Atomoxetine and Parent Training for Children With Autism and Attention-Deficit/Hyperactivity Disorder: A 24-Week Extension Study

Objective The authors previously reported on a 2-by-2 randomized clinical trial of individual and combined with atomoxetine (ATX) and parent training (PT) for attention-deficit/hyperactivity disorder (ADHD) symptoms and behavioral noncompliance in 128 5- to 14-year-old children with autism spectrum disorder. In the present report, they describe a 24-week extension of and nonresponders. Method One-hundred seventeen participants from the acute trial (91%) entered the extension; 84 of these were in 2 subgroups: treatment responders (n = 43) from all 4 groups in the acute trial, seen monthly for 24 weeks, and (n = 41), treated with open-label ATX for 10 weeks. Participants originally assigned to PT continued PT during the extension; the remainder served as controls. Primary outcome measurements were the parent-rated Swanson, Nolan and Pelham ADHD scale and the Home Situations Questionnaire. Results Sixty percent (26 of 43) of in the acute trial, including 68% of originally assigned to ATX, still met the response criteria at the end of the extension. The response rate of placebo nonresponders treated with 10-week open-label ATX was 37% (15 of 41), similar to the acute trial. Children receiving open-label ATX + PT were significantly more likely to be ADHD (53% versus 23%) and noncompliance (58% versus 14%) than those receiving open-label ATX alone. Conclusion Most ATX maintained their responses during the extension. PT combined with ATX in the open-label trial appeared to improve ADHD and noncompliance outcomes more than ATX alone. Clinical trial registration information —Atomoxetine, Placebo and Parent Management Training in Autism (Strattera); http://clinicaltrials.gov; NCT00844753.