418052572

 PubMed Web of Science ®Google Scholar

KolarDKellerAGolfinopoulosMCumynLSyerCHechtmanLTreatment of adults with attention-deficit/hyperactivity disorderNeuropsychiatr Dis Treat20084238940318728745

 PubMedGoogle Scholar

BiedermanJAttention-deficit/hyperactivity disorder: a selective overviewBiol Psychiatry200557111215122015949990

 PubMed Web of Science ®Google Scholar

KratochvilCJNewcornJHArnoldLEAtomoxetine alone or combined with fluoxetine for treating ADHD with comorbid depressive or anxiety symptomsJ Am Acad Child Adolesc Psychiatry200544991592416113620

 PubMed Web of Science ®Google Scholar

ChangKNayarDHoweMRanaMAtomoxetine as an adjunct therapy in the treatment of co-morbid attention-deficit/hyperactivity disorder in children and adolescents with bipolar I or II disorderJ Child Adolesc Psychopharmacol200919554755119877979

 PubMed Web of Science ®Google Scholar

HahMChangKAtomoxetine for the treatment of attention-deficit/hyperactivity disorder in children and adolescents with bipolar disordersJ Child Adolesc Psychopharmacol2005156996100416379520

 PubMed Web of Science ®Google Scholar

NewcornJHSpencerTJBiedermanJMiltonDRMichelsonDAtomoxetine treatment in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorderJ Am Acad Child Adolesc Psychiatry200544324024815725968

 PubMed Web of Science ®Google Scholar

BangsMEHazellPDanckaertsMAtomoxetine ADHD/ODD Study GroupAtomoxetine for the treatment of attention-deficit/hyperactivity disorder and oppositional defiant disorderPediatrics20081212e314e32018245404

 PubMed Web of Science ®Google Scholar

DittmannRWSchachtAHelsbergKAtomoxetine versus placebo in children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder: a double-blind, randomized, multicenter trial in GermanyJ Child Adolesc Psychopharmacol20112129711021488751

 PubMed Web of Science ®Google Scholar

Dell’AgnelloGMaschiettoDBravaccioCLYCY Study GroupAtomoxetine hydrochloride in the treatment of children and adolescents with attention-deficit/hyperactivity disorder and comorbid oppositional defiant disorder: a placebo-controlled Italian studyEur Neuropsychopharmacol2009191182283419716683

 PubMed Web of Science ®Google Scholar

GargJArunPChavanBSComparative efficacy of methylphenidate and atomoxetine in oppositional defiant disorder comorbid with attention deficit hyperactivity disorderInt J Appl Basic Med Res20155211411826097819

 PubMedGoogle Scholar

ChengJYChenRYKoJSNgEMEfficacy and safety of atomoxetine for attention-deficit/hyperactivity disorder in children and adolescents-meta-analysis and meta-regression analysisPsychopharmacology (Berl)2007194219720917572882

 PubMed Web of Science ®Google Scholar

WehmeierPMSchachtADittmannRWEffect of atomoxetine on quality of life and family burden: results from a randomized, placebo-controlled, double-blind study in children and adolescents with ADHD and comorbid oppositional defiant or conduct disorderQual Life Res201120569170221136299

 PubMed Web of Science ®Google Scholar

WaxmonskyJGWaschbuschDAAkinnusiOPelhamWEA comparison of atomoxetine administered as once versus twice daily dosing on the school and home functioning of children with attention-deficit/hyperactivity disorderJ Child Adolesc Psychopharmacol2011211213221288121

 PubMed Web of Science ®Google Scholar

van WykGWHazellPLKohnMRGrangerREWaltonRJHow oppositionality, inattention, and hyperactivity affect response to atomoxetine versus methylphenidate: a pooled meta-analysisJ Atten Disord201216431432421289234

 PubMed Web of Science ®Google Scholar

WehmeierPMKippLBanaschewskiTDittmannRWSchachtADoes comorbid disruptive behavior modify the effects of atomoxetine on ADHD symptoms as measured by a continuous performance test and a motion tracking device?J Atten Disord201519759160222930789

 PubMed Web of Science ®Google Scholar

ErcanESAkyol ArdicUKabukcu BasayBErcanEBasayOAtomoxetine response in the inattentive and combined subtypes of attention deficit hyperactivity disorder: a retrospective chart reviewAtten Defic Hyperact Disord20135437738523737214

 PubMedGoogle Scholar

KaplanSHeiligensteinJWestSEfficacy and safety of atomoxetine in childhood attention-deficit/hyperactivity disorder with comorbid oppositional defiant disorderJ Atten Disord200482455215801334

