| We know from patient reporting that | | | | had anxiety as a side effect of stimulant |
| non-stimulant medications for ADHD does not | | | | medication, when the patient has had a tic |
| work for everyone. Until recently, it was | | | | disorder side effect on stimulant medication, or in |
| thought that responding to the non-stimulant | | | | patients who can not or should not take stimulant |
| medication, Atomoxetine (Strattera), was a | | | | medication. Atomoxetine is also helpful when |
| hit-or-miss proposition. Anecdotal reports and | | | | there is a coexisting reading problems. |
| scientific journals report that Atomoxetine works | | | | Atomoxetine improved visuospacial deficits in |
| very well in some patients and not at all in | | | | children with ADHD and reading difficulties. |
| others. Most of the scientific studies done on | | | | Children with ADHD and reading difficulties are |
| Atomoxetine have found that it works about as | | | | thought to have a very specific executive |
| well as short acting stimulants in most patients | | | | function deficit. The connection between ADHD |
| but not nearly as well as the long acting or | | | | and visuospacial deficits are poorly understood and |
| sustained release stimulants. In fact, there | | | | require more study but it is this same connection |
| may be some rhyme and reason to when the | | | | which is thought to be the reason why visual |
| Atomoxetine will work and when it will not. As | | | | therapy improves attention in some children with |
| more research studies are completed, a clearer | | | | ADHD. Some other interesting facts about |
| picture has emerged of when Atomoxetine is | | | | Atomoxetine include: 1. . There is a subset |
| most helpful. The findings from these studies | | | | of patient who do not respond at all to stimulants |
| report that Atomoxetine is probably not useful in | | | | but do respond to Atomoxetine. 2. |
| treating patients with ADHD and co-morbid | | | | Atomoxetine may be better for morning control |
| Oppositional Defiance Disorder. In most families, | | | | of symptoms than stimulants because of their |
| the treatment of co-morbidities such as ODD is | | | | steady duration of action. The stimulants work |
| as important as the treatment of the core | | | | only when they are at therapeutic levels which |
| symptoms of ADHD. The percentage of | | | | occurs typically 30-60 minutes after taking the |
| individuals with co-morbid Oppositional symptoms | | | | medication. Atomoxetine reaches it's full |
| in combined type ADHD and Hyperactive | | | | therapeutic potential in about 6 weeks though |
| Impulsive ADHD is amazingly high. One study | | | | some individuals report improvement immediately. |
| found that more than 50% of patients with the | | | | 3. Atomoxetine works better for all types of |
| combined type of ADHD had oppositional | | | | ADHD at a daily dose of 1.4 mg/kg (0.65 mg |
| symptoms. That same study reported that | | | | per pound) when compared to the dose of .8 mg |
| greater than 40% of patients with hyperactive | | | | kg (0.36 mg per pound) and once daily dosing of |
| impulsive ADHD exhibited symptoms of ODD. If | | | | Atomoxetine is as effective and as well tolerated |
| you have ever lived or worked with an individual | | | | with regards to side effects as twice a day |
| with ODD you will understand how disruptive | | | | dosing. 4. Side effects which required |
| these symptoms are to a healthy social or | | | | discontinuation of the medicine occurred in less |
| family dynamic. Most adults and families would | | | | than 10% of individuals started on Atomoxetine. |
| consider Atomoxetine to be an ADHD treatment | | | | The most common side effects in children and |
| failure if the symptoms of ODD were not | | | | teenagers were upset stomach, decreased |
| improved while taking this medication. It is | | | | appetite, nausea or vomiting, dizziness, and |
| estimated that 75% of ADHD is either the | | | | tiredness. Atomoxetine works extremely well in |
| combined subtype (hyperactive, Impulsive, and | | | | a specific subset of individuals with ADHD. |
| inttentive) or hyperactive/impulsive subtype. If | | | | Knowing which groups may respond best to this |
| we do the math we can see that in 100 patients, | | | | medication will give patients the necessary |
| about 33 will not be helped by Atomoxetine | | | | information to best address their ADHD |
| because of the lack of control of their ODD | | | | symptoms. Further study into the effectiveness |
| symptoms. Atomoxetine is also most helpful | | | | of Atomoxetine will allow us to better understand |
| when the patient has not already been treated | | | | why this medicine is effective in certain people |
| with a stimulant medication, when the patient has | | | | and totally ineffective in others. |