Randomised Controlled Trial Investigation of a Non-stimulant in Attention Deficit Hyperactivity Disorder

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Atomoxetine (ATMX) is a viable non-stimulant alternative to treat Attention Deficit Hyperactivity Disorder (ADHD), however, clinicians require more objective information on its effectiveness. This is the first study to examine the effectiveness of ATMX using objective cognitive and emotion markers in ADHD. The outcomes from this project will be a significant step towards a 'personalised medicine' approach to ADHD, providing clinicians with increased options in the treatment of ADHD. ADHD is considered the most common neurodevelopmental or child psychiatric disorder. ADHD affects approximately 10% of children and adolescents, in other words, 'at least one in every classroom'. ADHD has a significant burden, including treatment costs, family stress, loss of productivity, increased risk of drug abuse and accidents. It is increasingly clear that new medications need to be evaluated to make ADHD treatment more effective and efficient. The vast majority of medicated ADHD individuals are treated with stimulants, which are controlled substances. A large number do not respond to stimulant treatment, and in others the potential for abuse remains. Some ADHD report negative feelings about taking stimulants and there is growing concern about increasing prescription rates. ATMX is a recently approved non-stimulant (therefore, non-controlled) to treat ADHD, with evidence of clinical effectiveness. Yet, the impact of ATMX on objective measures of a range of cognitive and emotional function has not been studied. Several lines of evidence indicate it is effective for these functions. ATMX has been shown to alleviate inhibitory capacity, while stimulants have not. Of the 30% of ADHD who do not respond to stimulants, the least responsive are those categorized as 'internalizing' types who show allied anxiety. Common disturbances may underlie abnormal inhibitory capacity and impaired emotional recognition in ADHD that is best treated with ATMX rather than stimulants.