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Research ArticleRegular Articles

Atomoxetine for the Treatment of ADHD in Incarcerated Adolescents

Sarah Jillani, Prina Patel, Robert Trestman and Jayesh Kamath
Journal of the American Academy of Psychiatry and the Law Online June 2016, 44 (2) 158-163;
Sarah Jillani
Dr. Jillani is a Child and Adolescent Psychiatry Fellow, Yale Child Study Center, Yale University, New Haven, CT. Dr. Patel is a Pediatric Resident Physician, Winthrop University Hospital, Mineola, NY. Dr. Trestman is Professor of Medicine, Psychiatry, and Nursing, University of Connecticut School of Medicine, and Executive Director, UConn Health Correctional Managed Health Care, Farmington, CT. Dr. Kamath is Associate Professor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT.
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Prina Patel
Dr. Jillani is a Child and Adolescent Psychiatry Fellow, Yale Child Study Center, Yale University, New Haven, CT. Dr. Patel is a Pediatric Resident Physician, Winthrop University Hospital, Mineola, NY. Dr. Trestman is Professor of Medicine, Psychiatry, and Nursing, University of Connecticut School of Medicine, and Executive Director, UConn Health Correctional Managed Health Care, Farmington, CT. Dr. Kamath is Associate Professor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT.
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Robert Trestman
Dr. Jillani is a Child and Adolescent Psychiatry Fellow, Yale Child Study Center, Yale University, New Haven, CT. Dr. Patel is a Pediatric Resident Physician, Winthrop University Hospital, Mineola, NY. Dr. Trestman is Professor of Medicine, Psychiatry, and Nursing, University of Connecticut School of Medicine, and Executive Director, UConn Health Correctional Managed Health Care, Farmington, CT. Dr. Kamath is Associate Professor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT.
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Jayesh Kamath
Dr. Jillani is a Child and Adolescent Psychiatry Fellow, Yale Child Study Center, Yale University, New Haven, CT. Dr. Patel is a Pediatric Resident Physician, Winthrop University Hospital, Mineola, NY. Dr. Trestman is Professor of Medicine, Psychiatry, and Nursing, University of Connecticut School of Medicine, and Executive Director, UConn Health Correctional Managed Health Care, Farmington, CT. Dr. Kamath is Associate Professor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT.
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    Figure 1.

    Change in ADHD symptoms before and after treatment with atomoxetine. PA, participant. Star: participant 5 (PA-5) withdrew at week 8 (of 10) because of persistent headaches.

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    Figure 2.

    Change in anxiety symptoms before and after treatment with atomoxetine. PA: Participant. Star: participant 5 (PA-5) withdrew at week 8 (of 10) because of persistent headaches.

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    Table 1

    Stimulants and Nonstimulants for the Treatment of ADHD

    I. Stimulants: methylphenidates and amphetamines
        MOA: blockade of dopamine transporters with additional effects of norepinephrine transporter blockade, dampening action of enzyme monoamine oxidase and enhanced release of dopamine in synaptic space
        SE: appetite loss, abdominal pain, headaches, sleep disturbances, and cardiovascular and neuropsychiatric side effects
    II. Nonstimulants
        A. α2-Adrenoreceptor agonists (e.g., guanfacine and clonidine)
            MOA: stimulation of the presynaptic and postsynaptic α2-adrenergic receptors that control the release of norepinephrine and the rate of cell firing
            SE: drowsiness, dizziness, irritability, headache, abdominal pain, and cardiovascular side effects (bradycardia, hypotension, and QTc prolongation)
        B. Atomoxetine
            MOA: norepinephrine reuptake inhibition
            SE: sedation, fatigue, nausea, vomiting, reduced appetite, headaches, and irritability
    • MOA, mechanism of action; SE, side effect.

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Journal of the American Academy of Psychiatry and the Law Online: 44 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 44, Issue 2
1 Jun 2016
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Atomoxetine for the Treatment of ADHD in Incarcerated Adolescents
Sarah Jillani, Prina Patel, Robert Trestman, Jayesh Kamath
Journal of the American Academy of Psychiatry and the Law Online Jun 2016, 44 (2) 158-163;

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Atomoxetine for the Treatment of ADHD in Incarcerated Adolescents
Sarah Jillani, Prina Patel, Robert Trestman, Jayesh Kamath
Journal of the American Academy of Psychiatry and the Law Online Jun 2016, 44 (2) 158-163;
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