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Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) With Atomoxetine in Young Adults and Its Effects on Functional Outcomes

A Double-Blind Study of Atomoxetine Hydrochloride Versus Placebo for the Treatment of ADHD in Young Adults With an Assessment of Associated Functional Outcomes

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00510276
Enrollment
445
Registered
2007-08-01
Start date
2007-08-31
Completion date
2009-02-28
Last updated
2010-04-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Attention Deficit Hyperactivity Disorder

Brief summary

This study will evaluate atomoxetine's efficacy in treating attention-deficit/hyperactivity disorder (ADHD) symptoms and atomoxetine's effect on functional outcomes in young adults. A gatekeeper strategy will be employed for sequentially testing the secondary objectives. This study also has an observational community sample arm in which patients will complete all the efficacy measurements via web-based self reporting.

Interventions

DRUGAtomoxetine hydrochloride

20-50 mg, twice a day per by mouth for 12 weeks, followed by up to an additional 12 weeks

DRUGPlacebo

twice a day, by mouth for 12 weeks

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 30 Years
Healthy volunteers
No

Inclusion criteria

* positive attention-deficit/hyperactivity disorder (ADHD) diagnosis with at least moderate severity * male or female 18 to 30 years of age * must be able to swallow capsules * must be able to communicate effectively in English * must not have cognitive impairment * be reliable to keep appointments for clinic visits and all related tests

Exclusion criteria

* patients diagnosed with obsessive-compulsive disorder, bipolar affective disorder, or psychosis * females who are pregnant or breastfeeding * patients with dementia or traumatic brain injury * patients with a history of severe allergy to atomoxetine * have untreated hypertension or thyroid problem * have serious medical illness including any heart, liver, kidney, respiratory, blood, endocrine, or neuromuscular diseases

Design outcomes

Primary

MeasureTime frameDescription
Mean Change in the Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) Total ADHD Symptom Score From Baseline to 12 Week EndpointBaseline, Week 12CAARS-Inv:SV is a 30-item scale containing 3 subscales: the Inattention subscale, the Hyperactivity-Impulsivity subscale, and the ADHD Index. The 18-item total ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.

