current literature in adhd by sam goldstein (2006) - an article

8/13/2019 Current Literature in ADHD by Sam Goldstein (2006) - an article

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10.1177/1087054705283884OTHERJournal of Attention DisordersCurrent Literature

Current Literature in ADHD

Summarized by Sam Goldstein

Abikoff, H., McGough, J., Vitiello B., McCracken, J.,

Davies, M., Walkup, J., et al. (2005). Sequential

pharmacotherapy for children with comorbid ADHDand

anxiety disorders. Journal of the American Academy of

Child and Adolescent Psychiatry, 44, 418-427.

Children ages 6 to 17 years with ADHD and anxiety

were titrated to optimal methylphenidate doses and

assessed along with children who entered the study on a

previously optimized stimulant. Children with improved

ADHD who remained anxious were randomly assigned

to 8 weeks of double-blindstimulantplus Fluvoxamineor

stimulant plus placebo. Of the 32 medication-naive chil-

drenopenly treated withmethylphenidate, 81%improved

as to ADHD. In this study, 25 children entered the ran-

domized trial. Intent-to-treat analysis indicated no differ-

ences between the stimulant plus Fluvoxamine and the

stimulant plus placebo groups on the Pediatric AnxietyRating Scale or clinical global impressions-improvement-

defined responder rate. Medications in both arms were

well tolerated. The authors concluded that children with

ADHD plus anxiety havea response rate to stimulants for

ADHD that is comparable with that of children with gen-

eral ADHD. They noted that the benefit of adding

Fluvoxamine to stimulants for anxiety remains unproven.

Boonstra, A. M., Oosterlaan, J., Sergeant, J. A., &

Buitelaar, J. K. (2005). Executive functioning in adultADHD: A meta-analytic review. Psychological Medi-

cine, 35, 1097-1108.

To establish if theories of executive functioning defi-

cits as responsible forADHD symptoms aresupportedby

research data for adults with ADHD, these authors com-

pared executive functioning and nonexecutive function-

ing between adults with ADHD and normal controls in a

meta-analytic design. The authors compared 13 studies

finding mediumeffect sizes both in executive functioning

areas (verbal fluency, inhibition, and set shifting) and in

nonexecutive functioning domains (consistency of

response, word reading, and color naming). The authors

concluded that neuropsychological difficulties in adultADHD may not be confined to executive functioning.

Chacko, A., Pelham, W. E., Gnagy, E. M., Greiner, A.,

Vallano, G.,Bukstein,O.,et al.(2005). Stimulantmedica-

tion effects in a summer treatment program among young

children with ADHD. Journal of the American Academy

of Child and Adolescent Psychiatry, 44, 249-257.

Between 1987 and 1997, 5- and 6-year-old childrenattending a summer treatment program underwent a ran-

domized, clinical assessment of the effect of two doses of

methylphenidate and placebo on social behavior and aca-

demic performance. Methylphenidate had an effect on all

four social behaviors and improved two of the three areas

of academic functioning. Dose effects were present for

three of the seven dependent measures. Individual analy-

ses indicated the therapeutic response rate between 39%

and 100% across dependent measures. Furthermore, an

individual analysis of response indicated that across sev-

eral important dependent measures, 39% to 98% of chil-

dren showed little incremental improvement with thehigher dose compared with the lower dose of stimulant

medication. The authors concluded that stimulant medi-

cation is an effective treatment for young children diag-

nosed with ADHD. However, multiple domains of func-

tioning must be assessed to determine the most effective

dose in thisage range. In thisstudy, nearlyhalfof the orig-

inal participant pool were significantly benefited by

561

Journal of Attention Disorder

Volume 9 Number

February 2006 561-567

© 2006 Sage Publication

10.1177/108705470528388

http://jad.sagepub.com

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psychosocial intervention. Their parents declined

medication treatment.

Counts, C. A., Nigg, J.T., Stawicki, J.A., Rappley, M. D.,

& Von Eye, A. (2005). Family adversity in DSM-IV

ADHDcombinedand inattentive subtypes andassociated

disruptive behavior problems. Journal of the American

Academy of Child and Adolescent Psychiatry, 44, 690-

698.

