{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:49:22Z","timestamp":1773294562203,"version":"3.50.1"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,2,1]]},"abstract":"<jats:p>OBJECTIVE. In this study we examined the effectiveness of atomoxetine for the treatment of oppositional defiant disorder comorbid with attention-deficit\/hyperactivity disorder.<\/jats:p>\n               <jats:p>METHODS. Patients were aged 6 to 12 years and met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria for attention-deficit\/hyperactivity disorder with a Swanson, Nolan, and Pelham Rating Scale-Revised attention-deficit\/hyperactivity disorder subscale score above age and gender norms; Clinical Global Impressions-Severity Scale score of \u22654; and Swanson, Nolan, and Pelham Rating Scale-Revised oppositional defiant disorder subscale score of \u226515. Patients were randomly assigned in a 2:1 ratio to receive 1.2 mg\/kg per day of atomoxetine (n = 156) or placebo (n = 70) for 8 weeks. Treatment effect on oppositional defiant disorder and attention-deficit\/hyperactivity disorder symptoms was measured by using the investigator-rated Swanson, Nolan, and Pelham Rating Scale-Revised.<\/jats:p>\n               <jats:p>RESULTS. Repeated-measures analysis demonstrated a statistically significant difference favoring atomoxetine over placebo in the reduction of Swanson, Nolan, and Pelham Rating Scale-Revised oppositional defiant disorder total scores. There were significant pairwise treatment differences at weeks 2 and 5 but not at week 8 postbaseline. A last-observation-carried-forward analysis showed Swanson, Nolan, and Pelham Rating Scale-Revised scores at endpoint for the atomoxetine and placebo groups were significantly different for attention-deficit\/hyperactivity disorder symptoms but not for oppositional defiant disorder symptoms. Atomoxetine was superior to placebo in a last-observation-carried-forward analysis of Clinical Global Impression-Improvement and Clinical Global Impression-Severity scores.<\/jats:p>\n               <jats:p>CONCLUSIONS. This study confirms previous findings that patients with attention-deficit\/hyperactivity disorder and comorbid oppositional defiant disorder show statistically and clinically significant improvement in attention-deficit\/hyperactivity disorder symptoms and global clinical functioning when treated with atomoxetine. It remains uncertain, however, whether atomoxetine exerts a specific and enduring effect on oppositional defiant disorder symptoms.<\/jats:p>","DOI":"10.1542\/peds.2006-1880","type":"journal-article","created":{"date-parts":[[2008,2,1]],"date-time":"2008-02-01T18:40:00Z","timestamp":1201891200000},"page":"e314-e320","source":"Crossref","is-referenced-by-count":60,"title":["Atomoxetine for the Treatment of Attention-Deficit\/Hyperactivity Disorder and Oppositional Defiant Disorder"],"prefix":"10.1542","volume":"121","author":[{"given":"Mark E.","family":"Bangs","sequence":"first","affiliation":[{"name":"Lilly Research Laboratories, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Hazell","sequence":"additional","affiliation":[{"name":"Child and Adolescent Mental Health Services, University of Newcastle, Newcastle, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Danckaerts","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, University of Ziekenhuis Gasthuisberg Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Hoare","sequence":"additional","affiliation":[{"name":"Child and Family Health Service, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Coghill","sequence":"additional","affiliation":[{"name":"Section of Psychiatry, Division of Pathology and Neuroscience, University of Dundee, Dundee, Scotland, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter M.","family":"Wehmeier","sequence":"additional","affiliation":[{"name":"Lilly