Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for developing comorbid non-bipolar mood disorders. Fluoxetine monotherapy is an established treatment for pediatric mood disorders; however its efficacy in ADHD and comorbid mood disorder is unknown. Therefore, we evaluated 30 children who met DSM-IV criteria for ADHD and comorbid non-bipolar mood disorders in a prospective, 6–12-week open-label, study of fluoxetine monotherapy. Fluoxetine was associated with significant decreases in the severity of depressive symptoms, and also, associated with significant decreases on subscales of inattention/overactivity and aggression/defiant symptoms—47% of participants were much or very much improved without observed adverse effects.
Similar content being viewed by others
References
American Psychiatric Association (1997) diagnostic and statistical manual of mental disorders, 4th edn (DSM-IV). American Psychiatric Association, Washington, DC
Cheung AH, Emslie GJ, Mayes TL (2005) Review of the efficacy and safety of antidepressants in youth depression. J Child Psychol Psychiatry 46:735–754
Yorbik O, Birmaher B, Axelson D, Williamson DE, Ryan ND (2004) Clinical characteristics of depressive symptoms in adolescents with major depressive disorder. J Clin Psychiatry 65(12):1654–1659 (ISSN: 0160-6689)
Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L, Mennin D, Marrs A, Ouellette C, Moore P, Spencer T, Norman D, Wilens T, Kraus I, Perrin J (1996) A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 53:437–446
Barkley RA (1990) ADHD: a handbook for diagnosis and treatment. Guilford Press, New York
Pliszka SR (1987) Tricyclic antidepressants in the treatment of children with attention deficit disorder. J Am Acad Child Adolesc Psychiatry 26:127–132
Hazell P, O’Connell D, Heathcote D, Robertson J, Henry D (1995) Efficacy of tricyclic drugs in treating child and adolescent depression: a meta-analysis. BMJ 310:897–901
Vitiello B, Swedo S (2004) Antidepressant medications in children. N Engl J Med 350:1489–1491
Whittington CG, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E (2004) Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet 363:1341–1345
Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Hughes CW, Carmody T, Rintelmann J (1997) A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry 54:1031–1037
Emslie GJ, Heiligenstein JH, Wagner KD, Hoog SL, Ernest DE, Brown E, Nilsson M, Jacobson JG (2002) Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial. J Am Acad Child Adolesc Psychiatry 41:1205–1215
Barrickman L, Noyes R, Kuperman S, Schumacher E, Verda M (1991) Treatment of ADHD with fluoxetine: A preliminary trial. J Am Acad Child Adolesc Psychiatry 30:762–767
Treatment for Adolescents with Depressions Study (TADS) Team (2004) Fluoxetine, cognitive-behavioral therapy and their combination for adolescents with depression. JAMA 292:807–820
Hechtman L (2003) Clinical trial of Dexedrine, Paxil, and placebo for adult ADHD. AACAP Sci Proc 94
Weiss M, Hechtman L (2006). A randomized double-blind trial of paroxetine and/or dextroamphetamine and problem-focused therapy for attention- deficit/hyperactivity disorder. J Clin Psychiatry 67(4):611–619 (ISSN: 0160-6689)
Gammon GD, Brown TE (1993) Fluoxetine and methylphenidate in combination for treatment of attention deficit disorder and comorbid depressive disorder. J Child Adolesc Psychopharmacol 3:1–10
Findling R (1996) Open-label treatment of comorbid depression and attentional disorders with co-administration of serotonin reuptake inhibitors and psychostimulants in children, adolescents, and adults: a case series. J Child Adolesc Psychopharmacol 6:165–175
Teare M, Fistad MA, Weller EB, Weller RA, Salmon P (1998) Development and criterion validity of the Children’s Interview for Psychiatric Syndromes (ChIPS). J Child Adolesc Psychopharmacol 8:205–211
Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62
Guy W (1976) ECDEU Assessment Manual for Psychopharmacology (DHEW Publication ADM 76-338). US Department of Health, Education, and Welfare, Rockville, MD
Conners CK (1973) Rating scales for use in drug studies with children. Psychopharmacol Bull 9:24–84
Loney J, Milich R (1982) Hyperactivity, inattention, and aggression in clinical practice. In: Wolraich M, Routh D (eds) Advances in developmental and behavioral pediatrics. vol 3, JAL, Greenwich CT, pp113–147
Barrickman L, Perry P, Allen AJ, Kuperman S, Arndt S, Herrmann K, Schumacher E (1995) Buproprion versus methylphenidate in the treatment of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 34:649–657
Kutcher S, Reiter S, Gardner D (1995) Pharmacotherapy approaches and applications. In: March J (ed.), Anxiety disorders in children and adolescents. Guilford Press, New York, pp 341–385
Cook T, Campbell D (1979) Quasi-experimentation: design and analysis issues for field settings. Houghton Mifflin, Boston
Shaffer D, Guold MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) Children’s global assessment scale [CGAS]. Arch Gen Psychiatry 40:1228–1231
Bangs M, Petti T, Janus M-D (1994) Fluoxetine-induced memory impairment in an adolescent. J Am Acad Child Adolesc Psychiatry 33:1303–1306
Nemeroff CB, DeVane CL, Pollack BG (1996) Newer antidepressants and the cytochrome P450 system. Am J Psychiatry 153:311–320
Acnowledgments
The authors are thankful to Eli Lilly for their support of this research through Grant ID # B1Y-MC-X143. We also want to thank the LSUHSC IRB that approved this study and that has encouraged our research in child and adolescent psychiatry.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Quintana, H., Butterbaugh, G.J., Purnell, W. et al. Fluoxetine Monotherapy in Attention-Deficit/Hyperactivity Disorder and Comorbid Non-Bipolar Mood Disorders in Children and Adolescents. Child Psychiatry Hum Dev 37, 241–253 (2007). https://doi.org/10.1007/s10578-006-0032-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10578-006-0032-7