This study evaluated the relationship between a family

adversity index and Diagnostic and Statistical Manual of

Mental Disorders (4th ed.; DSM-IV ) ADHD subtypes and

associated behavior problems. Parents and 206 children

ages 7 to 13 completed diagnostic interviews and rating

scales about socioeconomic status, parental lifetime psy-

chiatric disorders, marital conflict, and stressful lifeevents. Children with ADHD combined type experienced

more risk factors than community controls or children

with the predominantly inattentive type of ADHD. The

families of children with ADHD combined type

described more risk factors associated with family adver-

sity than the families of children with ADHD inattentive

type and the control group. Children’s perceptions of

marital conflict were independently related to inattention

andhyperactivity behaviors as rated by parents andteach-

ers after control of all other risk factors. Oppositional

defiant symptoms were independently related to marital

conflict and maternal psychopathology, whereas conductdisorder symptoms were uniquely related to low socio-

economic status and maternal psychopathology. The

authors concluded that family adversity is related to

ADHD combined type in children and may be related

specifically to ADHD symptoms in addition to conduct

disorder symptoms.

Doyle, R. E., Biederman, J., Seidman, L. J., Reske-

Nielsen, J., & Faraone, S. V. (2005). Neuropsychological

functioning in relatives of girls with and without ADHD.

Psychological Medicine, 35, 1121-1132.

Structured diagnostic interviews and neuropsycho-

logical batteries were administered to parents and sib-

lings enrolled in a family study of girls with and without

ADHD. Relatives were stratified into four groups, those

with DSM-IV ADHD probands, relatives of ADHD

probands with ADHD, relatives of ADHD probands

without ADHD, and relativesof controls without ADHD.

Analyses were also conducted on a subgroup of families

in which more than one member had ADHD. The

neuropsychological battery as a whole distinguished

affected and unaffected ADHD relatives from controls.

The Wechsler Oral Arithmetic subtest and the Stroop

Word Color and Color-Word subscales were impaired in

affected ADHD relatives, as were the academic measures

of arithmetic and reading on the Wide Range Achieve-

ment Test. Only the Stroop Color-Word and Interference

subtests and an arithmetic measure demonstrated signifi-

cant impairments in unaffected relatives. In multiplex

families, additional impairments were found in unaf-

fected relatives as well. The authors concluded that their

data are consistent with previous studies of relatives of

males with ADHD. Neuropsychological impairments in

relatives of females with ADHD were primarily associ-

ated with the diagnosis of ADHD, but subtle cognitive

impairments that index familial vulnerability to thedisorder may also exist according to these findings.

Fein, D., Dickson, P., Paul, J., & Levin, H. (2005). Brief

report: Pervasive developmental disorder can evolve into

ADHD: Case illustrations. Journal of Autism and Devel-

opmental Disorders, 35, 525-534.

Despite prominent symptoms of inattention noted in

pervasive developmental disorders (PDD), the relation-

ship of PDD and ADHD has received scant direct exami-nation. In addition,outcome studies of children with PDD

often focus on language and social and adaptive skills but

seldom on the loss of the PDD diagnosis or change to

another clinical syndrome. These authors presented three

cases in detail and tabular data on eight more, illustrating

a clinical presentation in which prototypical cases of

PDD evolved into clear-cut cases of ADHD from early to

middle childhood.

Filho, A. G., Bodanese, R., Silva, T. L., Alvares, J. P.,

Aman, M., & Rohde, L. A. (2005). Comparison of

Risperidone and methylphenidate for reducing ADHD

symptoms in children and adolescents with moderate

mental retardation. Journal of the American Academy of


The authors sought to evaluate the short-term efficacy

and tolerability of Risperidone and methylphenidate for

562 Journal of Attention Disorders



reducing symptoms related to ADHD in children and

adolescents with moderate mental retardation. In a 4-

week, single-blind, parallel group trial, 45 participants

with these comorbid problems were randomized to

Risperidone or methylphenidate and assessed using a

number of objective rating scales. Both groups had

reduced ADHD symptoms during the trial. Repeated

measures analysis of variance yielded a significant effect

for the interaction between time and group assignments,

suggesting a more pronounced effect for Risperidone.

There was a significant weight reduction in the

methylphenidate group and a weight gain in the

Risperidone group.Theauthors concluded that their find-

ings suggest that Risperidone is associated with greater

reductions in ADHD symptoms than methylphenidate in

children with moderate mental retardation. Comorbidity

and the side effects profiles they noted might be of impor-

tance in choosing between the medications. However, the

authors suggested that it is prudent to attempt stimulantsbefore antipsychotic medications in children.

