current literature in adhd by sam goldstein (2006) - an article
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10.1177/1087054705283884OTHERJournal of Attention DisordersCurrent Literature
Current Literature in ADHD
Summarized by Sam Goldstein
Abikoff, H., McGough, J., Vitiello B., McCracken, J.,
Davies, M., Walkup, J., et al. (2005). Sequential
pharmacotherapy for children with comorbid ADHDand
anxiety disorders. Journal of the American Academy of
Child and Adolescent Psychiatry, 44, 418-427.
Children ages 6 to 17 years with ADHD and anxiety
were titrated to optimal methylphenidate doses and
assessed along with children who entered the study on a
previously optimized stimulant. Children with improved
ADHD who remained anxious were randomly assigned
to 8 weeks of double-blindstimulantplus Fluvoxamineor
stimulant plus placebo. Of the 32 medication-naive chil-
drenopenly treated withmethylphenidate, 81%improved
as to ADHD. In this study, 25 children entered the ran-
domized trial. Intent-to-treat analysis indicated no differ-
ences between the stimulant plus Fluvoxamine and the
stimulant plus placebo groups on the Pediatric AnxietyRating Scale or clinical global impressions-improvement-
defined responder rate. Medications in both arms were
well tolerated. The authors concluded that children with
ADHD plus anxiety havea response rate to stimulants for
ADHD that is comparable with that of children with gen-
eral ADHD. They noted that the benefit of adding
Fluvoxamine to stimulants for anxiety remains unproven.
Boonstra, A. M., Oosterlaan, J., Sergeant, J. A., &
Buitelaar, J. K. (2005). Executive functioning in adultADHD: A meta-analytic review. Psychological Medi-
cine, 35, 1097-1108.
To establish if theories of executive functioning defi-
cits as responsible forADHD symptoms aresupportedby
research data for adults with ADHD, these authors com-
pared executive functioning and nonexecutive function-
ing between adults with ADHD and normal controls in a
meta-analytic design. The authors compared 13 studies
finding mediumeffect sizes both in executive functioning
areas (verbal fluency, inhibition, and set shifting) and in
nonexecutive functioning domains (consistency of
response, word reading, and color naming). The authors
concluded that neuropsychological difficulties in adultADHD may not be confined to executive functioning.
Chacko, A., Pelham, W. E., Gnagy, E. M., Greiner, A.,
Vallano, G.,Bukstein,O.,et al.(2005). Stimulantmedica-
tion effects in a summer treatment program among young
children with ADHD. Journal of the American Academy
of Child and Adolescent Psychiatry, 44, 249-257.
Between 1987 and 1997, 5- and 6-year-old childrenattending a summer treatment program underwent a ran-
domized, clinical assessment of the effect of two doses of
methylphenidate and placebo on social behavior and aca-
demic performance. Methylphenidate had an effect on all
four social behaviors and improved two of the three areas
of academic functioning. Dose effects were present for
three of the seven dependent measures. Individual analy-
ses indicated the therapeutic response rate between 39%
and 100% across dependent measures. Furthermore, an
individual analysis of response indicated that across sev-
eral important dependent measures, 39% to 98% of chil-
dren showed little incremental improvement with thehigher dose compared with the lower dose of stimulant
medication. The authors concluded that stimulant medi-
cation is an effective treatment for young children diag-
nosed with ADHD. However, multiple domains of func-
tioning must be assessed to determine the most effective
dose in thisage range. In thisstudy, nearlyhalfof the orig-
inal participant pool were significantly benefited by
561
Journal of Attention Disorder
Volume 9 Number
February 2006 561-567
© 2006 Sage Publication
10.1177/108705470528388
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psychosocial intervention. Their parents declined
medication treatment.
Counts, C. A., Nigg, J.T., Stawicki, J.A., Rappley, M. D.,
& Von Eye, A. (2005). Family adversity in DSM-IV
ADHDcombinedand inattentive subtypes andassociated
disruptive behavior problems. Journal of the American
Academy of Child and Adolescent Psychiatry, 44, 690-
698.
