A review of atomoxetine effects in young people with developmental disabilities.
Atomoxetine can calm ADHD in kids with developmental delays, but evidence is thin and irritability is common, so pair it with close monitoring and strong behavior plans.
01Research in Context
What this study did
de Kuijper et al. (2014) hunted every paper on atomoxetine for kids with autism, intellectual disability, or other delays. They kept only studies that measured ADHD symptoms.
Most papers they found had no control group. The team looked at side-effect lists and how doctors measured success.
What they found
Atomoxetine helped many kids pay attention, but the proof is thin. Almost all studies were small and had no placebo.
Irritability and mood swings showed up again and again. The authors say start low, go slow, and watch closely.
How this fits with other research
Kumar et al. (2025) found that kids who have both ADHD and motor problems feel worse in daily life. This pair of problems is common, so atomoxetine may help the ADHD part while you still need motor work.
Peng et al. (2026) and Smits-Engelsman et al. (2018) show large gains from exercise for coordination. No drug-versus-exercise trial exists, but the two roads may run side-by-side: atomoxetine for attention, exercise for motor skills.
Singh et al. (1985) warned that early drug studies in DD were weak; de Kuijper et al. (2014) shows little has changed for atomoxetine. The field still needs big, placebo-controlled trials.
Why it matters
You may face parents who want a pill for ADHD when their child also has autism or ID. This review gives you the script: atomoxetine can help, but benefits are modest and irritability is real. Pair any med talk with solid behavior plans and, if motor issues are present, add movement programs shown by Changhui and Bouwien. Document mood daily for the first month—small dose jumps and parent data sheets keep everyone safe.
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02At a glance
03Original abstract
UNLABELLED: This review summarizes the pharmacokinetic characteristics, pharmacodynamic properties, common side effects, and clinical advantages and disadvantages associated with atomoxetine (ATX) treatment in typically developing children and adults with ADHD. Then the clinical research to date in developmental disabilities (DD), including autism spectrum disorders (ASD), is summarized and reviewed. Of the 11 relevant reports available, only two were placebo-controlled randomized clinical trials, and both focused on a single DD population (ASD). All trials but one indicated clinical improvement in ADHD symptoms with ATX, although it was difficult to judge the magnitude and validity of reported improvement in the absence of placebo controls. Effects of ATX on co-occurring behavioral and cognitive symptoms were much less consistent. Appetite decrease, nausea, and irritability were the most common adverse events reported among children with DD; clinicians should be aware that, as with stimulants, irritability appears to occur much more commonly in persons with DD than in typically developing individuals. Splitting the dose initially, starting below the recommended starting dose, and titrating slowly may prevent or ameliorate side effects. Patience is needed for the slow build-up of benefit. CONCLUSIONS: ATX holds promise for managing ADHD symptoms in DD, but properly controlled, randomized clinical trials of atomoxetine in intellectual disability and ASD are sorely needed. Clinicians and researchers should be vigilant for the emergence of irritability with ATX treatment. Effects of ATX on cognition in DD are virtually unstudied.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.03.006