Hudziak, J. J., Dirks, E. M., Althoff, R. R., Rettew, D. C.,

& Boomsma,D. I. (2005). Thegenetic andenvironmental

contributions to ADHD as measured by theConners’Rat-

ing Scales–Revised. American Journal of Psychiatry,

162, 1614-1620.

From the Conners’ scale forms, data for the ADHD

index was collected from the mothers of 1,595 7-year-oldtwin pairs from the Netherlands twin registry. Rates of

ADHD diagnoses were computed by using Conners’

gender- and age-specific cutoffs. Contributions from

additive, dominant, unique environmental, interaction,

and gender effects were computed by using gender-

genetic models. Theprevalence of ADHD acrossthe sam-

ple of 7-year-old twin pairs was approximately 4%

according to the mothers’ reports. However, using the

gender norms provided with the ADHD index, the

authors found slightly higher rates of ADHD in females

than previously reported. Genetic analyses yielded a

model that included genetic dominance (48%), additive

genetic factors (30%), and unique environmental factors

(22%). The ADHD index from the Conners’scale identi-

fied an appropriate percentage of children across this

epidemiologic twin span as being at risk for ADHD. The

results of the genetic analyses are also consistent with

prior reports that ADHD is predominantly influenced by

genetic factors that are both dominant and additive.

Jensen, P. S., Garcia, J. A., Glied, S., Crowe, M., Foster,

M., Schlander, M., et al. (2005). Cost effectiveness of

ADHD treatments: Findings from the multimodal treat-

ment study of children with ADHD. American Journal of

Psychiatry, 162, 1628-1636.

In the first large-scale, cost-effectiveness study of the

major forms of treatment of ADHD, 579 children as part

of the National Institutes of Mental Health multimodal

treatment study of children with ADHD were assigned to

14 months of medication management, behavioral treat-

ment, both combined, or community care. Services were

tallied throughout the study, including costs of medica-

tion, health care visits, behavioral treatments, and related

rental costs. Provider specialty, total time, and number of

visits with providers were used to calculate cost adjusted

with the consumer price index. Treatment cost variedfourfold, with medication management being the least

expensive followed by behavioral treatment and then

combined treatment. Lower costs of medication treat-

ment were found in the community care group, reflecting

the less intensive (and less effective) nature of commu-

nity-delivered treatment. Medical management was more

effective but more costly than community care and more

cost-effective than combination treatment and behavioral

treatment alone. Under some conditions, combined treat-

ment (medication management and psychotherapy) was

somewhat more cost-effective as demonstrated by lower

cost per additional child (normalized) among children

withmultiplecomorbiddisorders. The authors concluded

that medical management treatment, although not as

effective as combined medical management and behav-

ioral treatment, is likely to be more cost-effective in the

routine treatment of children with ADHD, particularly

those without comorbid disorders. For those with

comorbid disorders and ADHD, it may be cost effective

to provide combination treatment according to these

authors.

Kratochvil, C. J., Newcorn, J. H., Arnold, L. E.,

Duesenberg, D., Emslie, G., Quintana, H., et al. (2005).

Atomoxetine alone or combined with Fluoxetine for

treating ADHD with comorbid depressive or anxiety

symptoms. Journal of the American Academy of Child

and Adolescent Psychiatry, 44, 915-924.

Current Literature 563



The authors assessed the safety and efficacy of

Atomoxetine monotherapy compared with combined

Atomoxetine/Fluoxetine therapy in a population of chil-

dren and adolescents with ADHD and concurrent symp-

toms of depression or anxiety. Patients were randomized

to treatment with Fluoxetine or placebo under double-

blind conditions for 8 weeks with concomitant

Atomoxetine used the last 5 weeks. At the endpoint,

reductions in ADHD, and depressive and anxiety symp-

toms were marked for both treatment groups. Some dif-

ferences between treatment groups for depressive symp-

toms were significant, but the magnitudes of the

differences were small and likely of limited clinical

importance. Completion rates for the two groups were

similar, as were discontinuation rates for adverse events.

The authors concluded that in pediatric patients with

ADHD andcomorbid symptoms of depression or anxiety,

Atomoxetine monotherapy appears to be effective for

treating ADHD. Anxiety and depressive symptoms alsoimprove, but the absence of a placebo-only arm does not

allow for the conclusion that these effects are specifically

the result of treatment with Atomoxetine. Combined

Atomoxetine/Fluoxetine therapy according to these

authors was also well tolerated.