This study evaluated the relationship between a family
adversity index and Diagnostic and Statistical Manual of
Mental Disorders (4th ed.; DSM-IV ) ADHD subtypes and
associated behavior problems. Parents and 206 children
ages 7 to 13 completed diagnostic interviews and rating
scales about socioeconomic status, parental lifetime psy-
chiatric disorders, marital conflict, and stressful lifeevents. Children with ADHD combined type experienced
more risk factors than community controls or children
with the predominantly inattentive type of ADHD. The
families of children with ADHD combined type
described more risk factors associated with family adver-
sity than the families of children with ADHD inattentive
type and the control group. Children’s perceptions of
marital conflict were independently related to inattention
andhyperactivity behaviors as rated by parents andteach-
ers after control of all other risk factors. Oppositional
defiant symptoms were independently related to marital
conflict and maternal psychopathology, whereas conductdisorder symptoms were uniquely related to low socio-
economic status and maternal psychopathology. The
authors concluded that family adversity is related to
ADHD combined type in children and may be related
specifically to ADHD symptoms in addition to conduct
disorder symptoms.
Doyle, R. E., Biederman, J., Seidman, L. J., Reske-
Nielsen, J., & Faraone, S. V. (2005). Neuropsychological
functioning in relatives of girls with and without ADHD.
Psychological Medicine, 35, 1121-1132.
Structured diagnostic interviews and neuropsycho-
logical batteries were administered to parents and sib-
lings enrolled in a family study of girls with and without
ADHD. Relatives were stratified into four groups, those
with DSM-IV ADHD probands, relatives of ADHD
probands with ADHD, relatives of ADHD probands
without ADHD, and relativesof controls without ADHD.
Analyses were also conducted on a subgroup of families
in which more than one member had ADHD. The
neuropsychological battery as a whole distinguished
affected and unaffected ADHD relatives from controls.
The Wechsler Oral Arithmetic subtest and the Stroop
Word Color and Color-Word subscales were impaired in
affected ADHD relatives, as were the academic measures
of arithmetic and reading on the Wide Range Achieve-
ment Test. Only the Stroop Color-Word and Interference
subtests and an arithmetic measure demonstrated signifi-
cant impairments in unaffected relatives. In multiplex
families, additional impairments were found in unaf-
fected relatives as well. The authors concluded that their
data are consistent with previous studies of relatives of
males with ADHD. Neuropsychological impairments in
relatives of females with ADHD were primarily associ-
ated with the diagnosis of ADHD, but subtle cognitive
impairments that index familial vulnerability to thedisorder may also exist according to these findings.
Fein, D., Dickson, P., Paul, J., & Levin, H. (2005). Brief
report: Pervasive developmental disorder can evolve into
ADHD: Case illustrations. Journal of Autism and Devel-
opmental Disorders, 35, 525-534.
Despite prominent symptoms of inattention noted in
pervasive developmental disorders (PDD), the relation-
ship of PDD and ADHD has received scant direct exami-nation. In addition,outcome studies of children with PDD
often focus on language and social and adaptive skills but
seldom on the loss of the PDD diagnosis or change to
another clinical syndrome. These authors presented three
cases in detail and tabular data on eight more, illustrating
a clinical presentation in which prototypical cases of
PDD evolved into clear-cut cases of ADHD from early to
middle childhood.
Filho, A. G., Bodanese, R., Silva, T. L., Alvares, J. P.,
Aman, M., & Rohde, L. A. (2005). Comparison of
Risperidone and methylphenidate for reducing ADHD
symptoms in children and adolescents with moderate
mental retardation. Journal of the American Academy of
Child and Adolescent Psychiatry, 44, 748-755.
The authors sought to evaluate the short-term efficacy
and tolerability of Risperidone and methylphenidate for
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reducing symptoms related to ADHD in children and
adolescents with moderate mental retardation. In a 4-
week, single-blind, parallel group trial, 45 participants
with these comorbid problems were randomized to
Risperidone or methylphenidate and assessed using a
number of objective rating scales. Both groups had
reduced ADHD symptoms during the trial. Repeated
measures analysis of variance yielded a significant effect
for the interaction between time and group assignments,
suggesting a more pronounced effect for Risperidone.
There was a significant weight reduction in the
methylphenidate group and a weight gain in the
Risperidone group.Theauthors concluded that their find-
ings suggest that Risperidone is associated with greater
reductions in ADHD symptoms than methylphenidate in
children with moderate mental retardation. Comorbidity
and the side effects profiles they noted might be of impor-
tance in choosing between the medications. However, the
authors suggested that it is prudent to attempt stimulantsbefore antipsychotic medications in children.
