Revisión crítica de la eficacia y seguridad de atomoxetina
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2006-10-10
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de Lucas Taracena, M. T., & Montañés Rada, F. (2006). Revisión crítica de la eficacia y seguridad de atomoxetina. Revista De Psiquiatría Infanto-Juvenil, 23(1, 3 y 4), 20–32. Recuperado a partir de https://www.aepnya.eu/index.php/revistaaepnya/article/view/42
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Artículo de revisión
Palabras clave:
Atomoxetina, estimulantes, hiperactividad, déficit de atención, comorbilidad, eficacia, toleranciaResumen
La atomoxetina es un fármaco que inhibe la recaptación de noradrenalina, y que se está estudiando para el tratamiento del trastorno de déficit de atención con hiperactividad (TDAH) en España. Se han publicado con este fármaco en países anglosajones, diversos estudios pre y post-comercialización, tanto abiertos como aleatorizados, doble ciego y controlados con placebo, en niños y adolescentes y en adultos. Señalamos sus propiedades farmacológicas y sus indicaciones, así como los datos publicados sobre su eficacia en TDAH y trastornos comórbidos, y revisamos críticamente su perfil de efectos adversos y las últimas cuestiones sobre su seguridad.
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2. Higgins ES. A comparative analysis of antidepressants and stimulants for the treatment of adults with attention-deficit hyperactivity disorder. J Fam Pract. 1999 Jan;48(1):15-20.
3. Conners CK, Casat CD, Gualtieri CT, Weller E, Reader M, Reiss A, Weller RA, Khayrallah M, Ascher J. Bupropion hydrochloride in attention deficit disorder with hyperactivity. J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1314-21.
4. Popper CW. Pharmacologic alternatives to psychostimulants for the treatment of attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2000 Jul;9(3):605-46, viii.
5. Davidson J. Seizures and bupropion: a review. J Clin Psychiatry 1989; 50:
256-61.
6. Hazell P. Review of new compounds available in Australia for the treatment
of attention-deficit hyperactivity disorder. Australas Psychiatry. 2004 Dec;12(4):369-757.
7. Corman SL, Fedutes BA, Culley CM.Atomoxetine: the first nonstimulant for the management of attention-deficit/hyperactivity disorder. Am J Health Syst Pharm. 2004 Nov 15;61(22):2391-9.
8. Sauer JM, Ring BJ, Witcher JW. Clinical pharmacokinetics of atomoxetine. Clin Pharmacokinet. 2005;44(6):571-90.
9. Michelson D, Allen AJ, Busner J, Casat C, Dunn D, Kratochvil C, Newcorn J, Sallee FR, Sangal RB, Saylor K, West S, Kelsey D, Wernicke J, Trapp NJ, Harder D. Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study. American Journal of Psychiatry 2002; 159: 1896-1901.
10. Michelson D, Faries D, Wernicke J, Kelsey D, Kendrick K, Sallee FR, Spencer T; Atomoxetine ADHD Study Group. Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, doseresponse study. Pediatrics 2001; 108: E83.
11. Sauer JM, Ponsler GD, Mattiuz EL, Long AJ, Witcher JW, Thomasson HR, Desante KA. Disposition and metabolic fate of atomoxetine hydrochloride: the role of CYP2D6 in human disposition and metabolism. Drug Metab Dispos. 2003 Jan;31(1):98-107.
12. Ring BJ, Gillespie JS, Eckstein JA, Wrighton SA. Identification of the human cytochromes P450 responsible for atomoxetine metabolism. Drug Metab Dispos. 2002 Mar;30(3):319-23.
13. Caballero J, Nahata MC.Atomoxetine hydrochloride for the treatment of attention-deficit/hyperactivity disorder. Clinical Therapeutics 2003; 25: 3065-83.
14. Witcher JW, Long A, Smith B, Sauer JM, Heilgenstein J, Wilens T, Spencer T, Biederman J.Atomoxetine pharmacokinetics in children and adolescents with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 2003 Spring;13(1):53-63.
15. Steinhoff KW.Attention-deficit/hyperactivity disorder: medication treatment- dosing and duration of action. Am J Manag Care. 2004 Jul;10(4 Suppl):S99-106.
16. Sauer JM, Long AJ, Ring B, Gillespie JS, Sanburn NP, DeSante KA, Petullo D, VandenBranden MR, Jensen CB, Wrighton SA, Smith BP, Read HA, Witcher JW. Atomoxetine hydrochloride: clinical drug-drug interaction prediction and outcome. J Pharmacol Exp Ther. 2004 Feb;308(2):410-8. Epub 2003 Nov 10.
17. Chalon SA, Desager JP, Desante KA, Frye RF, Witcher J, Long AJ, Sauer JM, Golnez JL, Smith BP, Thomasson HR, Horsmans Y. Effect of hepatic impairment on the pharmacokinetics of atomoxetine and its metabolites. Clin Pharmacol Ther. 2003 Mar;73(3):178-91.
18. Levy F, Farrow M. Working memory in ADHD: prefrontal/parietal connections. Current Drug Targets 2001; 2: 347-52.
19. Hazell PL, Stuart JE.Arandomized controlled trial of clonidine added to psychostimulant medication for hyperactive and aggressive children. J Am Acad Child Adolesc Psychiatry 2003; 42: 886-94.
20. Swanson CJ, Perry KW, Koch-Krueger S, Katner J, Svensson KA, Bymaster FP. Effect of the attention deficit/hyperactivity disorder drug atomoxetine on extracellular concentrations of norepinephrine and dopamine in several brain regions of the rat. Neuropharmacology 2006 May; 50 (6): 755-60.
21. Tzavara ET, Bymaster FP, Overshiner CD, Davis RJ, Perry KW, Wolff M, McKinzie DL, Witkin JM, Nomikos GG. Procholinergic and memory enhancing properties of the selective norepinephrine uptake inhibitor atomoxetine. Mol Psychiatry 2006 Feb; 11 (2): 187-95.
22. Creighton CJ, Ramabadran K, Ciccone PE, Liu J, Orsini MJ, Reitz AB. Synthesis and biological evaluation of the major metabolite of atomoxetine: elucidation of a partial kappa-opioid agonist effect. Bioorg Med Chem Lett. 2004 Aug 2; 14 (15): 4083-5.
23. Carrey N, MacMaster FP, Sparkes SJ, Khan SC, Kusumakar V. Glutamatergic changes with treatment in attention deficit hyperactivity disorder: a preliminary case series. J Child Adolesc Psychopharmacol. 2002 Winter;12 (4) : 331-6.
24. Bymaster FP, Katner JS, Nelson DL, Hemrick-Luecke SK, Threlkeld PG, Heiligenstein JH, Morin SM, Gehlert DR, Perry KW. Atomoxetine increases extracellular levels of norepinephrine and dopamine in prefrontal cortex of rat: a potential mechanism for efficacy in attention deficit/hyperactivity disorder. Neuropsychopharmacology. 2002 Nov;27(5):699-711.
25. Spencer T, Heiligenstein JH, Biederman J, Biederman J, Faries DE, Kratochvil CJ, Conners CK, Potter WZ. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention deficit/hyperactivity disorder. J Clin Psychiatry 2002; 63: 1140-7.
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