Leo Bastiaens1. 1. Dr. Bastiaens is from Family Services of Western Pennsylvania and is Clinical Associate Professor of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: To evaluate the effectiveness of atomoxetine in a real-world attention deficit hyperactivity disorder (ADHD) population. DESIGN: A retrospective chart review with two nonrandomized samples-patients treated with atomoxetine and patients treated with stimulants. SETTING: One community mental health clinic. PARTICIPANTS: Over a two-year period, 85 patients treated with atomoxetine and 81 patients treated with stimulants were identified. Many patients had comorbid conditions and were treated concomitantly with other medications. MEASUREMENTS: Clinical Global Impression-Improvement scale (CGI-I) and Global Assessment of Functioning scale (GAF). RESULTS: On average, all patients showed mild improvement, as measured by the CGI, while staying on the same medication for approximately six months. There was no significant difference in GAF, at baseline or at endpoint, or in CGI at endpoint between the two groups. Even though more patients on atomoxetine showed side effects, there was a trend for patients to stay on it longer. CONCLUSION: Taking into account the limitations of a retrospective chart review in nonrandomized samples, it appears that patients with (comorbid) ADHD benefit as well from atomoxetine as from stimulants. If replicated in larger, better controlled studies, atomoxetine should be considered a first-line agent for the treatment of ADHD.
OBJECTIVE: To evaluate the effectiveness of atomoxetine in a real-world attention deficit hyperactivity disorder (ADHD) population. DESIGN: A retrospective chart review with two nonrandomized samples-patients treated with atomoxetine and patients treated with stimulants. SETTING: One community mental health clinic. PARTICIPANTS: Over a two-year period, 85 patients treated with atomoxetine and 81 patients treated with stimulants were identified. Many patients had comorbid conditions and were treated concomitantly with other medications. MEASUREMENTS: Clinical Global Impression-Improvement scale (CGI-I) and Global Assessment of Functioning scale (GAF). RESULTS: On average, all patients showed mild improvement, as measured by the CGI, while staying on the same medication for approximately six months. There was no significant difference in GAF, at baseline or at endpoint, or in CGI at endpoint between the two groups. Even though more patients on atomoxetine showed side effects, there was a trend for patients to stay on it longer. CONCLUSION: Taking into account the limitations of a retrospective chart review in nonrandomized samples, it appears that patients with (comorbid) ADHD benefit as well from atomoxetine as from stimulants. If replicated in larger, better controlled studies, atomoxetine should be considered a first-line agent for the treatment of ADHD.
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