Hudziak, J. J., Dirks, E. M., Althoff, R. R., Rettew, D. C.,
& Boomsma,D. I. (2005). Thegenetic andenvironmental
contributions to ADHD as measured by theConners’Rat-
ing Scales–Revised. American Journal of Psychiatry,
162, 1614-1620.
From the Conners’ scale forms, data for the ADHD
index was collected from the mothers of 1,595 7-year-oldtwin pairs from the Netherlands twin registry. Rates of
ADHD diagnoses were computed by using Conners’
gender- and age-specific cutoffs. Contributions from
additive, dominant, unique environmental, interaction,
and gender effects were computed by using gender-
genetic models. Theprevalence of ADHD acrossthe sam-
ple of 7-year-old twin pairs was approximately 4%
according to the mothers’ reports. However, using the
gender norms provided with the ADHD index, the
authors found slightly higher rates of ADHD in females
than previously reported. Genetic analyses yielded a
model that included genetic dominance (48%), additive
genetic factors (30%), and unique environmental factors
(22%). The ADHD index from the Conners’scale identi-
fied an appropriate percentage of children across this
epidemiologic twin span as being at risk for ADHD. The
results of the genetic analyses are also consistent with
prior reports that ADHD is predominantly influenced by
genetic factors that are both dominant and additive.
Jensen, P. S., Garcia, J. A., Glied, S., Crowe, M., Foster,
M., Schlander, M., et al. (2005). Cost effectiveness of
ADHD treatments: Findings from the multimodal treat-
ment study of children with ADHD. American Journal of
Psychiatry, 162, 1628-1636.
In the first large-scale, cost-effectiveness study of the
major forms of treatment of ADHD, 579 children as part
of the National Institutes of Mental Health multimodal
treatment study of children with ADHD were assigned to
14 months of medication management, behavioral treat-
ment, both combined, or community care. Services were
tallied throughout the study, including costs of medica-
tion, health care visits, behavioral treatments, and related
rental costs. Provider specialty, total time, and number of
visits with providers were used to calculate cost adjusted
with the consumer price index. Treatment cost variedfourfold, with medication management being the least
expensive followed by behavioral treatment and then
combined treatment. Lower costs of medication treat-
ment were found in the community care group, reflecting
the less intensive (and less effective) nature of commu-
nity-delivered treatment. Medical management was more
effective but more costly than community care and more
cost-effective than combination treatment and behavioral
treatment alone. Under some conditions, combined treat-
ment (medication management and psychotherapy) was
somewhat more cost-effective as demonstrated by lower
cost per additional child (normalized) among children
withmultiplecomorbiddisorders. The authors concluded
that medical management treatment, although not as
effective as combined medical management and behav-
ioral treatment, is likely to be more cost-effective in the
routine treatment of children with ADHD, particularly
those without comorbid disorders. For those with
comorbid disorders and ADHD, it may be cost effective
to provide combination treatment according to these
authors.
Kratochvil, C. J., Newcorn, J. H., Arnold, L. E.,
Duesenberg, D., Emslie, G., Quintana, H., et al. (2005).
Atomoxetine alone or combined with Fluoxetine for
treating ADHD with comorbid depressive or anxiety
symptoms. Journal of the American Academy of Child
and Adolescent Psychiatry, 44, 915-924.
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The authors assessed the safety and efficacy of
Atomoxetine monotherapy compared with combined
Atomoxetine/Fluoxetine therapy in a population of chil-
dren and adolescents with ADHD and concurrent symp-
toms of depression or anxiety. Patients were randomized
to treatment with Fluoxetine or placebo under double-
blind conditions for 8 weeks with concomitant
Atomoxetine used the last 5 weeks. At the endpoint,
reductions in ADHD, and depressive and anxiety symp-
toms were marked for both treatment groups. Some dif-
ferences between treatment groups for depressive symp-
toms were significant, but the magnitudes of the
differences were small and likely of limited clinical
importance. Completion rates for the two groups were
similar, as were discontinuation rates for adverse events.
The authors concluded that in pediatric patients with
ADHD andcomorbid symptoms of depression or anxiety,
Atomoxetine monotherapy appears to be effective for
treating ADHD. Anxiety and depressive symptoms alsoimprove, but the absence of a placebo-only arm does not
allow for the conclusion that these effects are specifically
the result of treatment with Atomoxetine. Combined
Atomoxetine/Fluoxetine therapy according to these
authors was also well tolerated.
Levy, F., Hay, D. A., Bennett, K. S., & McStephen, M.
