Section - CAP Smart Takes

03. Personalizing Atomoxetine Dosing in Children With ADHD

Published on September 1, 2023 Certification expiration date: September 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

No strong evidence supports the relationship between atomoxetine levels and ADHD clinical response. Individualizing atomoxetine dosage remains a complex challenge.
Despite pharmacogenetic advancements in the field, the psychiatrist’s clinical judgment remains irreplaceable.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP or Child and Adolescent Psychiatry Smart Take, we’ll take a close look at the feasibility of individualizing atomoxetine dosing in pediatric patients with ADHD treated with atomoxetine. Now, efforts to characterize dose–exposure relationships and identify clinically relevant metrics for atomoxetine dosage have so far been elusive. Atomoxetine was the first nonstimulant medication approved by the FDA for ADHD. In North America and Europe, stimulant medications are the recommended first-line treatment for pediatric patients with ADHD; nonstimulant medications, such as atomoxetine, are viewed as second-line treatment for those who do not respond to or cannot tolerate stimulant medications.

Interestingly, Japanese guidelines recommend both stimulants and nonstimulants as first-line therapy for pediatric ADHD patients. In China, methylphenidate and atomoxetine are also first-line treatments. Atomoxetine is sometimes used as a primary treatment for ADHD with comorbid anxiety disorders or substance use disorders.

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04. Safety and Tolerability of Serdexmethylphenidate/Dexmethylphenidate in Children with ADHD

Learning Objectives:

Learn effective strategies for evaluating, monitoring, and managing antidepressant-related side effects in young patients.
Understand the impact of age on antidepressant response in patients with major depressive disorder and its implications for clinical practice.
Recognize that lamotrigine appears to be effective in pediatric mood disorders as monotherapy or an augmenting agent.
Recognize that ADHD with comorbid anxiety requires distinct diagnostic and treatment approaches.
Understand the real-world prescribing patterns of OROS-MPH in treating ADHD in children and adolescents.

Original Release Date: September 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: September 1, 2026

Expert: David Rosenberg, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.