Atomoxetine for Attention Deficit Hyperactivity Disorder in Adolescents With Substance Use Disorder

Not Applicable

Completed

Brief Summary: The purpose of this study is to find out whether atomoxetine (also called Strattera) helps teenagers (12-19) with Attention Deficit Hyperactivity Disorder (ADHD) and drug/alcohol problems.

Detailed Description: Evidence-based psychosocial treatments have recently been developed. However, very little data exist on the use of pharmacotherapy for adolescents SUD (Substance Use Disorder). One promising pharmacotherapy approach is to treat co-occuring psychiatric disorders. A common co-occurring disorder in adolescent SUD is attention-deficit/hyperactivity disorder (ADHD). Fortunately, new ADHD medications, such as atomoxetine, that do not have addictive potential are now available. However, all controlled studies of atomoxetine have specifically excluded teens with SUD. Therefore, little data exist on the safety and efficacy of the medication in this population. This research project will address the important research gap with the specific aim: to conduct a randomized, placebo-controlled trial of atomoxetine for ADHD in teens with SUD.

Recruitment & Eligibility

Inclusion Criteria

Age 12-19
Provided assent/consent
attention-deficit hyperactivity disorder (ADHD) by Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS)
Diagnostic and statistical manual of mental disorders, 4th edition (DSM-IV) checklist <=22
At least one non-nicotine substance use disorder (SUD) by KSADS
Plans to live locally for 4 months
Willing to participate in cognitive behavioral therapy (CBT)

Exclusion Criteria

No mental illness that cannot be managed as an outpatient or without concurrent psychotropic medication
No allergy to atomoxetine
No narrow angle glaucoma
No serious medical illness
Not pregnant
Not unwilling to use an effective form of contraception during the trial
No SUD that cannot be managed as an outpatient or without concurrent psychotropic medication

Arm && Interventions

Group	Intervention	Description
1	Placebo	placebo plus individual cognitive behavioral therapy
2	Atomoxetine	atomoxetine plus individual cognitive behavioral therapy

Primary Outcome Measures

Name	Time	Method
Change in Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Attention-deficit/Hyperactivity Disorder (ADHD) Checklist	baseline and weekly through week 12 post randomization	All 18 ADHD symptoms are rated on a scale of 0 (none) to 3 (severe) since the previous study visit. The scores are summed to create a total ADHD severity scale score ranging from 0 (none) to 54 (most severe). A single value of mean change in ADHD severity for each group (placebo and atomoxetine) was calculated using linear mixed models in an intent-to-treat an analysis.

Secondary Outcome Measures

Name	Time	Method
Time Line Followback Interview (TLFB)	12 weeks	The TLFB assesses the number of days in which a substance was used in the past 28 days. The TLFB is administered by the clinician and uses a 28-day calendar with anchor points to record this information. This instrument relies on confidential self-report of the adolescent participant. The result is reported as mean change in the number of days used substances in the past 28 days from baseline to the end of treatment using linear mixed models in an intent-to-treat analysis.
Side Effect Form for Children and Adolescents (SEFCA)	weekly from randomization to 12 weeks post-randomization	The SEFCA is a clinician-administered instrument that systematically assesses 52 possible side effects and rates them on a scale of 0 (not present) to 3 (severe). The instrument relies on confidential, self-report of the adolescent.The number of serious adverse events was recorded by intervention assignment.