(2005). Gender differences in ADHD subtype
comorbidity. Journal of the American Academy of Child
and Adolescent Psychiatry, 44, 368-376.
These authors sought to examine gender differences in
ADHD symptom comorbidity with oppositional defiant
disorder, conduct disorder, separation anxiety disorder,
generalized anxiety disorder, speech therapy, and reme-
dial reading inchildren.Data from a large sampleof twins
andsiblings studied in theAustralian twin ADHD project
were obtained through DSM-IV -based questionnaires
investigating patterns of comorbidity in the three sub-
types of ADHD. A total of 1,550 questionnaires were
returned over a 12- to 18-month period. Analysis of vari-
ance showed significant between-group differences in
males and females for inattention and hyperactive/
impulsive symptom counts, with higher rates of opposi-
tional defiant disorder and conduct disorder in males and
higher rates of separation anxiety disorder in females.
The authors concluded that this indicated that internaliz-
ing disorders are more common in females and
externalizing disorders occur more often in males. Gen-
der differences and speech therapy were significant only
for the children without ADHD. The rates of separation
anxiety disorder were higher in females, with the inatten-
tion subtype and the rate of generalized anxiety disorder
higher for females with the combined subtype. Although
comorbidity differences among ADHD subtypes occur,
the authors concluded that there were no significant gen-
der differences in comorbidity for externalizing disor-
ders. Inattentive girls may present with anxiety. Clinical
approaches forboth males and females according to these
authors shouldbe sensitive to possible language andread-
ing problems.
Martinussen, R., Hayden, J., Hogg-Johnson, S., &
Tannock, R. (2005). A meta-analysis of working memory
impairments in children with ADHD. Journal of the
American Academy of Child and Adolescent Psychiatry,44, 377-384.
Exploratory meta-analytic procedures were used to
investigate whether children withADHDexhibit working
memoryimpairments. In this study, 26 empirical research
studies published from 1997 to 2003 met inclusion crite-
ria. Children with ADHD exhibited deficits in multiple
components of working memory that appeared independ-
ent of comorbidity with language learning disorders and
weaknesses in general intellectual ability. Evidence of
working memory impairments in children with ADHD
supports recent theoretical models implicating workingmemory processes in ADHD according to these authors.
The authors concluded that it is possible that providing
support for working memory limitations mayhelp reduce
the functional impairments experienced by children with
ADHD.
Max, J. E., Manes, F. F., Robertson, B. A., Matthews, K.,
Fox, P., & Lancaster, J. (2005). Prefrontal and executive
attention network lesions in the development of ADHD
symptomatology. Journal of the American Academy of
Child and Adolescent Psychiatry, 44, 443-450.
In this study, 29 children with focal strokelesions were
studied with standardized psychiatric assessments and
anatomical brain MRI. The pattern of lesion overlapped
in participants with ADHD symptomatology was deter-
mined. Of 28 participants, 15 with no prestroke ADHD
564 Journal of Attention Disorders
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were diagnosed with ADHD symptomatology at the time
of assessment. The extent of lesions within the executive
attention network was marginally related to ADHD
symptomatology, whereas theextent of lesions in thespe-
cific frontal region of interest was significantly related to
ADHD symptomatology. The authors concluded that
lesions within Posner’s executive attention network and
its orbital frontal connections may be linked to important
mechanisms in the expression of ADHD symptom-
atology after childhood stroke. These findings are consis-
tent with functional and structural imaging findings and
studies of idiopathic ADHD.
McGough, J. J., Smalley, S. L., McCracken, J. T., Yang,
M.,Delhomme,M.,Lynn, D.E.,et al.(2005). Psychiatric
comorbidity in adult attention deficit hyperactivity disor-
der: Findings from multiplex families. American Journalof Psychiatry, 162, 1621-1625.
Lifetime ADHD and comorbid psychopathology was
assessed in 435 parents of children with ADHD. Rates
and mean ages at onset of comorbid psychopathology
were compared in parents with lifetime ADHD, parents
with persistent ADHD, and those without ADHD. Age-
adjusted rates of comorbidity were compared with
Kaplan-Meier survival curves. Logistic regression was
used to assess additional risk factors for conditions more
frequent in participants with ADHD. The authors found
that parents with ADHD were significantly more likely tobe unskilled workers and less likely to have completed a
college degree. Participants with ADHD had more life-
time psychopathology; 80%hadat least oneand56%had
at least two other psychiatric disorders compared with
64% and 27%, respectively, in non–ADHD participants.
