Tehran University Medical Journal

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric disorder among children and adolescents. This disorder causes difficulties in academic, behavioral, emotional, social and family performance. Stimulants show robust efficacy and a good safety profile in children with this disorder, but a significant percent of ADHD children do not respond adequately or cannot tolerate the associated adverse effects with stimulants. Such difficulties highlight the need for alternative safe and effective medications in the treatment of this disorder. This open-label study assessed the effectiveness of reboxetine, a selective norepinephrine reuptake inhibitor, in children and adolescents with attention deficit hyperactivity disorder (ADHD).
Methods: Fifteen child and adolescent outpatients, aged 7 to 16 (Mean± SD=9.72±2.71) years, diagnosed with ADHD were enrolled in a six open-label study with reboxetine 4-6 mg/d. The principal measure of the outcome was the teacher and parent Attention Deficit Hyperactive Disorder Rating Scale (ADHD Rating Scale). Patients were assessed by a child psychiatrist at baseline, 2, 4 and 6 weeks of the medication started. Side effects questionnaire was used to detect side effects of reboxetine. Repeated measures Analysis of variance (ANOVA) was done for comparison of Teacher and Parent ADHD Rating Scale scores during the intervention.
Results: Twelve of 15 (80%) participants completed the treatment protocol. A significant decrease in ADHD symptoms on teacher (p=0.04) and parent (p=0.003) ADHD rating scale was noted. Adverse effects were mild to moderate in severity. The most common adverse effects were drowsiness/sedation and appetite decrease.
Conclusion: The results of the current study suggest the effectiveness of reboxetine in the treatment of ADHD in children and adolescents. Double-blind, placebo-controlled studies and larger sample size with long duration of intervention are indicated to rigorously test the efficacy of reboxetine in ADHD. It is important that future studies complete our knowledge about safety and side effects of reboxetine.