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Adding 8 weeks of behavioural therapy to atomoxetine does not improve classroom behaviour in children with ADHD

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Question

Question

Is the combination of atomoxetine and behavioural therapy (BT) more effective than drug treatment alone for children with attention-deficit hyperactivity disorder (ADHD)?

Patients

56 children (45 boys) aged 6–12 years with DSM-IV-TR ADHD of moderate severity (mean Clinical Global Impressions–Severity of Illness Score 4.3). Exclusions: history of seizures, contraindication to atomoxetine, previous documented failure of atomoxetine treatment (at least 0.8 mg/kg/day for at least 3 weeks), other serious psychopathology, IQ less than 75 and no history of ADHD-related impairment at school. Prior ADHD medication use was allowed: 37% had never used stimulants and 12.5% had previously used atomoxetine.

Setting

Community setting, Buffalo, New York, USA; March 2007 to May 2008.

Intervention

Atomoxetine plus BT or atomoxetine alone for 8 weeks. BT involved an 8-week parenting course, comprising weekly sessions of the Community Orientated Parent Education (COPE) programme; a child social skills course (eight 2 h sessions running simultaneously to COPE) covering skills of cooperation, participation, validation and communication; and a teacher-implemented daily report card of classroom behaviour. Atomoxetine was dosed openly (mean dose 1.44 mg/kg/day). …

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