Effects of atomoxetine on depression and anxiety symptoms in children with attention deficit-hyperactivity disorder: preliminary findings of a prospective, open-label study

Objective: Attention deficit-hyperactivity disorder (ADHD) is a common socially impairing neuropsychiatric disorder with onset in childhood. Anxiety and depression symptoms may accompany the core symptoms of ADHD in nearly one third of the children. The aim of the study is to evaluate the effects of atomoxetine HCl on self-reported anxiety symptoms, self and parent reported depression symptoms as well as parent and teacher reported core ADHD symptoms in children diagnosed with ADHD.

Method: Twenty-five children aged between 7-12 years and diagnosed as having ADHD based on DSM-IV-TR criteria were enrolled in an open label trial for atomoxetine HCL treatment. None of the patients had a DSM-IV-TR criteria based neither major depression nor any kind of an anxiety disorder. Anxiety symptoms were recorded using the State-Trait Anxiety Inventory, depression symptoms using self and parent reported the Children’s Depression Inventory and the core symptoms of ADHD using the Conners Parents/Teachers Rating Scales at baseline and after 6 weeks of atomoxetine HCl treatment.

Results: As reported by both parents and teachers on each subscale of the Conners Parents/Teachers Rating Scales (all p values ranged between 0.001-0.031),a six weeks of atomoxetine HCL treatment at an average dose of 1.10 mg/kg/day was associated with significant improvements in the core ADHD symptoms. Moreover parent reported depression and self-reported state anxiety scores decreased significantly (p: 0.004, p: 0.027). However, self-reported depression and trait anxiety scores did not show significant differences at the end of the six-week trial. Fourteen patients complaint about mild side effects mostly decreased appetite and irritability but none of the patients withdrew from the study.

Conclusion: The findings from this study demonstrate that even short-term atomoxetine treatment significantly improves core ADHD symptoms. In addition, atomoxetine treatment is associated with a significant decrease in anxiety and depression symptoms in ADHD even when these are not comorbid diagnosis.