Treatment of attention deficit-hyperactivity disorder with atomoxetine. Recommendations for changing the medication from stimulants to atomoxetine

Abstract

Most children presenting with attention deficit-hyperactivity syndrome (ADHS) do not receive any medication, even though pharmacological treatment of ADHS is one of the most efficient elements in a multimodal approach to treatment. As a rule, in children who are treated for ADHS with medication the drug administered is the stimulant methylphenidate. A stimulant therapy does have disadvantages, however: lack of efficacy or inadequate effect in some cases, and potential side effects and abuse. One alternative for use in ADHS is the noradrenaline receptor inhibitor atomoxetine. Its pharmacology, efficacy and tolerability in children and adolescents are presented, as are tips for making the switch from stimulants to atomoxetine. Early experience in children and adolescents in whom the switch has been made is definitely positive. The particular advantages of atomoxetine lie in its continuous effect, which lasts throughout the day to the next morning, and its favourable side effect profile. A combination of atomoxetine and psychostimulants is also possible, and it seems this would always be helpful when it has not proved possible to attenuate the symptoms by means of monotherapy.