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Effects of atomoxetine on cardiovascular functions and on QT dispersion in children with attention deficit hyperactivity disorder

  • Ahmet Sert (a1), Cem Gokcen (a2), Ebru Aypar (a1) and Dursun Odabas (a1)

Abstract

Background

Atomoxetine is a central norepinephrine reuptake inhibitor used to treat attention deficit/hyperactivity disorder. The effects of atomoxetine on cardiovascular functions and QT dispersion in children with attention deficit/hyperactivity disorder have not been previously reported. The aim of this study was to analyse cardiovascular functions and QT dispersion on the surface electrocardiogram of children with attention deficit/hyperactivity disorder during atomoxetine therapy.

Methods

A total of 40 children – with a mean age of 8.6 plus or minus 2.3 years and a median age of 11 years; ranged from 8 to 14 years – with attention deficit/hyperactivity disorder – with six girls and 34 boys – were included in the study. We recorded the mean systolic and diastolic blood pressure, heart rate, corrected QT interval, QT dispersion, and left ventricular systolic functions at baseline and 5 weeks after atomoxetine therapy.

Results

Atomoxetine decreased baseline mean systolic and diastolic blood pressure; baseline mean heart rate decreased; and baseline mean corrected QT interval and QT dispersion mildly increased. Atomoxetine decreased baseline mean ejection fraction and baseline mean shortening fraction.

Conclusion

The results of our study suggest that atomoxetine does not cause clinically significant alterations in QT dispersion, systolic and diastolic blood pressure, heart rate, corrected QT interval, and left ventricular systolic functions during short-term treatment in children with attention deficit/hyperactivity disorder.

Copyright

Corresponding author

Correspondence to: Dr A. Sert, Department of Pediatric Cardiology, Konya Training and Research Hospital, 42080, Konya, Turkey. Tel: +90 332 323 67 09, Fax:+90 332 323 6723; E-mail: ahmetsert2@hotmail.com

References

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1.Ralston, SJ, Lorenzo, MJ, ADORE Study Group. ADORE – Attention-Deficit Hyperactivity Disorder Observational Research in Europe. Eur Child Adolesc Psychiatr 2004; 13: 136142.
2.Li, WY, Strang, SE, Brown, DR, et al. Atomoxetine changes rat's HR response to stress from tachycardia to bradycardia via alterations in autonomic function. Auton Neurosci 2010; 154: 4853.
3.Wernicke, JF, Faries, D, Girod, D, et al. Cardiovascular effects of atomoxetine in children, adolescents, and adults. Drug Safe 2003; 26: 729740.
4.Barr, CS, Naas, A, Freeman, M, Lang, CC, Struthers, AD. QT Dispersion and sudden unexpected death in chronic heart failure. The Lancet 1994; 343: 327329.
5.Merx, W, Yoon, MS, Han, J. The role of local disparity in conduction and recovery time on ventricular vulnerability to fibrillation. Am Heart J 1977; 94: 603610.
6.Etheridge, SP, Shaddy, RE. QT dispersion after beta-blocker therapy in children with heart failure. Am J Cardiol 2003; 91: 15.
7.Zabel, M, Klingenheben, T, Franz, M, Hohnloser, S. Assessment of QT dispersion for prediction of mortality or arrhythmic events after myocardial infarction. Circulation 1998; 97: 25432550.
8.Tutar, HE, Ocal, B, Imamoglu, A, Atalay, S. Dispersion of QT and QTc interval in healthy children, and effects of sinus arrhythmia on QT dispersion. Heart 1998; 80: 7779.
9.Kaufman, J, Birmaher, B, Brent, D. Schedule for affective disorders and schizophrenia for school age children – present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatr 1997; 36: 980988.
10.Bazett, HC. An analysis of the time relations of electrocardiograms. Heart 1920; 7: 353.
11.Kimball, TR, Michelfelder, EC. Echocardiography. In: Allen, HD, Driscoll, DJ, Shaddy, RE, Feltes, TF (eds). Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, 7th edn. Lippincott Williams & Wilkins, Philadelphia, PA, 2008, pp 95163.
12.Walsh, EP, Saul, P. Cardiac arrhythmias. In: Fyler, DC (ed.). Nadas’ pediatric cardiology. Hanley and Belfus Inc., Philadelphia, PA, 1992, pp 377434.
13.Bednar, MM, Harrigan, EP, Ruskin, JN. Torsade de pointes associated with nonantiarrhythmic drugs and observations on gender and QTc. Am J Cardiol 2002; 89: 13161319.
14.Spencer, T, Biederman, J, Heiligenstein, J, et al. An open label, dose-ranging study of atomoxetine in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2001; 11: 251265.
15.Kratochvil, CJ, Wilens, TE, Greenhill, LL, et al. Effects of long-term atomoxetine treatment for young children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatr 2006; 45: 919927.
16.Allen, AJ, Kurlan, RM, Gilbert, DL, et al. Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology 2005; 65: 19411949.
17.Kautzner, J, Malik, M. QT interval dispersion and its clinical utility. Pacing Clin Electrophysiol 1997; 20: 26252640.
18.Statters, DJ, Malik, M, Ward, DE, Camm, AJ. QT dispersion: problems of methodology and clinical significance. J Cardiovasc Electrophysiol 1994; 5: 672685.
19.Davey, PP, Bateman, J, Mulligan, IP, Forfar, C, Barlow, C, Hart, G. QT interval dispersion in chronic heart failure and left ventricular hypertrophy: relation to autonomic nervous system and Holter tape abnormalities. Br Heart J 1994; 71: 268273.
20.Shah, CP, Thakur, RK, Reisdorff, EJ, Lane, E, Aufderheide, TP, Hayes, OW. QT dispersion may be a useful adjunct for detection of myocardial infarction in the chest pain center. Am Heart J 1998; 136: 496498.
21.Day, CP, McComb, JM, Campbell, RWF. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J 1990; 63: 342344.
22.Grimm, W, Steder, U, Menz, V, Hoffmann, J, Maisch, B. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol 1996; 78: 458461.
23.Michelson, D, Read, HA, Ruff, DD, Witcher, J, Zhang, S, McCracken, J. CYP2D6 and clinical response to atomoxetine in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatr 2007; 46: 242251.
24.Spencer, T, Heiligenstein, JH, Biederman, J, et al. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyperactivity disorder. J Clin Psychiatr 2002; 63: 11401147.
25.Donnelly, C, Bangs, M, Trzepacz, P, et al. Safety and tolerability of atomoxetine over 3 to 4 years in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatr 2009; 48: 176185.

Keywords

Effects of atomoxetine on cardiovascular functions and on QT dispersion in children with attention deficit hyperactivity disorder

  • Ahmet Sert (a1), Cem Gokcen (a2), Ebru Aypar (a1) and Dursun Odabas (a1)

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