Deutschland, Bad Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Williams","sequence":"additional","affiliation":[{"name":"Lilly Research Laboratories, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodney J.","family":"Moore","sequence":"additional","affiliation":[{"name":"Lilly Research Laboratories, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Levine","sequence":"additional","affiliation":[{"name":"Lilly Research Laboratories, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Atomoxetine ADHD\/ODD Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2008,2,1]]},"reference":[{"key":"2021120820175338800_R1","doi-asserted-by":"crossref","unstructured":"Kuhne M, Schachar R, Tannock R. Impact of comorbid oppositional or conduct problems on attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry.\u20081997;36(12):1715\u20131725","DOI":"10.1097\/00004583-199712000-00020"},{"key":"2021120820175338800_R2","doi-asserted-by":"crossref","unstructured":"Burke JD, Loeber R, Birmaher B. Oppositional defiant disorder and conduct disorder: a review of the past 10 years, part II. J Am Acad Child Adolesc Psychiatry.\u20082002;41(11):1275\u20131293","DOI":"10.1097\/00004583-200211000-00009"},{"key":"2021120820175338800_R3","doi-asserted-by":"crossref","unstructured":"Kirley A, Lowe N, Mullins C, et al. Phenotype studies of the DRD4 gene polymorphisms in ADHD: association with oppositional defiant disorder and positive family history. Am J Med Genet B Neuropsychiatr Genet.\u20082004;131(1):38\u201342","DOI":"10.1002\/ajmg.b.30072"},{"key":"2021120820175338800_R4","doi-asserted-by":"crossref","unstructured":"Satake H, Yamashita H, Yoshida K. The family psychosocial characteristics of children with attention-deficit hyperactivity disorder with or without oppositional or conduct problems in Japan. Child Psychiatry Hum Dev.\u20082004;34(3):219\u2013235","DOI":"10.1023\/B:CHUD.0000014998.93858.1d"},{"key":"2021120820175338800_R5","doi-asserted-by":"crossref","unstructured":"Oosterlaan J, Scheres A, Sergeant JA. Which executive functioning deficits are associated with AD\/HD, ODD\/CD and comorbid AD\/HD+ODD\/CD?J Abnorm Child Psychol.\u20082005;33(1):69\u201385","DOI":"10.1007\/s10802-005-0935-y"},{"key":"2021120820175338800_R6","doi-asserted-by":"crossref","unstructured":"Fergusson DM, Lynskey MT, Horwood LJ. Conduct problems and attention deficit behaviour in middle childhood and cannabis use by age 15. Aust NZ J Psychiatry.\u20081993;27(4):673\u2013682","DOI":"10.3109\/00048679309075830"},{"key":"2021120820175338800_R7","doi-asserted-by":"crossref","unstructured":"Fergusson DM, Horwood LJ, Lynskey MT. The effects of conduct disorder and attention deficit in middle childhood on offending and scholastic ability at age 13. J Child Psychol Psychiatry.\u20081993;34(6):899\u2013916","DOI":"10.1111\/j.1469-7610.1993.tb01097.x"},{"key":"2021120820175338800_R8","doi-asserted-by":"crossref","unstructured":"Fergusson DM, Lynskey MT, Horwood LJ. Attentional difficulties in middle childhood and psychosocial outcomes in young adulthood. J Child Psychol Psychiatry.\u20081997;38(6):633\u2013644","DOI":"10.1111\/j.1469-7610.1997.tb01690.x"},{"key":"2021120820175338800_R9","doi-asserted-by":"crossref","unstructured":"Drabick DA, Gadow KD, Carlson GA, et al. ODD and ADHD symptoms in Ukrainian children: external validators and comorbidity. J Am Acad Child Adolesc Psychiatry.\u20082004;43(6):735\u2013743","DOI":"10.1097\/01.chi.0000120019.48166.1e"},{"key":"2021120820175338800_R10","doi-asserted-by":"crossref","unstructured":"Paternite CE, Loney J, Roberts MA. External validation of oppositional disorder and attention deficit disorder with hyperactivity. J Abnorm Child Psychol.\u20081995;23(4):453\u2013471","DOI":"10.1007\/BF01447208"},{"key":"2021120820175338800_R11","doi-asserted-by":"crossref","unstructured":"Dick DM, Viken RJ, Kaprio J, et al. Understanding the covariation among childhood externalizing symptoms: genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. J Abnorm Child Psychol.