Levy, F., Hay, D. A., Bennett, K. S., & McStephen, M.

(2005). Gender differences in ADHD subtype

comorbidity. Journal of the American Academy of Child


These authors sought to examine gender differences in

ADHD symptom comorbidity with oppositional defiant

disorder, conduct disorder, separation anxiety disorder,

generalized anxiety disorder, speech therapy, and reme-

dial reading inchildren.Data from a large sampleof twins

andsiblings studied in theAustralian twin ADHD project

were obtained through DSM-IV -based questionnaires

investigating patterns of comorbidity in the three sub-

types of ADHD. A total of 1,550 questionnaires were

returned over a 12- to 18-month period. Analysis of vari-

ance showed significant between-group differences in

males and females for inattention and hyperactive/

impulsive symptom counts, with higher rates of opposi-

tional defiant disorder and conduct disorder in males and

higher rates of separation anxiety disorder in females.

The authors concluded that this indicated that internaliz-

ing disorders are more common in females and

externalizing disorders occur more often in males. Gen-

der differences and speech therapy were significant only

for the children without ADHD. The rates of separation

anxiety disorder were higher in females, with the inatten-

tion subtype and the rate of generalized anxiety disorder

higher for females with the combined subtype. Although

comorbidity differences among ADHD subtypes occur,

the authors concluded that there were no significant gen-

der differences in comorbidity for externalizing disor-

ders. Inattentive girls may present with anxiety. Clinical

approaches forboth males and females according to these

authors shouldbe sensitive to possible language andread-

ing problems.

Martinussen, R., Hayden, J., Hogg-Johnson, S., &

Tannock, R. (2005). A meta-analysis of working memory

impairments in children with ADHD. Journal of the

American Academy of Child and Adolescent Psychiatry,44, 377-384.

Exploratory meta-analytic procedures were used to

investigate whether children withADHDexhibit working

memoryimpairments. In this study, 26 empirical research

studies published from 1997 to 2003 met inclusion crite-

ria. Children with ADHD exhibited deficits in multiple

components of working memory that appeared independ-

ent of comorbidity with language learning disorders and

weaknesses in general intellectual ability. Evidence of

working memory impairments in children with ADHD

supports recent theoretical models implicating workingmemory processes in ADHD according to these authors.

The authors concluded that it is possible that providing

support for working memory limitations mayhelp reduce

the functional impairments experienced by children with

ADHD.

Max, J. E., Manes, F. F., Robertson, B. A., Matthews, K.,

Fox, P., & Lancaster, J. (2005). Prefrontal and executive

attention network lesions in the development of ADHD

symptomatology. Journal of the American Academy of


In this study, 29 children with focal strokelesions were

studied with standardized psychiatric assessments and

anatomical brain MRI. The pattern of lesion overlapped

in participants with ADHD symptomatology was deter-

mined. Of 28 participants, 15 with no prestroke ADHD




were diagnosed with ADHD symptomatology at the time

of assessment. The extent of lesions within the executive

attention network was marginally related to ADHD

symptomatology, whereas theextent of lesions in thespe-

cific frontal region of interest was significantly related to

ADHD symptomatology. The authors concluded that

lesions within Posner’s executive attention network and

its orbital frontal connections may be linked to important

mechanisms in the expression of ADHD symptom-

atology after childhood stroke. These findings are consis-

tent with functional and structural imaging findings and

studies of idiopathic ADHD.

McGough, J. J., Smalley, S. L., McCracken, J. T., Yang,

M.,Delhomme,M.,Lynn, D.E.,et al.(2005). Psychiatric

comorbidity in adult attention deficit hyperactivity disor-

der: Findings from multiplex families. American Journalof Psychiatry, 162, 1621-1625.

Lifetime ADHD and comorbid psychopathology was

assessed in 435 parents of children with ADHD. Rates

and mean ages at onset of comorbid psychopathology

were compared in parents with lifetime ADHD, parents

with persistent ADHD, and those without ADHD. Age-

adjusted rates of comorbidity were compared with

Kaplan-Meier survival curves. Logistic regression was

used to assess additional risk factors for conditions more

frequent in participants with ADHD. The authors found

that parents with ADHD were significantly more likely tobe unskilled workers and less likely to have completed a

college degree. Participants with ADHD had more life-

time psychopathology; 80%hadat least oneand56%had

at least two other psychiatric disorders compared with

64% and 27%, respectively, in non–ADHD participants.

