Abstract
BackgroundThe objective of this study was to assess the effects of atomoxetine on treating attention-deficit/hyperactivity disorder (ADHD), on reading performance, and on neurocognitive function in youth with ADHD and dyslexia (ADHD+D).MethodsPatients with ADHD (n = 20) or ADHD+D (n = 36), aged 10-16 years, received open-label atomoxetine for 16 weeks. Data from the ADHD Rating Scale-IV (ADHDRS-IV), Kaufman Test of Educational Achievement (K-TEA), Working Memory Test Battery for Children (WMTB-C), and Life Participation Scale for ADHD-Child Version (LPS-C) were assessed.ResultsAtomoxetine demonstrated significant improvement for both groups on the ADHDRS-IV, LPS-C, and K-TEA reading comprehension standard and composite scores. K-TEA spelling subtest improvement was significant for the ADHD group, whereas the ADHD+D group showed significant reading decoding improvements. Substantial K-TEA reading and spelling subtest age equivalence gains (in months) were achieved for both groups. The WMTB-C central executive score change was significantly greater for the ADHD group. Conversely, the ADHD+D group showed significant phonological loop score enhancement by visit over the ADHD group. Atomoxetine was well tolerated, and commonly reported adverse events were similar to those previously reported.ConclusionsAtomoxetine reduced ADHD symptoms and improved reading scores in both groups. Conversely, different patterns and magnitude of improvement in working memory component scores existed between ADHD and ADHD+D patients. Though limited by small sample size, group differences in relation to the comparable changes in improvement in ADHD symptoms could suggest that brain systems related to the therapeutic benefit of atomoxetine in reducing ADHD symptoms may be different in individuals with ADHD+D and ADHD without dyslexia.Trial RegistrationClinical Trial Registry: ClinicalTrials.gov: NCT00191048
Highlights
The objective of this study was to assess the effects of atomoxetine on treating attention-deficit/hyperactivity disorder (ADHD), on reading performance, and on neurocognitive function in youth with ADHD and dyslexia (ADHD+D)
There has been some speculation based on differential response to ADHD pharmacotherapy that the co-occurrence of ADHD and dyslexia is more related to the inattentive subtype of ADHD, and reduction in hyperactive symptoms alone may not correlate with significant change in reading competency [6]
The least squares mean change and associated standard error used in the Student's t-test were derived from an analysis of covariance (ANCOVA) model, with terms for diagnostic group, investigator, gender, age, baseline score, and baseline score-by-diagnostic group interaction
Summary
The objective of this study was to assess the effects of atomoxetine on treating attention-deficit/hyperactivity disorder (ADHD), on reading performance, and on neurocognitive function in youth with ADHD and dyslexia (ADHD+D). Of the children diagnosed with learning disabilities, over 80% have a reading disability or dyslexia [3]. Epidemiological and clinical studies suggest that 15%-40% of children with ADHD have concurrent reading disability [4,5] While these 2 conditions can occur concurrently, the exact nature of the relationship between ADHD and dyslexia is not completely clear. There has been some speculation based on differential response to ADHD pharmacotherapy that the co-occurrence of ADHD and dyslexia is more related to the inattentive subtype of ADHD, and reduction in hyperactive symptoms alone may not correlate with significant change in reading competency [6]
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