A review of atomoxetine effects in young people with developmental disabilities

Michael G. Aman, Tristram Smith, L. Eugene Arnold, Patricia Corbett-Dick, Rameshwari Tumuluru, Jill A. Hollway, Susan L. Hyman, Marissa Mendoza-Burcham, Xueliang Pan, Daniel W. Mruzek, Luc Lecavalier, Lynne Levato, Laura B. Silverman, Benjamin Handen

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations


This review summarizes the pharmacokinetic characteristics, pharmacodynamic properties, common side effects, and clinical advantages and disadvantages associated with atomoxetine (ATX) treatment in typically developing children and adults with ADHD. Then the clinical research to date in developmental disabilities (DD), including autism spectrum disorders (ASD), is summarized and reviewed. Of the 11 relevant reports available, only two were placebo-controlled randomized clinical trials, and both focused on a single DD population (ASD). All trials but one indicated clinical improvement in ADHD symptoms with ATX, although it was difficult to judge the magnitude and validity of reported improvement in the absence of placebo controls. Effects of ATX on co-occurring behavioral and cognitive symptoms were much less consistent. Appetite decrease, nausea, and irritability were the most common adverse events reported among children with DD; clinicians should be aware that, as with stimulants, irritability appears to occur much more commonly in persons with DD than in typically developing individuals. Splitting the dose initially, starting below the recommended starting dose, and titrating slowly may prevent or ameliorate side effects. Patience is needed for the slow build-up of benefit. Conclusions: ATX holds promise for managing ADHD symptoms in DD, but properly controlled, randomized clinical trials of atomoxetine in intellectual disability and ASD are sorely needed. Clinicians and researchers should be vigilant for the emergence of irritability with ATX treatment. Effects of ATX on cognition in DD are virtually unstudied.

Original languageEnglish (US)
Pages (from-to)1412-1424
Number of pages13
JournalResearch in Developmental Disabilities
Issue number6
StatePublished - Jun 2014

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Clinical Psychology


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