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Atomoxetine is a second-line medication treatment option for ADHD
  1. Jaswinder K Ghuman1,
  2. Shari L Hutchison2
  1. 1Community Care Behavioral Health, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  2. 2Community Care Behavioral Health, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Jaswinder K Ghuman; ghumanjk{at}

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What is already known on this topic?

Atomoxetine is a non-stimulant that has no abusive potential and a presynaptic inhibitor of the norepinephrine transporter, and has been found to be a safe and effective treatment for attention deficit/hyperactivity disorder (ADHD) in children, adolescents and adults.1

What this paper adds?

  • This is the largest meta-analysis of randomised controlled trials of atomoxetine for ADHD.

  • The effect size for atomoxetine versus placebo was higher for medication-naïve youth while factors such as demographic factors, mean dose, etc, did not moderate the treatment response.


  • Even though atomoxetine improved both inattentive and hyperactive symptoms, response was lower than for stimulants and 40% of participants taking atomoxetine had significant residual ADHD symptoms. Compared with placebo, a higher proportion of those taking atomoxetine had at least one adverse effect, experienced more weight loss and discontinued study participation.

  • Important treatment response moderators were not examined. For …

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  • Competing interests None.