ORIGINAL ARTICLE   

Minerva Psychiatry 2023 June;64(2):214-25

DOI: 10.23736/S2724-6612.21.02247-8

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Factors associated with short-term treatment response of atomoxetine in children and adolescents

Armagan ARAL ¹ ✉, Merve ONAT ¹, Mirac Baria USTA ²

¹ Department of Child and Adolescent Psychiatry, Samsun Mental Health Hospital, Samsun, Türkiye; ² Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Türkiye

BACKGROUND: Atomoxetine response has been reviewed in the literature to a limited extent. Thus, this 10-week retrospective study examined the influence of demographic, clinical, and familial predictors of atomoxetine response among children and adolescents with attention-deficit/hyperactivity disorder (ADHD).
METHODS: A total of 222 children and adolescents aged between 8 and 18 years who were diagnosed as having ADHD were retrospectively evaluated in three visits (T0: baseline, T1: between 4-6 weeks after dosage titration T2: between 8-10 weeks after dosage titration). Demographics, clinical findings, and familial predictors were examined using binary logistic regression analyses for good and minimal-poor responders in T2. to explore the direct effect of emotional regulation on ADHD symptom reduction, we unraveled the contribution of internalizing symptoms using mediation analysis.
RESULTS: The results indicated that the response in T1 was the best predictor of the response to treatment response in T2 above and beyond other variables, followed by the difficulty in emotional regulation at baseline. Reductions in total score, difficulty engaging in goal-directed behavior, and planning strategies for regulating emotions under stress were directly related to ADHD symptom reduction after controlling for self-esteem, depression, and anxiety in mediation analysis.
CONCLUSIONS: These findings identify the predictive value of early minimal response to atomoxetine in ADHD and emphasize emotional regulation in response to treatment.

KEY WORDS: Atomoxetine hydrochloride; Attention deficit disorder with hyperactivity; Emotion regulation