Atomoxetine Attenuates Dextroamphetamine Effects in Humans

Sofuoglu, Mehmet; Poling, James; Hill, Kevin P.; Kosten, Thomas R.

doi:10.3109/00952990903383961

Cited by 33 publications

(44 citation statements)

References 20 publications

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“…The DDDeqs for atomoxetine in these studies were 1.50 (Kelly et al 2005) and 0.50 (Sofuoglu et al 2009). …”

Section: Stimulant and Atomoxetine Combination Therapy Strategiesmentioning

confidence: 62%

“…The two publications including healthy volunteers reported findings from two randomized, placebocontrolled, crossover trials (Kelly et al 2005;Sofuoglu et al 2009). These publications reported safety and tolerability outcomes only.…”

Section: Publication and Study Characteristicsmentioning

confidence: 99%

“…In the two studies of healthy volunteers, atomoxetine was given in combination with methylphenidate (2.00 DDDeq) (Kelly et al 2005) or dextroamphetamine (1.34 DDDeq) (Sofuoglu et al 2009). The DDDeqs for atomoxetine in these studies were 1.50 (Kelly et al 2005) and 0.50 (Sofuoglu et al 2009).…”

Section: Stimulant and Atomoxetine Combination Therapy Strategiesmentioning

confidence: 99%

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A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

Treuer¹,

Gau

Méndez³

et al. 2013

Journal of Child and Adolescent Psychopharmacology

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Objective: The purpose of this article was to systematically review the literature on stimulant and atomoxetine combination therapy, in particular: 1) Characteristics of patients with attention-deficit/hyperactivity disorder (ADHD) given combination therapy, 2) treatment strategies used, 3) efficacy and effectiveness, and 4) safety and tolerability. Methods: Literature databases (MEDLINE Ò , EMBASE, Cochrane Central Register of Controlled Trials, Science Citation Index Expanded, and SciVerse Scopus) were systematically searched using prespecified criteria. Publications describing stimulant and atomoxetine combination therapy in patients with ADHD or healthy volunteers were selected for review. Exclusion criteria were comorbid psychosis, bipolar disorder, epilepsy, or other psychiatric/neurologic diseases that could confound ADHD symptom assessment, or other concomitant medication(s) to treat ADHD symptoms. Results: Of the 16 publications included for review, 14 reported findings from 3 prospective studies (4 publications), 7 retrospective studies, and 3 narrative reviews/medication algorithms of patients with ADHD. The other two publications reported findings from two prospective studies of healthy volunteers. The main reason for prescribing combination therapy was inadequate response to previous treatment. In the studies of patients with ADHD, if reported, 1) most patients were children/adolescents and male, and had a combined ADHD subtype; 2) methylphenidate was most often used in combination with atomoxetine for treatment augmentation or switch; 3) ADHD symptom control was improved in some, but not all, patients; and 4) there were no serious adverse events. Conclusions: Published evidence of the off-label use of stimulant and atomoxetine combination therapy is limited because of the small number of publications, heterogeneous study designs (there was only one prospective, randomized controlled trial), small sample sizes, and geographic bias. Existing evidence suggests, but does not confirm, that this drug combination may benefit some, but not all, patients who have tried several ADHD medications without success.

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“…The DDDeqs for atomoxetine in these studies were 1.50 (Kelly et al 2005) and 0.50 (Sofuoglu et al 2009). …”

Section: Stimulant and Atomoxetine Combination Therapy Strategiesmentioning

confidence: 62%

Section: Publication and Study Characteristicsmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

Treuer¹,

Gau

Méndez³

et al. 2013

Journal of Child and Adolescent Psychopharmacology

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“…For those with active substance use disorder and/or high risk of diversion, non-stimulants such as atomoxetine and bupropion should be considered. Studies (Stoops 2008;Sofuoglu 2009) determining the effects of atomoxetine on administration of stimulants such…”

