Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder

Özbaran, Burcu; Köse, Sezen; Yuzuguldu, Onur; Atar, Burcu; Aydın, Cahide

doi:10.3109/15622975.2015.1051109

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…In this study, 5.4% of patients were using MPH and ATX at the same time. In a Turkish university hospital, 12 patients (1.45%) among 824 patients with ADHD were treated with combinations of MPH and ATX [ 11 ]. Based on big data from the Danish Registry, treatment with 2% of MPH overlapped treatment with ATX [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a comparative study between monopharmacy and combined medication with MPH and ATX, although more side effects occurred with the use of combined medication, most of them were generally tolerable [ 9 ]. In a study investigating the efficacy, safety, and tolerability of the combined therapy of MPH and ATX, symptoms were improved significantly in nine out of twelve patients, and the combined therapy enhanced the effectiveness of monotherapy [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder

Bahn

Seo

2021

Clin Psychopharmacol Neurosci

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Objective: To study the efficiency and indication of combined medication with a stimulant and non-stimulant for attention-deficiency/hyperactivity disorder (ADHD), herein, the authors examined children and adult patients with ADHD. Methods: Subjects included patients diagnosed with ADHD who paid two or more visits to the outpatient clinic of the Kyung Hee University hospital from January 2009 to December 2019. The authors examined the age, sex, drugs, treatment adherence, and reason for combined medication. The subjects were classified into four groups: treatment with a non-stimulant (atomoxetine) only (Group ATX), treatment with a stimulant (methylphenidate immediate-release, extended-release, or osmotic-release oral system) only (Group MPH), exposed to both but separately used (Group SEP), and exposed to both with combined use (Group COM). The patient was considered adherent to treatment (1) on visiting the hospital ten or more times or consecutively for six months, and (2) medication possession ratio ≥ 0.8. Results: Of 929 patients, 229 (24.7%) were female. Group ATX comprised 146 (15.7%) patients, Group MPH comprised 627 (67.5%) patients, Group SEP comprised 106 (11.4%) patients, and Group COM comprised 50 (5.4%) patients. Longer-term adherence was seen with combined medication and in females than with monopharmacy and in males. The main indication for combination was dose-limiting untoward effects. Conclusion: These results suggest that combined medication would facilitate treatment adherence for ADHD. Further research is essential for the replication of these results in a large sample and the investigation of the indications for administering combined medication in children and adults with ADHD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder

Bahn

Seo

2021

Clin Psychopharmacol Neurosci

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“…Łączenie atomoksetyny z lekami psychostymulującymi teoretycznie jest możliwe. Pojedyncze badania na małej grupie pacjentów wykazały użyteczność takiej strategii (Ozbaran et al, 2015;Treuer et al, 2013). Nie stwierdzono istotnych interakcji pomiędzy stosowanymi jednocześnie metylofenidatem i atomoksetyną.…”

Section: Praktyczne Informacje Kliniczneunclassified

Atomoxetine in the pharmacotherapy of hyperkinetic syndrome

Wiśniewski¹

2020

Psychiatr Psychol Klin

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Atomoksetyna jest stosunkowo nowym lekiem zarejestrowanym do leczenia zespołu nadpobudliwości psychoruchowej z deficytem uwagi (nazywanego w klasyfikacji ICD-10 zespołem hiperkinetycznym) u dzieci, młodzieży i dorosłych. Jest selektywnym inhibitorem wychwytu zwrotnego noradrenaliny. Nie należy do substancji psychostymulujących, dzięki czemu sprawdza się szczególnie w sytuacjach klinicznych związanych z ryzykiem uzależnienia, a także u pacjentów, którzy doświadczają poważnych objawów ubocznych po psychostymulantach w postaci labilności emocjonalnej czy tików, oraz u osób, które nie zgadzają się na stosowanie psychostymulantów. Jej cennym walorem jest skuteczność u osób z zespołem nadpobudliwości psychoruchowej z deficytem uwagi i zaburzeniami współistniejącymi: czynnym uzależnieniem od substancji psychoaktywnych, zaburzeniami lękowymi i tikami. Lek ma uznane miejsce w międzynarodowych standardach leczenia zespołu hiperkinetycznego, w licznych badaniach dowiedziono jego skuteczności. W pracy przedstawiono charakterystykę leku, wskazania do jego stosowania i przeciwwskazania, najczęstsze objawy niepożądane oraz środki ostrożności, dokonano również przeglądu prac na temat jego skuteczności w leczeniu zespołu nadpobudliwości psychoruchowej z deficytem uwagi, również w porównaniu z innymi najczęściej stosowanymi lekami w tym wskazaniu. Omówiono zalety i wady oraz miejsce atomoksetyny w standardach leczenia zespołu nadpobudliwości psychoruchowej z deficytem uwagi, jej przewagę nad innymi metodami leczenia i ograniczenia w stosowaniu. Omówiono również praktyczne informacje związane z włączaniem i dawkowaniem leku oraz szczególnymi sytuacjami klinicznymi. Słowa kluczowe: zespół hiperkinetyczny, ADHD, farmakoterapia, atomoksetynaAtomoxetine is a relatively new medication used in the treatment of attention deficit hyperactivity disorder (hyperkinetic disorder in the ICD-10 classification) in children, adolescents and adults. The drug is a selective noradrenaline reuptake inhibitor. Since atomoxetine does not belong to psychostimulants, it is particularly useful in clinical situations associated with the risk of dependence as well as in patients experiencing severe psychostimulant-induced adverse reactions, such as emotional lability or tics, and those refusing psychostimulant therapy. Importantly, it is effective in patients with attention deficit hyperactivity disorder and coexisting conditions, such as active psychoactive substance dependence, anxiety disorders and tics. The drug has a recognised position in the international standards for the treatment of hyperkinetic syndrome, with multiple studies supporting its efficacy. The paper presents a characteristics of the drug, indications and contraindications for its use, the most common adverse reactions and precautions as well as a literature review on its efficacy in the treatment of attention deficit hyperactivity disorder, including comparison with other drugs most commonly used in this indication. Benefits and risks associated with the use of atomoxetine as well as it...

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“…Attention deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that decreases development and daily functioning of children and adolescent. Attention deficit hyperactivity disorder symptoms can cause academic, social, and/or occupational problems (1). Attention deficit hyperactivity disorder is one of the most common psychiatric conditions in pediatric ages.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Tolerability of Modified Release Methylphenidate, Osmotic-Release Methylphenidate and Atomoxetine in Children with Attention Deficit Hyperactivity Disorder

Güneş¹

2019

Ulutas Med J

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Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder

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

Cited by 8 publications

References 12 publications

Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder

Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder

Atomoxetine in the pharmacotherapy of hyperkinetic syndrome

Comparison of Efficacy and Tolerability of Modified Release Methylphenidate, Osmotic-Release Methylphenidate and Atomoxetine in Children with Attention Deficit Hyperactivity Disorder

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