ADHD was associated with greater disruptive behavior,
substance use, mood and anxiety disorders, earlier onset
of major depression, dysthymia, oppositional defiant dis-
order, and conduct disorder. Group differences based on
Kaplan-Meier age-corrected risks were consistent with
those for raw frequency distributions. Male gender added
risk for disruptive behavior disorders. Female gender and
oppositional defiant disorder contributed to risk for
depression and anxiety. ADHD was not a significant risk
factor for substance use disorders when male gender, dis-
ruptive behavior disorders, and socioeconomic status
were controlled. This study adds to the growing body of
literature noting that ADHD in adulthood is associated
with significant lifetime psychiatric comorbidity
unexplained by other variables.
Newcorn, J. H., Spencer, T. J., Biederman, J., Milton, D.
R., & Michelson, D. (2005). Atomoxetine treatment in
children and adolescents with ADHD and comorbid
oppositional defiant disorder. Journal of the American
Academy of Child and Adolescent Psychiatry, 44, 240-
248.
Children and adolescents ages 8 to 18 with ADHD
were treated for approximately 8 weeks with placebo or
Atomoxetine under randomized, double-blind condi-
tions. Among patients with lifetime diagnostic informa-
tion, 39% were diagnosed with oppositional defiant dis-
order and61%were not. Treatment group differences and
differences between patients with and without
oppositional defiant disorder were examined post hoc for
changes on a number of rating scales. Youth with ADHD
and oppositional defiant disorder demonstrated statisti-cally significant improvements in ADHD, oppositional,
and quality-of-life measures. Treatment response was
similar to youths with and without oppositional prob-
lems. The authors concluded that Atomoxetine treatment
improves ADHD and oppositional symptoms in youth
with thecombined conditions but noted that thecomorbid
group may require higher doses of medication.
Owens, J.A. (2005). The ADHDand sleep conundrum:A
review. Journalof Developmentaland BehavioralPediat-
rics, 26 , 312-322.
This author provided a good overview of current
knowledge in the field relative to ADHD and sleep prob-
lems. Recent studies have helped to elucidate the nature
of the brain mechanisms and neuromodular systems
underlying the theoretical associations amongsleepiness,
arousal, and attention. The author reviewed new method-
ologies used in examining sleep andsleep patterns in chil-
dren diagnosed with ADHD. Guidelines are provided for
a clinical approach to evaluation andmanagement of chil-dren with ADHD and co-occurring sleep problems.
Peck, H. L., Kehle, T. J., Bray, M. A., & Theodore, L. A.
(2005). Yogaasan interventionfor children with attention
problems. School Psychology Review, 34, 415-424.
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These authors used a multiple baseline design across
three grade-level groups with a comparison group to
investigate the effectiveness of yoga for improving time
on task with 10 elementary school children who evi-
denced attention problems. A yoga videotape was used
requiring children to follow an adult instructor engaging
in deep breathing, physical postures, and relaxation exer-
cises for 30 minutes twice a week for a period of 3 weeks.
The authors suggested very strong positive effect sizes,
suggesting the yoga exercises improved time on task.
Peer comparison data indicated the classmates’ time on
taskremained essentially unchanged throughout the three
phases of the study. The authors noted a number of limita-
tions, including small sample size and that the investiga-
tors served dual roles as both implementor of the inter-
vention and observer of the participants. They also noted
that interpretation of the results of this study should be
made with caution.
Ratner, S.,Laor,N.,Bronstein, Y., Weizman, A.,& Toren,
P. (2005). Six-week open-label Reboxetine treatment in
children and adolescents with ADHD. Journal of the
American Academy of Child and Adolescent Psychiatry,
44, 428-433.
In this study, 31 children and adolescent outpatients
ages 8 to 18 years of age diagnosed with ADHD were
enrolled in a 6-weekopen-label study assessing theeffec-
tiveness of Reboxetine, a selective norepinephrinereuptake inhibitor. A significant decrease in ADHD
symptoms on all scales measured was noted. Adverse
effects were relatively mild and transient. The most com-
mon adverse effects were drowsiness/sedation and gas-
trointestinal complaints. The results of this open-label
study suggest Reboxetine may be effective in the treat-
ment of ADHD for methylphenidate-resistant patients in
thispopulation. Double-blind placebo and active compar-
ison control studies were recommended.