Section: Future Directionsmentioning

confidence: 99%

ADHD with comorbid substance use disorder: review of treatment

Magon¹,

Müller²

2012

Adv. psychiatr. treat

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SUMMarySubstance use disorders are a frequent co morbidity in adult attentiondeficit hyperactivity disorder (ADHD). This review discusses the relationship between adult ADHD and substance use disorder, including use of licit and illicit substances such as nicotine, alcohol, cocaine and cannabis. We discuss treatment studies in this area and provide a treatment algorithm to guide clinicians in the management of adult ADHD comorbid with different forms and severities of substance use disorder. Declaration of intereStU.M. has received research grant support from JanssenCilag and honoraria and/or travel expenses for conference presentations from BristolMyers Squibb, Eli Lilly, JanssenCilag, PharmaciaUpjohn, and UCB Pharma. Box 1 Main clinical issues of ADHD comorbid with substance misuse• Substance use disorders are a frequent comorbidity in ADHD• Significant challenges exist in assessing and treating ADHD in the context of substance use disorder comorbidity• No clear treatment guidelines and care pathways exist to guide clinicians to manage ADHD with comorbid substance use disorder• Issues in relation to exacerbation of substance use disorder, future risk of substance misuse and diversion of psychostimulants complicate treatment Patients with ADHD and substance use disorders tend to commence early and experiment more freely with substance misuse compared with patients with substance use disorder without ADHD (Krause 2002a). Two recent studies, the UMASS project and Milwaukee study (Barkley 2008) demonstrate important findings. Compared with matched controls, adults with ADHD were more likely to be past or current users of substances and used these substances in greater amounts. They were also more likely to receive treatment for previous alcohol and drug use disorders. The UMASS project and the Milwaukee study further demonstrate that children growing up with ADHD may carry a greater risk for using alcohol and tobacco, while clinic-referred adults with ADHD seem more likely to use marijuana, cocaine and lysergic acid diethylamide (LSD). Substances most commonly used by adults with aDHD (Box 3)Nicotine Studies in both adults and adolescents have found ADHD to be associated with earlier initiation of regular cigarette smoking and higher rates of lifetime smoking (41-42% v. 26% for ADHD and non-ADHD respectively) (Pomerleau 1995). Significant associations between ADHD symptoms and cigarette smoking have been found in both general population (Kollins 2005) and longitudinal studies (Milberger 1997;Molina 2003). Attention-deficit hyperactivity disorder has been shown to be an independent risk factor for tobacco use specifically in clinical and highrisk samples, even after controlling for comorbid conduct disorder (Milberger 1997;Molina 2003). Milberger et al (1997) followed 6-to 17-year-olds with and without ADHD for 4 years and found that ADHD was specifically associated with a higher risk of initiating cigarette smoking even when controlling for social class, psychiatric comorbidity and intelligence.Factors such as i...

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“…Both the subjective and cardiovascular responses to MDMA can be reduced by blocking the NE or 5-HT transporter by using selective transporter inhibitors (Liechti et al, 2000;Farré et al, 2007;Tancer and Johanson, 2007;Hysek et al, 2011). The release of NE has been shown to critically mediate the effects of psychostimulants (Rothman et al, 2001;Sofuoglu et al, 2009), including MDMA (Hysek et al, 2011;Newton, 2011). However, MDMA-induced increases in extracellular monoamines may also result from impulse-dependent vesicular/exocytotic release or transmitter uptake inhibition (Seiden et al, 1993;Florin et al, 1994;Hondebrink et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Effects of the α₂-Adrenergic Agonist Clonidine on the Pharmacodynamics and Pharmacokinetics of 3,4-Methylenedioxymethamphetamine in Healthy Volunteers

Hysek¹,

Brugger²,

Simmler³

et al. 2011

J Pharmacol Exp Ther

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The mechanism of action of 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) involves the carrier-mediated and potentially vesicular release of monoamines. We assessed the effects of the sympatholytic ␣ 2 -adrenergic receptor agonist clonidine (150 g p.o.), which inhibits the neuronal vesicular release of norepinephrine, on the cardiovascular and psychotropic response to MDMA (125 mg p.o.) in 16 healthy subjects. The study used a randomized, double-blind, placebo-controlled crossover design with four experimental sessions. The administration of clonidine 1 h before MDMA reduced the MDMA-induced increases in plasma norepinephrine concentrations and blood pressure but only to the extent that clonidine lowered norepinephrine levels and blood pressure compared with placebo. Thus, no interaction was found between the cardiovascular effects of the two drugs. Clonidine did not affect the psychotropic effects or pharmacokinetics of MDMA. The lack of an interaction of the effects of clonidine and MDMA indicates that vesicular release of norepinephrine, which is inhibited by clonidine, does not critically contribute to the effects of MDMA in humans. Although clonidine may be used in the treatment of stimulant-induced hypertensive reactions, the present findings do not support a role for ␣ 2 -adrenergic receptor agonists in the prevention of psychostimulant dependence.

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Atomoxetine Attenuates Dextroamphetamine Effects in Humans

Abstract: Background-Although preclinical studies support the contribution of the noradrenergic system activation in mediating the acute effects of amphetamines, these findings have not been followed up in clinical studies.

Cited by 33 publications

References 20 publications

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

ADHD with comorbid substance use disorder: review of treatment

Effects of the α₂-Adrenergic Agonist Clonidine on the Pharmacodynamics and Pharmacokinetics of 3,4-Methylenedioxymethamphetamine in Healthy Volunteers

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Atomoxetine Attenuates Dextroamphetamine Effects in Humans

Abstract: Background-Although preclinical studies support the contribution of the noradrenergic system activation in mediating the acute effects of amphetamines, these findings have not been followed up in clinical studies.

Cited by 33 publications

References 20 publications

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

ADHD with comorbid substance use disorder: review of treatment

Effects of the α2-Adrenergic Agonist Clonidine on the Pharmacodynamics and Pharmacokinetics of 3,4-Methylenedioxymethamphetamine in Healthy Volunteers

Contact Info

Product

Resources

About

Effects of the α₂-Adrenergic Agonist Clonidine on the Pharmacodynamics and Pharmacokinetics of 3,4-Methylenedioxymethamphetamine in Healthy Volunteers