 PubMedGoogle Scholar

HazellPZhangSWolanczykTComorbid oppositional defiant disorder and the risk of relapse during 9 months of atomoxetine treatment for attention-deficit/hyperactivity disorderEur Child Adolesc Psychiatry200615210511016523251

 PubMed Web of Science ®Google Scholar

ScottNGRipperger-SuhlerJRajabMHKjarDFactors associated with atomoxetine efficacy for treatment of attention-deficit/hyperactivity disorder in children and adolescentsJ Child Adolesc Psychopharmacol201020319720320578932

 PubMed Web of Science ®Google Scholar

BangsMEEmslieGJSpencerTJAtomoxetine ADHD and Comorbid MDD Study GroupEfficacy and safety of atomoxetine in adolescents with attention-deficit/hyperactivity disorder and major depressionJ Child Adolesc Psychopharmacol200717440742017822337

 PubMed Web of Science ®Google Scholar

WietechaLWilliamsDShaywitzSAtomoxetine improved attention in children and adolescents with attention-deficit/hyperactivity disorder and dyslexia in a 16 week, acute, randomized, double-blind trialJ Child Adolesc Psychopharmacol201323960561324206099

 PubMed Web of Science ®Google Scholar

de JongCGVan De VoordeSRoeyersHDifferential effects of atomoxetine on executive functioning and lexical decision in attention-deficit/hyperactivity disorder and reading disorderJ Child Adolesc Psychopharmacol200919669970720035588

 PubMed Web of Science ®Google Scholar

SumnerCRGathercoleSGreenbaumMAtomoxetine for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children with ADHD and dyslexiaChild Adolesc Psychiatry Ment Health200934020003507

 PubMedGoogle Scholar

ShaywitzBAWilliamsDWFoxBKWietechaLAReading outcomes of children and adolescents with attention-deficit/hyperactivity disorder and dyslexia following atomoxetine treatmentJ Child Adolesc Psychopharmacol201424841942525299355

 PubMed Web of Science ®Google Scholar

ArnoldLEAmanMGCookAMAtomoxetine for hyperactivity in autism spectrum disorders: placebo-controlled crossover pilot trialJ Am Acad Child Adolesc Psychiatry200645101196120517003665

 PubMed Web of Science ®Google Scholar

HarfterkampMvan de Loo-NeusGMinderaaRBA randomized double-blind study of atomoxetine versus placebo for attention-deficit/hyperactivity disorder symptoms in children with autism spectrum disorderJ Am Acad Child Adolesc Psychiatry201251773374122721596

 PubMed Web of Science ®Google Scholar

HarfterkampMBuitelaarJKMinderaaRBvan de Loo-NeusGvan der GaagRJHoekstraPJLong-term treatment with atomoxetine for attention-deficit/hyperactivity disorder symptoms in children and adolescents with autism spectrum disorder: an open-label extension studyJ Child Adolesc Psychopharmacol201323319419923578015

 PubMed Web of Science ®Google Scholar

TroostPWSteenhuisMPTuynman-QuaHGAtomoxetine for attention-deficit/hyperactivity disorder symptoms in children with pervasive developmental disorders: a pilot studyJ Child Adolesc Psychopharmacol200616561161917069549

 PubMed Web of Science ®Google Scholar

Fernández-JaénAFernández-MayoralasDMCalleja-PérezBMuñoz-JareñoNCampos DíazMRLópez-ArribasSEfficacy of atomoxetine for the treatment of ADHD symptoms in patients with pervasive developmental disorders: a prospective, open-label studyJ Atten Disord201317649750522366240

 PubMed Web of Science ®Google Scholar

JouRJHandenBLHardanAYRetrospective assessment of atomoxetine in children and adolescents with pervasive developmental disordersJ Child Adolesc Psychopharmacol200515232533015910217

 PubMed Web of Science ®Google Scholar

PoseyDJWiegandREWilkersonJMaynardMStiglerKAMcDougleCJOpen-label atomoxetine for attention-deficit/hyperactivity disorder symptoms associated with high-functioning pervasive developmental disordersJ Child Adolesc Psychopharmacol200616559961017069548

 PubMed Web of Science ®Google Scholar

CharnsilCEfficacy of atomoxetine in children with severe autistic disorders and symptoms of ADHD: an open-label studyJ Atten Disord201115868468920686100

 PubMed Web of Science ®Google Scholar

SangalRBOwensJAllenAJSuttonVSchuhKKelseyDEffects of atomoxetine and methylphenidate on sleep in children with ADHDSleep200629121573158517252888

