Published online September 1, 2004
PEDIATRICS Vol. 114 No. 3 September 2004, pp. 895-896 (doi:10.1542/peds.2004-1140)
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Aggression, Mania, and Hypomania Induction Associated With Atomoxetine

Theodore A. Henderson, MD, PhD
Private Practice,
Child and Adolescent Psychiatry,
Denver, CO 80122
Matrix ADHD Diagnostic Clinic,
Denver, CO 80122
Neurobehavioral Research,
Brain Matters, Inc,
Denver, CO 80122

Keith Hartman, MD
Private Practice,
Osceola, WI 54020

The first 20% of the full text of this article appears below.

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 . . . [Full Text of this Article]