Low-dose Strattera can keep ADHD under control

NEW YORK (Reuters Health) - For kids with attention-deficit/hyperactivity disorder (ADHD) who respond well to Strattera, it may be possible to lower the dose of the drug for maintenance therapy, according to researchers.

Studies suggest that when children with ADHD are started on Strattera, also known as atomoxetine, a dose of about 1.2 milligrams per kilogram of bodyweight (mg/kg) per day is required "to attain a maximal symptom response," Dr. Jeffrey H. Newcorn and colleagues write in the medical journal Pediatrics.

To see if effective maintenance treatment could be achieved using a lower dose, which would reduce drug exposure and potential tolerability problems, Newcorn, of Mount Sinai Medical Center, New York, and his team conducted a trial with 229 ADHD patients between the ages of 6 and 16 years.

The participants had responded well to an initial trial of atomoxetine. About half of them then continued treatment for up to 8 months on the same dose (1.2 to 1.8 mg/kg per day) while the others were given 0.5 mg/kg per day.

At the end of the study, no significant difference was observed between the groups in relapse rates. The mean change in the ADHD Rating Scale and total scores did not differ between the groups.

The participants who continued on the high-dose therapy had greater increases in heart rate compared with those on the low-dose atomoxetine, while those in the low-dose group had greater increases in weight over the course of the trial.

Lowering the dose of atomoxetine "may be an important strategy for those patients who respond very well to atomoxetine but continue to experience troublesome adverse effects that do not abate over the course of treatment," Newcorn and colleagues conclude.

SOURCE: Pediatrics, December 2006.