Title

Atomoxetine for Attention Deficit Hyperactivity Disorder in Adolescents With Substance Use Disorder
A Randomized, Placebo-controlled Trial of Atomoxetine for Attention Deficit Hyperactivity Disorder in Adolescents With Substance Use Disorder (SUD)
  • Phase

    N/A
  • Study Type

    Interventional
  • Intervention/Treatment

    atomoxetine ...
  • Study Participants

    70
The purpose of this study is to find out whether atomoxetine (also called Strattera) helps teenagers (12-19) with Attention Deficit Hyperactivity Disorder (ADHD) and drug/alcohol problems.
Evidence-based psychosocial treatments have recently been developed. However, very little data exist on the use of pharmacotherapy for adolescents SUD (Substance Use Disorder). One promising pharmacotherapy approach is to treat co-occuring psychiatric disorders. A common co-occurring disorder in adolescent SUD is attention-deficit/hyperactivity disorder (ADHD). Fortunately, new ADHD medications, such as atomoxetine, that do not have addictive potential are now available. However, all controlled studies of atomoxetine have specifically excluded teens with SUD. Therefore, little data exist on the safety and efficacy of the medication in this population. This research project will address the important research gap with the specific aim: to conduct a randomized, placebo-controlled trial of atomoxetine for ADHD in teens with SUD.
Study Started
Sep 30
2005
Primary Completion
Feb 29
2008
Study Completion
Feb 29
2008
Results Posted
Jul 08
2015
Estimate
Last Update
Jul 08
2015
Estimate

Drug Atomoxetine

Half of participants are randomized to atomoxetine plus individual cognitive behavioral therapy targeting substance use disorder

  • Other names: Strattera

Drug Placebo

Half of participants are randomized to placebo plus individual cognitive behavioral therapy targeting substance use disorder

1 Placebo Comparator

placebo plus individual cognitive behavioral therapy

2 Experimental

atomoxetine plus individual cognitive behavioral therapy

Criteria

Inclusion Criteria:

Age 12-19
Provided assent/consent
attention-deficit hyperactivity disorder (ADHD) by Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS)
Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV) checklist <=22
At least one non-nicotine substance use disorder (SUD) by KSADS
Plans to live locally for 4 months
Willing to participate in cognitive behavioral therapy (CBT)

Exclusion Criteria:

No mental illness that cannot be managed as an outpatient or without concurrent psychotropic medication
No allergy to atomoxetine
No narrow angle glaucoma
No serious medical illness
Not pregnant
Not unwilling to use an effective form of contraception during the trial
No SUD that cannot be managed as an outpatient or without concurrent psychotropic medication

Summary

Placebo

Atomoxetine

All Events

Event Type Organ System Event Term Placebo Atomoxetine

Change in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Attention-deficit/Hyperactivity Disorder (ADHD) Checklist

All 18 ADHD symptoms are rated on a scale of 0 (none) to 3 (severe) since the previous study visit. The scores are summed to create a total ADHD severity scale score ranging from 0 (none) to 54 (most severe). A single value of mean change in ADHD severity for each group (placebo and atomoxetine) was calculated using linear mixed models in an intent-to-treat an analysis.

Placebo

18.61
units on a scale (Mean)
95% Confidence Interval: 15.13 to 22.08

Atomoxetine

18.19
units on a scale (Mean)
95% Confidence Interval: 13.41 to 22.97

Time Line Followback Interview (TLFB)

The TLFB assesses the number of days in which a substance was used in the past 28 days. The TLFB is administered by the clinician and uses a 28-day calendar with anchor points to record this information. This instrument relies on confidential self-report of the adolescent participant. The result is reported as mean change in the number of days used substances in the past 28 days from baseline to the end of treatment using linear mixed models in an intent-to-treat analysis.

Placebo

-2.24
days (Mean)
95% Confidence Interval: -5.67 to 1.18

Atomoxetine

-5.78
days (Mean)
95% Confidence Interval: -9.21 to 2.35

Side Effect Form for Children and Adolescents (SEFCA)

The SEFCA is a clinician-administered instrument that systematically assesses 52 possible side effects and rates them on a scale of 0 (not present) to 3 (severe). The instrument relies on confidential, self-report of the adolescent.The number of serious adverse events was recorded by intervention assignment.

Placebo

1.0
Number of serious adverse events

Atomoxetine

1.0
Number of serious adverse events

Total

70
Participants

Age, Continuous

16.09
years (Mean)
Standard Deviation: 1.56

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Placebo

Atomoxetine

Drop/Withdrawal Reasons

Placebo

Atomoxetine