Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder

Acute comparison and differential response

Jeffrey H. Newcorn, Christopher J. Kratochvil, Albert J. Allen, Charles D. Casat, Dustin D. Ruff, Rodney J. Moore, David Michelson, Charles E. Bailey, David Dunn, L. Matthew Frank, Rosben L. Gutierrez, Rakesh Jain, Robert B. Lehman, Peter D. Londborg, Raun Melmed, Humberto Quintana, R. Bart Sangal, Shannon K. Robinson, Elias H. Sarkis, Keith E. Saylor

Research output: Contribution to journalArticle

232 Citations (Scopus)

Abstract

Objective: Response to atomoxetine, a nonstimulant norepinephrine-specific reuptake inhibitor, was compared with the effect of osmotic-release oral methylphenidate, a long-acting methylphenidate preparation, in patients with attention deficit hyperactivity disorder (ADHD). Method: In a large placebo-controlled, double-blind study, patients ages 6-16 with ADHD, any subtype, were randomly assigned to receive 0.8-1.8 mg/kg per day of atomoxetine (N=222), 18-54 mg/day of osmotically released methylphenidate (N=220), or placebo (N=74) for 6 weeks. The a priori specified primary analysis compared response (at least 40% decrease in ADHD Rating Scale total score) to osmotically released methylphenidate with response to atomoxetine and placebo. After 6 weeks, patients treated with methylphenidate were switched to atomoxetine under double-blind conditions. Results: The response rates for both atomoxetine (45%) and methylphenidate (56%) were markedly superior to that for placebo (24%), but the response to osmotically released methylphenidate was superior to that for atomoxetine. Each medication was well tolerated, with completion rates and discontinuations for adverse events not significantly different from those for placebo. Of the 70 subjects who did not respond to methylphenidate, 30 (43%) subsequently responded to atomoxetine. Likewise, 29 (42%) of the 69 patients who did not respond to atomoxetine had previously responded to osmotically released methylphenidate. Conclusion: Response was significantly greater with osmotically released methylphenidate than with atomoxetine. One-third of patients who received methylphenidate followed by atomoxetine responded better to one or the other, suggesting that there may be preferential responders.

Original languageEnglish (US)
Pages (from-to)721-730
Number of pages10
JournalAmerican Journal of Psychiatry
Volume165
Issue number6
DOIs
StatePublished - Jun 2008
Externally publishedYes

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Methylphenidate
Attention Deficit Disorder with Hyperactivity
Placebos
Therapeutics
Atomoxetine Hydrochloride
Double-Blind Method
Norepinephrine

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder : Acute comparison and differential response. / Newcorn, Jeffrey H.; Kratochvil, Christopher J.; Allen, Albert J.; Casat, Charles D.; Ruff, Dustin D.; Moore, Rodney J.; Michelson, David; Bailey, Charles E.; Dunn, David; Frank, L. Matthew; Gutierrez, Rosben L.; Jain, Rakesh; Lehman, Robert B.; Londborg, Peter D.; Melmed, Raun; Quintana, Humberto; Sangal, R. Bart; Robinson, Shannon K.; Sarkis, Elias H.; Saylor, Keith E.

In: American Journal of Psychiatry, Vol. 165, No. 6, 06.2008, p. 721-730.

Research output: Contribution to journalArticle

Newcorn, JH, Kratochvil, CJ, Allen, AJ, Casat, CD, Ruff, DD, Moore, RJ, Michelson, D, Bailey, CE, Dunn, D, Frank, LM, Gutierrez, RL, Jain, R, Lehman, RB, Londborg, PD, Melmed, R, Quintana, H, Sangal, RB, Robinson, SK, Sarkis, EH & Saylor, KE 2008, 'Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder: Acute comparison and differential response', American Journal of Psychiatry, vol. 165, no. 6, pp. 721-730. https://doi.org/10.1176/appi.ajp.2007.05091676
Newcorn, Jeffrey H. ; Kratochvil, Christopher J. ; Allen, Albert J. ; Casat, Charles D. ; Ruff, Dustin D. ; Moore, Rodney J. ; Michelson, David ; Bailey, Charles E. ; Dunn, David ; Frank, L. Matthew ; Gutierrez, Rosben L. ; Jain, Rakesh ; Lehman, Robert B. ; Londborg, Peter D. ; Melmed, Raun ; Quintana, Humberto ; Sangal, R. Bart ; Robinson, Shannon K. ; Sarkis, Elias H. ; Saylor, Keith E. / Atomoxetine and osmotically released methylphenidate for the treatment of attention deficit hyperactivity disorder : Acute comparison and differential response. In: American Journal of Psychiatry. 2008 ; Vol. 165, No. 6. pp. 721-730.
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AU - Moore, Rodney J.

AU - Michelson, David

AU - Bailey, Charles E.

AU - Dunn, David

AU - Frank, L. Matthew

AU - Gutierrez, Rosben L.

AU - Jain, Rakesh

AU - Lehman, Robert B.

AU - Londborg, Peter D.

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