. 2013 Apr;23(3):179–193. doi: 10.1089/cap.2012.0093

Table 3.

Reported Efficacy and Effectiveness Outcomes for Atomoxetine and Stimulant Combination Therapy

		Quantitative measures
Article statistic	Treatment/comparator groups	ADHDRS-	CGI-	Other quantitative measures or qualitative descriptions
Patients with ADHD – prospective studies
Carlson, 2007		IV-Parent:Inv	Severity	WREMB-AM		WREMB-PM		CPRS
Effect size^a 10 weeks	ATMX+OROS MPH (n=9)	1.3^***	1.3^*	0.60		0.56		1.2^*
ATMX treatment	ATMX+PB (n=8)	1.2^**	1.3^**	0.82		0.70		0.80^**
Effect size^a 6 weeks	ATMX+OROS MPH (n=9)	0.05	0.34	0.43		0.33		0.18
MPH augmentation	ATMX+PB (n=8)	0.18	0.38	0.07		0.01		0.09
Quintana, 2007		IV-Parent:Inv	ADHD-I	Inattention ADHDRS subscore				Hyp./Imp. ADHDRS subscore
Mean±SD scores	Baseline (n=61)	32.1±0.9 vs	NR vs	18.9±0.5 vs				13.2±0.5 vs
	End (n=60)	20.8±1.4^***	2.8±0.1^***	12.5±0.8^***				8.3±0.7^***
Wilens, 2009 & Hammerness, 2009				BRIEF subscales (n=38)
			Severity	EC	Inhib.	Initiat.	Monit.	O of M	Plan	Shift.	WM
Mean±SD scores	Baseline (n=40)	34.3±8.4	4.5±0.5	55	63	66	65	63	67	57	73
	Start (n=50)	21.1±9.9 vs	3.5±0.6 vs	53 vs	60 vs	59 vs	62 vs	59 vs	63 vs	54 vs	66 vs
	End (n=50)	12.8±9.7^***	2.7±1.1^***	52	55	53^***	56^***	55^**	56^***	51^*	59^***
Patients with ADHD – retrospective studies
Scott, 2010	NA	NA	NA	27% classified as ATMX treatment success^b received adjunct stimulant therapy; 15% classified as ATMX treatment failure^c received adjunct stimulant therapy
Brown, 2004	OROS MPH+ATMX	NR	NR	Improved oppositional behavior during periods when MPH had not taken effect or effects had dissipated
	Amphetamine XR+ATMX	NR	NR	Calmer, more focused, more alert; able to complete homework in pm and resume afterschool job
	ATMX+OROS MPH	NR	NR	Improved ability to remember and focus; improved school grades
	ATMX+amphetamine XR	NR	NR	Improved cooperative behavior; increased ability to sustain attention at school
Agarwal, 2008	Baseline Combination therapy	50 10	NR	NR
Niederhofer, 2009	ATMX+MPH	NR	NR	Improved ADHD symptomatology

^{^*}

p<0.05, ^**p<0.01, ^***p<0.001.

^{^a}

Effect size, mean improvement in standard deviation above the baseline score.

^{^b}

Patients who discontinued ATMX for reasons other than adverse events or treatment ineffectiveness were classified as treatment success.

^{^c}

Patients who discontinued ATMX because of adverse events or treatment ineffectiveness were classified as treatment failure.

ADHD, attention-deficit/hyperactivity disorder; ADHDRS, ADHD Rating Scale; ADHDRS-IV-Parent:Inv, ADHDRS-IV-Parent-Reported Investigator-Rated; ATMX, atomoxetine; BRIEF, Behavioral Rating Inventory of Executive Functioning; CGI, Clinical Global Impressions scale; CGI-ADHD-I, CGI-Improvement of Attention-Deficit/Hyperactivity Disorder scale; CPRS, Conners' Parent Rating Scale; EC, emotional control; Hyp., hyperactive; Imp., impulsive; Inhib., inhibition; Initiat., initiation; Mont., monitor; MPH, methylphenidate; NA, not applicable; NR, not reported; O of M, organization of material; OROS, Osmotic-controlled Release Oral delivery System; PB, placebo; plan, plan/organize; SD, standard deviation; shift., shifting; vs, versus; WM, working memory; WREMB, Weekly Parent Ratings of Evening and Morning Behavior; XR, extended release.