ADHD was associated with greater disruptive behavior,

substance use, mood and anxiety disorders, earlier onset

of major depression, dysthymia, oppositional defiant dis-

order, and conduct disorder. Group differences based on

Kaplan-Meier age-corrected risks were consistent with

those for raw frequency distributions. Male gender added

risk for disruptive behavior disorders. Female gender and

oppositional defiant disorder contributed to risk for

depression and anxiety. ADHD was not a significant risk

factor for substance use disorders when male gender, dis-

ruptive behavior disorders, and socioeconomic status

were controlled. This study adds to the growing body of

literature noting that ADHD in adulthood is associated

with significant lifetime psychiatric comorbidity

unexplained by other variables.

Newcorn, J. H., Spencer, T. J., Biederman, J., Milton, D.

R., & Michelson, D. (2005). Atomoxetine treatment in

children and adolescents with ADHD and comorbid

oppositional defiant disorder. Journal of the American

Academy of Child and Adolescent Psychiatry, 44, 240-

248.

Children and adolescents ages 8 to 18 with ADHD

were treated for approximately 8 weeks with placebo or

Atomoxetine under randomized, double-blind condi-

tions. Among patients with lifetime diagnostic informa-

tion, 39% were diagnosed with oppositional defiant dis-

order and61%were not. Treatment group differences and

differences between patients with and without

oppositional defiant disorder were examined post hoc for

changes on a number of rating scales. Youth with ADHD

and oppositional defiant disorder demonstrated statisti-cally significant improvements in ADHD, oppositional,

and quality-of-life measures. Treatment response was

similar to youths with and without oppositional prob-

lems. The authors concluded that Atomoxetine treatment

improves ADHD and oppositional symptoms in youth

with thecombined conditions but noted that thecomorbid

group may require higher doses of medication.

Owens, J.A. (2005). The ADHDand sleep conundrum:A

review. Journalof Developmentaland BehavioralPediat-

rics, 26 , 312-322.

This author provided a good overview of current

knowledge in the field relative to ADHD and sleep prob-

lems. Recent studies have helped to elucidate the nature

of the brain mechanisms and neuromodular systems

underlying the theoretical associations amongsleepiness,

arousal, and attention. The author reviewed new method-

ologies used in examining sleep andsleep patterns in chil-

dren diagnosed with ADHD. Guidelines are provided for

a clinical approach to evaluation andmanagement of chil-dren with ADHD and co-occurring sleep problems.

Peck, H. L., Kehle, T. J., Bray, M. A., & Theodore, L. A.

(2005). Yogaasan interventionfor children with attention

problems. School Psychology Review, 34, 415-424.




These authors used a multiple baseline design across

three grade-level groups with a comparison group to

investigate the effectiveness of yoga for improving time

on task with 10 elementary school children who evi-

denced attention problems. A yoga videotape was used

requiring children to follow an adult instructor engaging

in deep breathing, physical postures, and relaxation exer-

cises for 30 minutes twice a week for a period of 3 weeks.

The authors suggested very strong positive effect sizes,

suggesting the yoga exercises improved time on task.

Peer comparison data indicated the classmates’ time on

taskremained essentially unchanged throughout the three

phases of the study. The authors noted a number of limita-

tions, including small sample size and that the investiga-

tors served dual roles as both implementor of the inter-

vention and observer of the participants. They also noted

that interpretation of the results of this study should be

made with caution.

Ratner, S.,Laor,N.,Bronstein, Y., Weizman, A.,& Toren,

P. (2005). Six-week open-label Reboxetine treatment in

children and adolescents with ADHD. Journal of the

American Academy of Child and Adolescent Psychiatry,

44, 428-433.

In this study, 31 children and adolescent outpatients

ages 8 to 18 years of age diagnosed with ADHD were

enrolled in a 6-weekopen-label study assessing theeffec-

tiveness of Reboxetine, a selective norepinephrinereuptake inhibitor. A significant decrease in ADHD

symptoms on all scales measured was noted. Adverse

effects were relatively mild and transient. The most com-

mon adverse effects were drowsiness/sedation and gas-

trointestinal complaints. The results of this open-label

study suggest Reboxetine may be effective in the treat-

ment of ADHD for methylphenidate-resistant patients in

thispopulation. Double-blind placebo and active compar-

ison control studies were recommended.

