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Patterns of long-term and short-term responses in adult patients with attention-deficit/hyperactivity disorder in a completer cohort of 12 weeks or more with atomoxetine

Published online by Cambridge University Press:  24 October 2015

E. Sobanski ,
S. Leppämäki ,
C. Bushe ,
L. Berggren ,
M. Casillas  and
W. Deberdt
E. Sobanski*
Affiliation:
Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, J5, 68159Mannheim, Germany
S. Leppämäki
Affiliation:
Finnish Institute of Occupational Health, PL40, FIN-00250 Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, PL590, FIN-00250 HUS, Helsinki, Finland
C. Bushe
Affiliation:
Medical Department, Eli Lilly & Co. Ltd, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, United Kingdom
L. Berggren
Affiliation:
Global Statistical Sciences, Lilly Deutschland GmbH, Werner Reimers Str. 2-4, 61350Bad Homburg, Germany
M. Casillas
Affiliation:
Medical Department, Lilly S.A., Avenida de la Industria, 30, 28108 Alcobendas, Madrid, Spain
W. Deberdt
Affiliation:
Medical Department, S.A Eli Lilly Benelux N.V., Markiesstraat 1/4B, B - 1000Brussel, Belgium
*
⁎Corresponding author. Tel.: +49 0 621 1703 2852. E-mail address:[email protected] (E. Sobanski).
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Abstract

Background

Atomoxetine is a well-established pharmacotherapy for adult ADHD. Long-term studies show incremental reductions in symptoms over time. However, clinical experience suggests that patients differ in their response patterns.

Methods

From 13 Eli Lilly-sponsored studies, we pooled and analyzed data for adults with ADHD who completed atomoxetine treatment at long-term (24 weeks; n = 1443) and/or short-term (12 weeks; n = 2830) time-points, and had CAARS-Inv:SV total and CGI-S data up to or after these time-points and at Week 0 (i.e. at baseline, when patients first received atomoxetine). The goal was to identify and describe distinct trajectories of response to atomoxetine using hierarchical clustering methods and linear mixed modelling.

Results

Based on the homogeneity of changes in CAARS-Inv:SV total scores, 5 response clusters were identified for patients who completed long-term (24 weeks) treatment with atomoxetine, and 4 clusters were identified for patients who completed short-term (12 weeks) treatment. Four of the 5 long-term clusters (comprising 95% of completer patients) showed positive trajectories: 2 faster responding clusters (L1 and L2), and 2 more gradually responding clusters (L3 and L4). Responses (i.e. ≥ 30% reduction in CAARS-Inv:SV total score, and CGI-S score ≤ 3) were observed at 8 and 24 weeks in 80% and 95% of completers in Cluster L1, versus 5% and 48% in Cluster L4.

Conclusions

While many adults with ADHD responded relatively rapidly to atomoxetine, others responded more gradually without a clear plateau at 24 weeks. Longer-term treatment may be associated with greater numbers of responders.

Keywords

ADHDLong-termResponsePatternsClustersAtomoxetine
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015 , pp. 1011 - 1020
Copyright
Copyright © European Psychiatric Association 2020

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