Slaats-Willems, E. D., Swaab-Barneveld, H., de
Sonneville, L., & Buitelaar, J. (2005). Familial clustering
of executive functioning in affective sibling pair families
with ADHD. Journal of the American Academy of Child
and Adolescent Psychiatry, 44, 385-391.
In this study, 52affectedsibling pairs ages6 to18years
diagnosed with ADHD performed the Stroop Test, Go/
No-Go task, two different fine visual motor tracking
tasks, and a sustained-divided and focused attention task.
Significant correlations were found between siblings for
response inhibition and attentional control and for fine
visual motor skills that made high demands on executive
functioning. The authors concluded that response inhibi-
tion, higher order controlled fine visual motor function-
ing, andattentional control appeared to cluster in ADHD-
affected siblings. They suggested that these aspects of
executive dysfunctioning may reflect an endophenotype
of ADHD. Measurement of these executive functions
may facilitate the identification of genes involved in
ADHD by forming more homogenous subgroups.
Vaidya,C. J.,Bunge,S. A.,Dudukovic, N. M.,Zalecki, C.A., Elliott, G. R., & Gabrieli, J. D. (2005). Altered
neurosubstraits of cognitive control and childhood
ADHD: Evidence from functional magnetic resonance
imaging. American Journal of Psychiatry, 162, 1605-
1613.
This study compared the neuro bases of two cognitive
control operations, interference suppression and response
inhibition, between children with and without ADHD. In
a sample of 10 children with combined type ADHD and
10 matched controls, interference suppression in all par-
ticipants was characterized by reduced engagement of afrontal-striatal-temporal-parietal network. In contrast,
response inhibition performance relied on different
regions in the two groups, frontal-striatal in comparison
participants but right superior temporal in children with
ADHD. The authors concluded that alteration in the
neuro basis of two cognitive control operations in child-
hood ADHD was characterized by distinct rather than
unitary patterns of functional abnormality. The greater
between-group overlap in theneuro network activated for
interference suppression than in response inhibition
appears to suggest the components of cognitive control
are differentially sensitive to ADHD. The children with
ADHD were unable to activate the caudate nucleus, sug-
gesting a core abnormality in this function in ADHD. Fur-
thermore, the authors also noted that observed functional
abnormalities did not result from prolonged stimulant
exposure as most children were medication naive.
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Van Meel, C., Oosterlaan, J., Heslenfeld, D. J., &
Sergeant, J. A. (2005). Motivational effects on motor tim-
ing and ADHD. Journal of the American Academy of
Child and Adolescent Psychiatry, 44, 451-460.
In this study, 18 children ages 8 to 12 years of age with
ADHD were compared with 18 age- and gender-matched
normal controls with respected timing precision, timing
variability, and the frequency of extreme under- and
overestimations during a 1-second interval production
task. Monetary reward, response cost, andno reward were
implemented to manipulate motivation. Children with
ADHD produced significantly more inaccurate and more
variable time intervals and exhibited a larger number of
extreme over- and underestimations than control chil-
dren.Although all childrenperformedsignificantly better
when monetary incentives were applied, group differ-ences were not eliminated. In this study, no evidence was
found for a motivational deficit as an explanation for
impaired performance on a time production task in
ADHD. The authors concluded that their results provide
clear support for a generic motor timing deficit, probably
due to a dysfunctional frontostriatocerebellar network
involved in temporal aspects of motor preparation.
Weiss, M., Tannock, R., Kratochvil, C., Dunn, D., Velez-
Borras, J., Thomason, C., et al. (2005). Randomized
placebo-control study of once-daily Atomoxetine in the
school setting in children with ADHD. Journal of the
American Academy of Child and Adolescent Psychiatry,
44, 647-655.
Theprimary objective of this clinical trial wasto assess
the efficacy of once-daily Atomoxetine compared with
placebo using teacher reportas determining data. For this,
153 children ages 8 to 12 years were randomly assigned
to receive once-daily Atomoxetine or placebo in a 2:1
ratio for 7 weeks. ADHD symptoms at school were pri-
marily assessed by baseline to endpoint changes on a
teacher rating scale. The study demonstrated signifi-
cant improvements in ADHD symptoms with the
Atomoxetine. The authors concluded that their studyextendedprevious results based on parental reports show-
ing that once-daily administration of Atomoxetine is safe
and effective in improving ADHD symptoms in children
and demonstrates that outcomes at school are similar
when symptoms are reported by teachers.
Current Literature 567