BACKGROUND: Stimulants are the first-line medication in the psychopharmacological treatment of attention-deficit hyperactivity disorder (ADHD). However, 10 to 30% of all children and adults with ADHD either do not respond to or do not tolerate treatment with stimulants. OBJECTIVE: To describe alternative treatment approaches with various non-stimulant agents, especially atomoxetine. METHOD: General review of empirically based literature concerning efficacy and safety of the substances. RESULTS: A large and still increasing body of data supports the usefulness of atomoxetine, a once daily dosing, and new selective noradrenalin reuptake inhibitor, with few side effects. Atomoxetine has been licensed in the US for use in ADHD across the lifespan, and is currently under consideration in Europe. Other non-stimulant substances, such as tricyclic antidepressants (TCAs) and alpha-2-adrenergic agonists, which are used to treat ADHD, are also reviewed. TCAs have been well studied and shown to be efficacious in the treatment of ADHD, but are limited by side effects. The number of studies documenting the efficacy of alpha-2-adrenergic agonists is still limited. Some experimental studies support a potential role of cholinergic drugs such as acetylcholinesterase inhibitors (tacrine, donepezil) as well as novel nicotinic analogues (ABT-418). CONCLUSION: Non-stimulant agents have been shown to be effective in treatment of ADHD. Especially, atomoxetine seems promising and newline drugs are in development.
BACKGROUND: Stimulants are the first-line medication in the psychopharmacological treatment of attention-deficit hyperactivity disorder (ADHD). However, 10 to 30% of all children and adults with ADHD either do not respond to or do not tolerate treatment with stimulants. OBJECTIVE: To describe alternative treatment approaches with various non-stimulant agents, especially atomoxetine. METHOD: General review of empirically based literature concerning efficacy and safety of the substances. RESULTS: A large and still increasing body of data supports the usefulness of atomoxetine, a once daily dosing, and new selective noradrenalin reuptake inhibitor, with few side effects. Atomoxetine has been licensed in the US for use in ADHD across the lifespan, and is currently under consideration in Europe. Other non-stimulant substances, such as tricyclic antidepressants (TCAs) and alpha-2-adrenergic agonists, which are used to treat ADHD, are also reviewed. TCAs have been well studied and shown to be efficacious in the treatment of ADHD, but are limited by side effects. The number of studies documenting the efficacy of alpha-2-adrenergic agonists is still limited. Some experimental studies support a potential role of cholinergic drugs such as acetylcholinesterase inhibitors (tacrine, donepezil) as well as novel nicotinic analogues (ABT-418). CONCLUSION: Non-stimulant agents have been shown to be effective in treatment of ADHD. Especially, atomoxetine seems promising and newline drugs are in development.
Authors: John-Michael Sauer; G Douglas Ponsler; Edward L Mattiuz; Amanda J Long; Jennifer W Witcher; Holly R Thomasson; Karl A Desante Journal: Drug Metab Dispos Date: 2003-01 Impact factor: 3.922
Authors: David Michelson; Lenard Adler; Thomas Spencer; Frederick W Reimherr; Scott A West; Albert J Allen; Douglas Kelsey; Joachim Wernicke; Anthony Dietrich; Denái Milton Journal: Biol Psychiatry Date: 2003-01-15 Impact factor: 13.382
Authors: Estate M Sokhadze; Joshua M Baruth; Lonnie Sears; Guela E Sokhadze; Ayman S El-Baz; Emily Williams; Robert Klapheke; Manuel F Casanova Journal: J Neurother Date: 2012-03-02
Authors: Sandra J J Kooij; Susanne Bejerot; Andrew Blackwell; Herve Caci; Miquel Casas-Brugué; Pieter J Carpentier; Dan Edvinsson; John Fayyad; Karin Foeken; Michael Fitzgerald; Veronique Gaillac; Ylva Ginsberg; Chantal Henry; Johanna Krause; Michael B Lensing; Iris Manor; Helmut Niederhofer; Carlos Nunes-Filipe; Martin D Ohlmeier; Pierre Oswald; Stefano Pallanti; Artemios Pehlivanidis; Josep A Ramos-Quiroga; Maria Rastam; Doris Ryffel-Rawak; Steven Stes; Philip Asherson Journal: BMC Psychiatry Date: 2010-09-03 Impact factor: 3.630
Authors: Ralf W Dittmann; Peter M Wehmeier; Alexander Schacht; Anette Minarzyk; Martin Lehmann; Kathrin Sevecke; Gerd Lehmkuhl Journal: Child Adolesc Psychiatry Ment Health Date: 2009-08-24 Impact factor: 3.033