 PubMed Web of Science ®Google Scholar

ThurstoneCRiggsPDSalomonsen-SautelSMikulich-GilbertsonSKRandomized, controlled trial of atomoxetine for attention-deficit/hyperactivity disorder in adolescents with substance use disorderJ Am Acad Child Adolesc Psychiatry201049657358220494267

 PubMed Web of Science ®Google Scholar

AllenAJKurlanRMGilbertDLAtomoxetine treatment in children and adolescents with ADHD and comorbid tic disordersNeurology200565121941194916380617

 PubMed Web of Science ®Google Scholar

SpencerTJSalleeFRGilbertDLAtomoxetine treatment of ADHD in children with comorbid Tourette syndromeJ Atten Disord200811447048117934184

 PubMed Web of Science ®Google Scholar

WalkerDJMasonOClemowDBDayKAAtomoxetine treatment in adults with attention-deficit/hyperactivity disorderPostgrad Med2015127768670126343377

 PubMed Web of Science ®Google Scholar

AdlerLARubinRQiaoMHeinlothANDurellTMPatient characteristics and treatment response to atomoxetine in adults with ADHD versus ADHD comorbid with social anxiety disorderJ ADHD Relat Disord201013515

 Google Scholar

AdlerLALiebowitzMKronenbergerWAtomoxetine treatment in adults with attention-deficit/hyperactivity disorder and comorbid social anxiety disorderDepress Anxiety200926321222119194995

 PubMed Web of Science ®Google Scholar

DonnellyCLAdlerLAQiaoMDurellTMAnxiety response to atomoxetine in patients with attention-deficit/hyperactivity disorder and comorbid anxietyPoster presented at: 23rd Annual U.S. Psychiatric and Mental Health Congress (USPMHC)November 18, 2010Orlando, FL

 Google Scholar

RavindranLNKimDSLetamendiAMSteinMBA randomized controlled trial of atomoxetine in generalized social anxiety disorderJ Clin Psychopharmacol200929656156419910721

 PubMed Web of Science ®Google Scholar

GabrielAViolatoCAdjunctive atomoxetine to SSRIs or SNRIs in the treatment of adult ADHD patients with comorbid partially responsive generalized anxiety (GA): an open-label studyAtten Defic Hyperact Disord20113431932621833565

 PubMedGoogle Scholar

YoungJLSarkisEQiaoMWietechaLOnce-daily treatment with atomoxetine in adults with attention-deficit/hyperactivity disorder: a 24-week, randomized, double-blind, placebo-controlled trialClin Neuropharmacol2011342516021406998

 PubMed Web of Science ®Google Scholar

DurellTMAdlerLAWilliamsDWAtomoxetine treatment of attention-deficit/hyperactivity disorder in young adults with assessment of functional outcomes: a randomized, double-blind, placebo-controlled clinical trialJ Clin Psychopharmacol2013331455423277268

 PubMed Web of Science ®Google Scholar

WilensTEAdlerLAWeissMDAtomoxetine ADHD/SUD Study GroupAtomoxetine treatment of adults with ADHD and comorbid alcohol use disordersDrug Alcohol Depend2008961–214515418403134

 PubMed Web of Science ®Google Scholar

WilensTEAdlerLATanakaYCorrelates of alcohol use in adults with ADHD and comorbid alcohol use disorders: exploratory analysis of a placebo-controlled trial of atomoxetineCurr Med Res Opin201127122309232022029549

 PubMed Web of Science ®Google Scholar

BenegalVViswanathBNarayanaswamyJCThe efficacy of atomoxetine as adjunctive treatment for co-morbid substance use disorders and externalizing symptomsAsian J Psychiatry201366544547

 Google Scholar

AdlerLAGuidaFIronsSShawDMOpen label pilot study of atomoxetine in adults with ADHD and substance use disorderJ Dual Diagn201063–4196207

 Web of Science ®Google Scholar

LevinFRMarianiJJSecoraAAtomoxetine treatment for cocaine abuse and adult attention-deficit hyperactivity disorder (ADHD): a preliminary open trialJ Dual Diagn200951415619430599

 PubMed Web of Science ®Google Scholar

McRae-ClarkALCarterREKilleenTKCarpenterMJWhiteKGBradyKTA placebo-controlled trial of atomoxetine in marijuana-dependent individuals with attention deficit hyperactivity disorderAm J Addict201019648148920958842

 PubMed Web of Science ®Google Scholar