Slaats-Willems, E. D., Swaab-Barneveld, H., de

Sonneville, L., & Buitelaar, J. (2005). Familial clustering

of executive functioning in affective sibling pair families

with ADHD. Journal of the American Academy of Child


In this study, 52affectedsibling pairs ages6 to18years

diagnosed with ADHD performed the Stroop Test, Go/

No-Go task, two different fine visual motor tracking

tasks, and a sustained-divided and focused attention task.

Significant correlations were found between siblings for

response inhibition and attentional control and for fine

visual motor skills that made high demands on executive

functioning. The authors concluded that response inhibi-

tion, higher order controlled fine visual motor function-

ing, andattentional control appeared to cluster in ADHD-

affected siblings. They suggested that these aspects of

executive dysfunctioning may reflect an endophenotype

of ADHD. Measurement of these executive functions

may facilitate the identification of genes involved in

ADHD by forming more homogenous subgroups.

Vaidya,C. J.,Bunge,S. A.,Dudukovic, N. M.,Zalecki, C.A., Elliott, G. R., & Gabrieli, J. D. (2005). Altered

neurosubstraits of cognitive control and childhood

ADHD: Evidence from functional magnetic resonance

imaging. American Journal of Psychiatry, 162, 1605-

1613.

This study compared the neuro bases of two cognitive

control operations, interference suppression and response

inhibition, between children with and without ADHD. In

a sample of 10 children with combined type ADHD and

10 matched controls, interference suppression in all par-

ticipants was characterized by reduced engagement of afrontal-striatal-temporal-parietal network. In contrast,

response inhibition performance relied on different

regions in the two groups, frontal-striatal in comparison

participants but right superior temporal in children with

ADHD. The authors concluded that alteration in the

neuro basis of two cognitive control operations in child-

hood ADHD was characterized by distinct rather than

unitary patterns of functional abnormality. The greater

between-group overlap in theneuro network activated for

interference suppression than in response inhibition

appears to suggest the components of cognitive control

are differentially sensitive to ADHD. The children with

ADHD were unable to activate the caudate nucleus, sug-

gesting a core abnormality in this function in ADHD. Fur-

thermore, the authors also noted that observed functional

abnormalities did not result from prolonged stimulant

exposure as most children were medication naive.




Van Meel, C., Oosterlaan, J., Heslenfeld, D. J., &

Sergeant, J. A. (2005). Motivational effects on motor tim-

ing and ADHD. Journal of the American Academy of


In this study, 18 children ages 8 to 12 years of age with

ADHD were compared with 18 age- and gender-matched

normal controls with respected timing precision, timing

variability, and the frequency of extreme under- and

overestimations during a 1-second interval production

task. Monetary reward, response cost, andno reward were

implemented to manipulate motivation. Children with

ADHD produced significantly more inaccurate and more

variable time intervals and exhibited a larger number of

extreme over- and underestimations than control chil-

dren.Although all childrenperformedsignificantly better

when monetary incentives were applied, group differ-ences were not eliminated. In this study, no evidence was

found for a motivational deficit as an explanation for

impaired performance on a time production task in

ADHD. The authors concluded that their results provide

clear support for a generic motor timing deficit, probably

due to a dysfunctional frontostriatocerebellar network

involved in temporal aspects of motor preparation.

Weiss, M., Tannock, R., Kratochvil, C., Dunn, D., Velez-

Borras, J., Thomason, C., et al. (2005). Randomized

placebo-control study of once-daily Atomoxetine in the

school setting in children with ADHD. Journal of the

American Academy of Child and Adolescent Psychiatry,

44, 647-655.

Theprimary objective of this clinical trial wasto assess

the efficacy of once-daily Atomoxetine compared with

placebo using teacher reportas determining data. For this,

153 children ages 8 to 12 years were randomly assigned

to receive once-daily Atomoxetine or placebo in a 2:1

ratio for 7 weeks. ADHD symptoms at school were pri-

marily assessed by baseline to endpoint changes on a

teacher rating scale. The study demonstrated signifi-

cant improvements in ADHD symptoms with the

Atomoxetine. The authors concluded that their studyextendedprevious results based on parental reports show-

ing that once-daily administration of Atomoxetine is safe

and effective in improving ADHD symptoms in children

and demonstrates that outcomes at school are similar

when symptoms are reported by teachers.


current literature in adhd by sam goldstein (2006) - an article

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