\u20082005;33(2):219\u2013229","DOI":"10.1007\/s10802-005-1829-8"},{"key":"2021120820175338800_R12","doi-asserted-by":"crossref","unstructured":"Nadder TS, Rutter M, Silberg JL, Maes HH, Eaves LJ. Genetic effects on the variation and covariation of attention deficit-hyperactivity disorder (ADHD) and oppositional-defiant disorder\/conduct disorder (ODD\/CD) symptomatologies across informant and occasion of measurement.[published correction in Psychol Med 2002;32(2):378]. Psychol Med.\u20082002;32(1):39\u201353","DOI":"10.1017\/S0033291701004792"},{"key":"2021120820175338800_R13","doi-asserted-by":"crossref","unstructured":"Thapar A, Harrington R, McGuffin P. Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design. Br J Psychiatry.\u20082001;179:224\u2013229","DOI":"10.1192\/bjp.179.3.224"},{"key":"2021120820175338800_R14","unstructured":"Oosterlaan J, Sergeant JA. Effects of reward and response cost on response inhibition in AD\/HD, disruptive, anxious, and normal children. J Abnorm Child Psychol.\u20081998;26(3):161\u2013174"},{"key":"2021120820175338800_R15","doi-asserted-by":"crossref","unstructured":"Kaplan S, Heiligenstein J, West S, et al. Efficacy and safety of atomoxetine in childhood attention-deficit\/hyperactivity disorder with comorbid oppositional defiant disorder. J Atten Disord.\u20082004;8(2):45\u201352","DOI":"10.1177\/108705470400800202"},{"key":"2021120820175338800_R16","doi-asserted-by":"crossref","unstructured":"Newcorn J, Spencer TJ, Biederman J, et al. Atomoxetine treatment in children and adolescents with attention-deficit\/hyperactivity disorder and comorbid oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry.\u20082005;44(3):240\u2013248","DOI":"10.1097\/00004583-200503000-00008"},{"key":"2021120820175338800_R17","unstructured":"Newcorn J, Michelson D, Spencer T, and Milton D. Atomoxetine treatment in child\/adolescent ADHD with comorbid ODD. Presented at the 49th annual meeting of the American Academy of Child and Adolescent Psychiatry; October 22\u201327, 2002; San Francisco, CA"},{"key":"2021120820175338800_R18","unstructured":"World Medical Association. Declaration of Helsinki: Recommendations Guiding Medical Doctors in Biomedical Research Involving Human Subjects. Edinburgh, Scotland: World Medical Association; 2000"},{"key":"2021120820175338800_R19","doi-asserted-by":"crossref","unstructured":"Gaub M, Carlson CL. Gender differences in ADHD: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry.\u20081997;36(8):1036\u20131045","DOI":"10.1097\/00004583-199708000-00011"},{"key":"2021120820175338800_R20","unstructured":"Swanson J. School-Based Assessments and Interventions for ADD. Irvine, CA: KC Publishing; 1992"},{"key":"2021120820175338800_R21","doi-asserted-by":"crossref","unstructured":"Guy W. ECDEU Assessment Manual for Psychopharmacology, Revised. Bethesda, MD: US Department of Health, Education, and Welfare; 1976. Publication ADM 76\u2013338","DOI":"10.1037\/e591322011-001"},{"key":"2021120820175338800_R22","unstructured":"National Institute of Mental Health. Clinical global impressions. Psychopharmacol Bull.\u20081985;21:839\u2013843"},{"key":"2021120820175338800_R23","doi-asserted-by":"crossref","unstructured":"Conners CK. Conners' Rating Scales: Revised Technical Manual. North Tonawanda, NY: Multi-Health Systems Inc; 1997","DOI":"10.1037\/t81067-000"},{"key":"2021120820175338800_R24","doi-asserted-by":"crossref","unstructured":"Holmes T, Rahe R. The social readjustment rating scale. J Psychosom Res.\u20081967;11:214","DOI":"10.1016\/0022-3999(67)90010-4"},{"key":"2021120820175338800_R25","doi-asserted-by":"crossref","unstructured":"Katz N. Methodological issues in clinical trials of opioids for chronic pain. 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