Nonstimulant Therapy Shows Effectiveness in ADHD

Non-stimulant, Amoxetine, for treating ADHD appears to be safe and effective - providing alternative to stimulants for treatment of ADHD.

An experimental drug could offer an effective nonstimulant alternative for treating attention-deficit/hyperactivity disorder (ADHD), according to Dr. David Michelson, who spoke here at the 154th annual meeting of the American Psychiatric Association.

Atomoxetine is more effective than placebo for treating ADHD and may be more easily tolerated, said Michelson, medical director at Eli Lilly, the company responsible for the drug's development. In a presentation of several studies funded by Eli Lilly that involved adults and children, he and his colleagues concluded that atomoxetine was superior to placebo in controlling ADHD symptoms.

ADHD is characterized by impulsiveness, difficulty with academic and social functioning, and short attention span. It is most frequently treated with the stimulant drug Ritalin.

In one study in which some patients were given Ritalin, investigators found some evidence that atomoxetine is more easily tolerated. For example, atomoxetine does not appear to be associated with insomnia.

"Atomoxetine seems to work by blocking the norepinephrine transporter and doesn't involve the dopamine receptors directly,'' he told Reuters Health. "Therefore, it has a different mechanism of action than the stimulants commonly used to treat ADHD.''

"Clinicians and parents have been looking for alternatives to stimulants for the treatment of ADHD for years,'' Dr. Christopher Kratochvil, assistant professor of psychiatry at the University of Nebraska, told Reuters Health. "There are concerns about side effects, and about reports of children and adolescents using it recreationally. We're looking for an alternative class of medications that will be effective and have a different side effects profile than stimulants. Indications are that atomoxetine is not an abusable drug.''

In addition, stimulants are not effective for every patient with ADHD. For example, children with ADHD who have other conditions, such as anxiety disorder, may be more effectively treated with a nonstimulant alternative, said Kratochvil, who was an investigator in the study. He has also worked as a consultant for Eli Lilly and other companies.

In his experience, Kratochvil said, atomoxetine has been a safe and effective treatment for the management of this condition. Phase III studies of atomoxetine are ongoing, and Eli Lilly is preparing to submit an application to the Food and Drug Administration for approval of this drug for the treatment of ADHD later this year, Kratochvil told Reuters Health.