Atomoxetine for attention deficit hyperactivity disorder in children and adolescents with autism: A systematic review and meta-analysis.
Atomoxetine gives modest ADHD symptom relief in autistic kids but plan for tummy and sleep side effects.
01Research in Context
What this study did
Patra et al. (2019) pooled three small drug trials.
All trials tested atomoxetine in autistic kids who also had ADHD.
Parents scored hyperactivity and inattention before and after treatment.
What they found
Atomoxetine gave a small but real drop in parent-rated hyperactivity and inattention.
More kids had mild belly pain, nausea, and trouble sleeping.
No serious harm showed up in the pooled data.
How this fits with other research
Hara et al. (2016) first showed the idea could work. Their mice with autism-like features played more and remembered better after chronic atomoxetine.
Hudson et al. (2012) looked at every mind drug tried in autistic kids. They flagged atomoxetine as “needs more proof.” The new meta gives that proof.
Rimmer et al. (1995) tested methylphenidate years earlier. It also calmed hyperactivity without worsening stereotypy. Atomoxetine now offers a non-stimulant option with similar small gains.
Why it matters
You now have solid numbers to share with families. Atomoxetine can take the edge off ADHD symptoms when behavior plans alone fall short. Warn parents about upset stomach and sleepless nights, start low, and track both gains and side effects weekly.
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02At a glance
03Original abstract
Atomoxetine is prescribed to children with autism spectrum disorder having symptoms of attention deficit hyperactivity disorder. We sought to examine the efficacy and safety of atomoxetine in this population. After screening for inclusion criteria, we identified three randomized placebo controlled trials involving 241 children. We assessed internal validity using standard Cochrane Risk of bias tool for randomized controlled trials (RCTs). We used Revman 5.3 for meta-analysis and GRADE approach to create summary of findings with grading of the quality of evidence. Atomoxetine had a benefit on improving parent-rated hyperactivity (standardized mean difference [SMD] = -0.73, 95% Confidence Interval, CI = -1.15 to -0.34) and parent-rated inattention (SMD = -0.53, 95% CI = -0.93 to -0.12) but the magnitude of effects is uncertain. However, atomoxetine was also associated with increased risk of non-serious adverse effects like nausea and vomiting, decreased sleep, and decreased appetite. Atomoxetine may be effective in improving hyperactivity and inattention in children with autism spectrum disorder and attention deficit hyperactivity disorder. However, we are uncertain about the true effect of this intervention and need more RCTs trials designed to evaluate this. Autism Research 2019, 12: 542-552. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Atomoxetine is prescribed for Attention Deficit Hyperactivity Disorder (ADHD). About a third of children and adolescents with autism also suffer from ADHD. We carried out an analysis of data reported from a specific kind of medication trials which had examined the effectiveness and side effects of atomoxetine in this patient population. We could find only three such trials and analyzed the reported data. Our analysis revealed that atomoxetine is effective in improving symptoms of ADHD like hyperactivity and inattention and also causes side effects like nausea, vomiting, decreased sleep, and decreased appetite. However, the existing data are insufficient to provide a conclusive statement with certainty and more trials are needed for this.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2059