The acronym PANDAS is for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, has 5 criteria: presence of OCD and/or tic disorder, prepubertal symptom onset, sudden onset or episodic course of symptoms, temporal association between streptococcal infections and neuropsychiatric symptom exacerbations, and associated neurological abnormalities. Atomoxetine is a type of non-stimulant medicine with a selective noradrenaline re-uptake inhibitor activity. Here we report two cases with diagnosis of Attention deficit hyperactivity disorder and PANDAS. Both of them have tics therefore; we preferred atomoxetine for ADHD instead of stimulant agents. Sydenham’s chorea (SC) was excluded by neurological examination. Their clinical global impression (CGI) severity (S) and improvement (I) scores were obtained. Case 1 is a 10-year-old girl. She was hospitalized two months ago for streptococcal pneumonia and high fever for 5 days, motor tics started in the 2nd day of hospitalization. She was admitted to clinic with complaint of involuntary movements of head, mouth, eye blinking and irritability She was diagnosed as tic disorder as PANDAS phenomena and ADHD mixed type. Her laboratory findings were normal except ASO. Her ASO level was higher (777.7 U/L). Atomoxetine (starting dose 10 mg, final dose 35 mg/day) was administered. Her CGI-S was 6, CGI-I was 2 for both ADHD and tic disorder. Decreased appetite was seen as side effect, but she lost only 1 kg in 3 months. She was also on penicillin prophylaxis, her final ASO level is still high with level of 216 U/L. Case 2 is a 13 ½ year old boy. He has been followed for acute rheumatic fever (ARF) since 5 years old. He has involuntary movements for 3 years. He is on depot penicillin prophylaxis. EEG, cranial MR and CT assessments, laboratory findings were normal. Neurologic examination ruled out SC. His cardiac examination showed minimal mitral valve regurgitation. He was diagnosed with both PANDAS and ARF. Before admission to our clinic, he was treated with haloperidol and risperidone unsuccessfully. His mother and teachers complained about ADHD symptoms. Atomoxetine was administered (starting from 10 to 60 mg/day), his CGI-S was 5 and CGI-I for ADHD is 2 and for tics 3. Therefore aripiprazole (5 mg/day) was added to his treatment. Now his CGI-I is 2 for tics. Nausea, dizziness were seen as side effects. Here we present two cases with diagnosis of ADHD and tic disorder following by PANDAS. Instead of stimulants, atomoxetine is preferred for ADHD comorbid with tic disease. Our first case is successfully treated with atomoxetine whereas the other showed little improvement. Tic disorder was of acute type in the first case but chronic in the second case. Drug metabolisms may differ according to age and gender, leading to different effects on subjects.