Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder

World J Biol Psychiatry. 2015;16(8):619-24. doi: 10.3109/15622975.2015.1051109. Epub 2015 Jul 30.

Abstract

Objectives: Pharmacological treatment of attention deficit hyperactivity disorder (ADHD) includes stimulant and non-stimulant medications. Our purpose in this study is to investigate efficacy, safety and tolerability of combined methylphenidate and atomoxetine pharmacotherapy.

Methods: We included 12 patients of the 824 patients with ADHD using methylphenidate and atomoxetine combined therapy between the years 2010 and 2014. Kiddie-SADS, Turgay DSM-IV Based Child and Adolescent Behavior Disorders Screening and Rating Scale, Child Behavior Checklist, Clinic Global Impression Scale Severity and Impression (CGIS-S-I) scales were used.

Results: Patients were between the ages of 7 and 17 years. Before combined pharmacotherapy the CGIS-S score mean was 5.08. Mean CGIS-S score after the combined pharmacotherapy was 3.08 (P = 0.03; -2,980). The most common side effects were irritability (n = 5, 41.6%), appetite reduction (n = 3, 25%), palpitations (n = 2, 16.7%), headache (n = 1, 8.3%).

Conclusions: Nine of these 12 patients showed significant improvement in their symptoms, combined therapy enhanced the effectiveness of monotherapy.

Keywords: atomoxetine; attention deficit hyperactivity disorder; combined therapy; methylphenidate; pharmacotherapy.

MeSH terms

  • Adolescent
  • Atomoxetine Hydrochloride / adverse effects
  • Atomoxetine Hydrochloride / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders
  • Drug Therapy, Combination
  • Female
  • Headache / etiology
  • Humans
  • Male
  • Methylphenidate / adverse effects
  • Methylphenidate / therapeutic use*
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride