Keith Hartman, MD
Private Practice,
Osceola, WI 54020
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To the Editor.
Atomoxetine is a selective inhibitor of norepinephrine reuptake recently approved for the treatment of attention-deficit/hyperactivity disorder (ADHD). In 4 double-blind, placebo-controlled clinical trials leading to Food and Drug Administration approval,
70% of child and adolescent subjects responded based on reductions in scores on a variety of measures for ADHD symptomatology.1,2 Although no major risks were identified in these trials, a small percentage of subjects seem to have experienced mood destabilization. Irritability was reported in 8% of subjects, and mood swings were observed in 2% of subjects. Four subjects discontinued the drug because of irritability or aggression.3 Our clinical experience has been that mood destabilization is a