Safety and Tolerability of Atomoxetine Over 3 to 4 Years in Children and Adolescents With ADHD

ObjectiveTo assess the long-term safety and tolerability of atomoxetine hydrochloride in children and adolescents with attention-deficit/hyperactivity disorder treated for ≥3 years.MethodData from 13 double-blind, placebo-controlled trials and 3 open-label extension studies were pooled. Outcome measures were patient-reported treatment-emergent adverse events (AEs); discontinuations due to AEs, serious AEs, and changes in body weight, height, vital signs, electrocardiogram, and hepatic function tests.ResultsIn total, 714 patients were treated with atomoxetine for ≥3 years (mean follow-up 4.8 years [SD 1.1 years]), including a subset of 508 treated for ≥4 years (mean follow-up 5.3 years [SD 0.8 years]). Most subjects were younger than 12 years at entry (73.8%), male (78.4%), and white (88.9%). The mean final daily dose of atomoxetine was 1.35 mg/kg (SD 0.37 mg/kg). No new or unexpected AEs were observed compared with acute-phase treatment. Less than 6% of patients exhibited aggressive/hostile behaviors, and less than 1.6% reported suicidal ideation/behavior. No clinically significant effects were seen on growth rate, vital signs, or electrocardiographic parameters, and ≤2% of patients showed potentially clinically significant hepatic changes.ConclusionAtomoxetine was safe and well tolerated for children and adolescents with ≥3 and/or ≥4 years of treatment.