Objective Attention deficit hyperactivity disorder (ADHD) is an established diagnosis in children with large evidence on the benefits of treatment. Atomoxetine, however, is a fairly new drug and was licensed in the UK in May 2004. There is a general reluctance regarding the use of this medication among community paediatricians. The objective of this study was to assess the effectiveness and safety of atomoxetine in children with ADHD managed by community paediatricians.

Methods A retrospective study of case notes of 30 children with a diagnosis of ADHD on treatment with atomoxetine during September 2005 to September 2006.

Results Of the 30 patients on atomoxetine, 21 (70%) showed improvement in their symptoms. All of them were offered atomoxetine within licensed indications. The most common reason for changing to atomoxetine was methylphenidate being ineffective or side effects being unacceptable (73%). Of the 24 patients on methylphenidate, 19 (79%) had it stopped after starting atomoxetine. The majority of patients (80%) had no significant adverse effects while on atomoxetine. However, in three (10%) children, a significant change in behaviour was found including suicidal ideation, violent and aggressive behaviour. Atomoxetine was stopped in seven (23%) patients, (3) due to change in behaviour, no improvement in symptoms (2) and tummy aches (2). Approximately 50% of children on atomoxetine had also been seen by the Child and Adolescent Mental Health Service (CAMHS) team.

Conclusion Atomoxetine was mainly used as a second-line therapy and mostly in more difficult cases of ADHD involving the CAMHS team. It was found to be effective and well tolerated in these children and adolescents; however, it requires close monitoring for changes in behaviour.