Atomoxetine versus stimulants in the community treatment of children with ADHD: an electronic diary study

Abstract

Objective: To compare the morning and afternoon/evening functioning of children with ADHD treated in the community with either atomoxetine or long-acting stimulants and reported to be doing well.

Method: 109 8- to 12-year-olds and their mothers participated in one of three groups: stimulants (STIM, N = 26), atomoxetine (ATMX, N = 25), or comparison (COMP, N = 58). Mothers completed morning and evening electronic diaries installed on personal digital assistants throughout an entire week, rating the child's behaviors and moods as well as their own moods and perceptions.

Results: There was no evidence that ongoing pharmacotherapy fully normalized the behaviors of children with ADHD: Mothers in both ADHD groups reported higher rates of child inattention, hyperactivity/impulsivity, oppositionality, and negative affect and lower levels of parenting efficacy and positive affect than did COMP mothers. Although the behavioral profiles were generally comparable for the STIM and ATMX groups, there were indications of better functioning in the ATMX group during mornings only.

Conclusion: Children treated in the community with either STIM or ATMX appear to have similar behavioral profiles, suggesting that medication decisions be guided by other factors such as comorbid disorders, child and parent preferences, and effects on nontargeted behaviors and moods.