Suravi Patra1, Naresh Nebhinani2, Anand Viswanathan3, Richard Kirubakaran4. 1. Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, India. 2. Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, India. 3. Princess Royal Spinal Injuries Centre, Northern General Hospital, Sheffield, S5 7AU, United Kingdom. 4. Cochrane South Asia, Christian Medical College, Vellore, India.
Abstract
Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta-analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent-rated hyperactivity (standardized mean difference [SMD] = -0.73, 95% Confidence Interval, CI = -1.15 to -0.34) and parent-rated inattention (SMD = -0.53, 95% CI = -0.93 to -0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non-serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542-552.
Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta-analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent-rated hyperactivity (standardized mean difference [SMD] = -0.73, 95% Confidence Interval, CI = -1.15 to -0.34) and parent-rated inattention (SMD = -0.53, 95% CI = -0.93 to -0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non-serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542-552.
Authors: Marco Solmi; Michele Fornaro; Edoardo G Ostinelli; Caroline Zangani; Giovanni Croatto; Francesco Monaco; Damir Krinitski; Paolo Fusar-Poli; Christoph U Correll Journal: World Psychiatry Date: 2020-06 Impact factor: 49.548
Authors: Maria M Lilja; Emil Sandblom; Paul Lichtenstein; Eva Serlachius; Clara Hellner; Jyoti Bhagia; Linda Halldner Journal: J Neurodev Disord Date: 2022-03-06 Impact factor: 4.025
Authors: Larissa Niemeyer; Konstantin Mechler; Ralf W Dittmann; Tobias Banaschewski; Jan Buitelaar; Sarah Durston; Alexander Häge Journal: Contemp Clin Trials Commun Date: 2022-08-14