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The effects of atomoxetine on emotional control in adults with ADHD: An integrated analysis of multicenter studies

Published online by Cambridge University Press:  15 April 2020

P. Asherson ,
S. Stes ,
M. Nilsson Markhed ,
L. Berggren ,
P. Svanborg ,
A. Kutzelnigg  and
W. Deberdt
P. Asherson*
Affiliation:
Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, De Crespigny ParkSE5 8AF, United Kingdom
S. Stes
Affiliation:
ADHD Program, University Psychiatric Center, KU Leuven, Leuvensesteenweg 517, Campus Kortenberg, Belgium Code Thomas More, Jozef De Bomstraat 11, 2018Antwerpen, Belgium
M. Nilsson Markhed
Affiliation:
Department of Psychiatry, Uppsala University, 751 85, Uppsala, Sweden
L. Berggren
Affiliation:
Global Statistical Sciences, Eli Lilly & Co., Werner Reimers Str. 2-4, 61350Bad Homburg, Germany
P. Svanborg
Affiliation:
Neuroscience, Eli Lilly & Co., Sweden AB, Gustav III Boulevard 42, PO box 721, SE-169 27Solna, Sweden
A. Kutzelnigg
Affiliation:
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
W. Deberdt
Affiliation:
Medical Department, Eli Lilly & Co., Markiesstraat 1, 1000Brussels, Belgium
*
⁎Corresponding author. Tel.: +44 0207 8480 078. E-mail address:philip.asherson@kcl.ac.uk (P. Asherson).
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Abstract

Purpose:

To investigate the effects of atomoxetine on emotional control in adults with ADHD.

Methods:

We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data.

Results:

Two populations were identified: a large sample of patients with pre-treatment baseline data (the “overall population”; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the “placebo-controlled population”; n = 829). At baseline, in the overall population, ∼50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with ∼10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life.

Discussion:

As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant.

Conclusion:

At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.

Keywords

AtomoxetineADHDEmotional controlIntegrated analysis
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 4 , June 2015 , pp. 511 - 520
Copyright
Copyright © Elsevier Masson SAS 2015

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