{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:11:18Z","timestamp":1787008278464,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2009,10,1]],"date-time":"2009-10-01T00:00:00Z","timestamp":1254355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Atomoxetine has been proposed to be effective for treating co-morbid attention-deficit\/hyperactivity disorder (ADHD) in children with bipolar disorder (BPD) without destabilizing mood. We conducted an 8-week, open label study to study the efficacy and tolerability of adjunct atomoxetine in euthymic children and adolescents with BPD and ADHD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We evaluated 12 youth aged 6\u201317 years (mean\u2009=\u200911.3 years; 7 males) with a diagnosis of BPD I or II and ADHD. Subjects were euthymic at baseline and taking at least one mood stabilizer or antipsychotic. Primary outcome measure was the ADHD Rating Scale-IV (ADHD-RS-IV) (response\u2009=\u200925% decrease; remission\u2009=\u200940% decrease). Secondary outcome measures were change in Young Mania Rating Scale (YMRS) and Children's Depression Rating Scale (CDRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In primary outcome criteria, 8 (67%) were responders and 6 (50%) were remitters by ADHD-RS criteria. There was a significant decrease in ADHD-RS scores over the study (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001; Cohen\n                      <jats:italic toggle=\"yes\">d<\/jats:italic>\n                      \u2009=\u20092.18, effect size\u2009=\u20090.73). YMRS and CDRS scores did not change significantly from baseline to week 8. No subjects experienced a manic or mixed episode during the study, but 2 subjects were discontinued early due to worsening of mood symptoms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We found atomoxetine to be efficacious in treating symptoms of ADHD in children and adolescents with BPD taking mood stabilizers or antipsychotics. It is unclear whether symptomatic worsening of 2 subjects was due to atomoxetine or the natural course of illness. Placebo-controlled studies are needed to clarify the role of atomoxetine in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2009.0030","type":"journal-article","created":{"date-parts":[[2009,10,30]],"date-time":"2009-10-30T18:59:33Z","timestamp":1256929173000},"page":"547-551","source":"Crossref","is-referenced-by-count":50,"title":["Atomoxetine as an Adjunct Therapy in the Treatment of Co-Morbid Attention-Deficit\/Hyperactivity Disorder in Children and Adolescents with Bipolar I or II Disorder"],"prefix":"10.1177","volume":"19","author":[{"given":"Kiki","family":"Chang","sequence":"first","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Nayar","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Howe","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manasi","family":"Rana","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2009,10,1]]},"reference":[{"key":"e_1_3_1_2_1","unstructured":"American Psychiatric Association. Diagnostic Statistical Manual of Mental Disorders 4th edition (DMS-IV) Washington (DC): American Psychiatric Association 1994."},{"key":"e_1_3_1_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31815d88b2"},{"key":"e_1_3_1_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.63.2.175"},{"key":"e_1_3_1_5_1","first-page":"16","article-title":"Stimulant use in pediatric bipolar disorder with attention-deficit\/hyperactivity disorder: Pro.","volume":"2","author":"Chang K","year":"2003","unstructured":"Chang K. Stimulant use in pediatric bipolar disorder with attention-deficit\/hyperactivity disorder: Pro. J Bipolar Disorders: Reviews and Commentaries, 2:16\u201317. 2003.","journal-title":"J Bipolar Disorders: Reviews and Commentaries"},{"key":"e_1_3_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e318040b25f"},{"key":"e_1_3_1_7_1","volume-title":"ADHD Rating Scale-IV: Checklists, Norms, Clinical Interpretation","author":"DuPaul GL","year":"1998","unstructured":"DuPaul GL, , Power TJ, , Anastopoulos AD. ADHD Rating Scale-IV: Checklists, Norms, Clinical Interpretation. 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