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

托莫西汀（ATMX）是治疗注意缺陷多动障碍（ADHD）的一种可行的非兴奋剂替代药物，然而，临床医生需要更多关于其有效性的客观信息。这是第一个研究ATMX的有效性，使用客观的认知和情感标记在ADHD。该项目的成果将是朝着ADHD的“个性化医疗”方法迈出的重要一步，为临床医生提供更多治疗ADHD的选择。ADHD被认为是最常见的神经发育或儿童精神疾病。ADHD影响大约10%的儿童和青少年，换句话说，“每个教室至少有一个”。ADHD有一个重大的负担，包括治疗费用，家庭压力，生产力损失，药物滥用和事故的风险增加。越来越清楚的是，需要对新药物进行评估，以使ADHD治疗更加有效和高效。绝大多数接受药物治疗的ADHD患者都接受兴奋剂治疗，这是一种受管制的物质。许多人对兴奋剂治疗没有反应，在其他人中，滥用的可能性仍然存在。一些ADHD患者报告了服用兴奋剂的负面感受，越来越多的人担心处方率的增加。ATMX是最近批准的非兴奋剂（因此，非受控）治疗ADHD，具有临床有效性的证据。然而，ATMX对一系列认知和情感功能的客观测量的影响尚未研究。几条证据表明，它对这些功能是有效的。ATMX已被证明可以减轻抑制能力，而兴奋剂则没有。在30%对兴奋剂没有反应的ADHD患者中，反应最小的是那些被归类为“内化”类型的人，他们表现出相关的焦虑。常见的障碍可能是ADHD的异常抑制能力和受损的情绪识别的基础，最好用ATMX而不是兴奋剂治疗。

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.