Secondary

MeasureTime frameDescription
Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Relationship SubscaleBaseline, 12 weeksPatient-reported outcome measure used to examine the disease-specific functional impariments and quality of life for adults with ADHD. This subscale asseses quality of relationships. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.
Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Productivity SubscaleBaseline, 12 weeksPatient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale assesses life productivity. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.
Mean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey-Other ReportBaseline, 12 weeks26-item driving survey completed by someone other than the patient/driver. Examples of driving behaviors included in the survey match those listed in the Self-Report version of the scale. Items are rated on a 4-point scale (1 = not at all or rarely, 2 = sometimes, 3 = often, 4 = very often). The total score is the sum of the 26 items and ranges from 26 to 104.
Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Psychological Health SubscaleBaseline, 12 weeksPatient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale asseses the psychological health. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.
Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Outlook SubscaleBaseline, 12 weeksPatient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale asseses life outlook. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.
Mean Change From Baseline to 12 Week Endpoint in Clinical Global Impression-ADHD- Severity (CGI-ADHD-S)Baseline, 12 weeksSingle-item clinician rating of the clinician's assessment of the patient's severity of the ADHD symptoms in relation to the clinician's total experience with ADHD patients. Severity is rated on a 7-point scale (1 = normal, not at all ill; 7 = among the most extremely ill patients). The total score ranges from 1 to 7.
Mean Change From Baseline to 12 Week Endpoint in CAARS Self Report (CAARS-S:SV) Total ScoreBaseline, 12 weeks30-item patient-reported scale with 3 subscales: Inattention subscale, Hyperactivity-Impulsivity subscale, and ADHD Index. 18-item total ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each individual item is scored on a 0 to 3 scale (0 = not at all, never; 1 = just a little, once in a while; 2 = Pretty much, often; 3 = very much, very frequently). The rating scale assesses symptom severity over the past week. The total score ranges from 0 to 54.
Endpoint Scores in Patient Global Impression - Improvement (PGI-I)Baseline, 12 weeks7-point scale modeled after the CGI on which patients rate any change in their overall status that they had experienced since beginning the study drug. The score on this scale ranges from 1 (very much improved) to 7 (very much worse).
Mean Change From Baseline to 12 Week Endpoint on the Montgomery Asberg Depression Rating Scale (MADRS)Baseline, 12 weeksRating scale for severity of depressive mood symptoms, administered by the investigator. The scale consists of 10 items, each rated on a scale from 0 to 6. The MADRS total score is the sum of the 10 items and the score ranges from 0 to 60. Higher scores denote more severe depressive symptoms.
Mean Change From Baseline to 12 Week Endpoint on the Beck Anxiety Inventory (BAI)Baseline, 12 weeks21-item self-reported screening tool for measuring anxiety severity. Each item is rated on a 4-point Likert scale ranging from 0 (not at all) to 3 (severely; I could barely stand it). Each item is descriptive of subjective, somatic, or panic-related symptoms of anxiety. Patients record how much they have been bothered by each symptom during the past week, including the day the questionnaire is administered. The total score ranges from 0 to 63.
Correlation of Mean Changes From Baseline to 12 Week on the Adult ADHD Quality of Life-29 Total Score and of Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated:Screening Version Total ScoreBaseline, 12 weeksAAQOL-29: Patient-reported outcome measure examining disease-specific functional impariments and quality of life for adults with ADHD. The domains included in the AAQOL are life productivity, psychological health, quality of relationships, and life outlook. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning. CAARS-Inv:SV: Inattention subscale, Impulsivity subscale, and ADHD Index. Each item is scored on a 0 to 3 scale, assessing symptom severity over the past week. The total score is the sum of all subscale scores.
Mean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of AlcoholBaseline, 12 weeksVariation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome. Recorded is the number of standard drinks that have been consumed.
Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of CaffeineBaseline, 12 weeksVariation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of caffeine consumed by an individual. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome.
Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of DrugsBaseline, 12 weeksVariation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of recreational drugs other than marijuana an individual consumed and is expressed as the ratio of number of days on which drugs were used over the total number of days, resulting in a total score ranging from 0 to 1. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year.
Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of NicotineBaseline, 12 weeksVariation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of nicotine consumed by an individual. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome.
Mean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of MarijuanaBaseline, 12 weeksVariation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome. Recorded is the number of joints that have been consumed.
Mean Change From Baseline to 12 Week Endpoint on the Fagerstrom Test for Nicotine Dependence (FTND)Baseline, 12 weeksThe FTND was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains items that evaluate the quantity of cigarette consumption, the compulsion to use, and dependence. The FTND contains 4 yes-no and 2 multiple choice questions and can be used in a self-report format. The items on FTND are scored 0 to 3 for multiple choice items, the items are summed to yield a total score of 0-10 (0=minimum nicotine dependence; 10=maximum nicotine dependence).
Mean Change From Baseline to 12 Week Endpoint on the Social Adaptation Self-Evaluation Scale (SASS)Baseline, 12 weeksPatient completed scale that consists of 21 items that examine behavior and subjective perception, including satisfaction, self-perception and motivation in participating in and maintaining relationships with family and friends, satisfaction in work, home and leisure activities, and intellectual interests. Each item is scored from 0 to 3, corresponding to minimal and maximal social adjustment, with a total score range from 0 to 60.
Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Total ScoreBaseline, 12 weeksPatient-reported outcome measure used to examine the disease-specific functional impariments and quality of life for adults with ADHD. The domains included in the AAQOL are life productivity, psychological health, quality of relationships, and life outlook. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Behavioral Regulation Section ScoreBaseline, 12 weeksThe BRIEF-A behavioral regulation subscale measures an individuals control over behavior in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 30 to 90.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Emotional Control Section ScoreBaseline, 12 weeksThe BRIEF-A emotional control subscale assesses an individuals emotional control in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 10 to 30.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - GEC Section ScoreBaseline, 12 weeksThe BRIEF-A GEC rates the global executive composite of the patient in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 75 to 225.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inconsistency SectionBaseline, 12 weeksThe BRIEF-A Inconsistency rates the behavioral inconsistency displayed by the patient in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 0 to 20.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Infrequency SectionBaseline, 12 weeksStandardized measure assessing adult executive functioning/self-regulation in his/her everyday environment. Extent to which respondent answers additional items in an unusual and infrequent direction. Form is designed to be completed by adults 18-90 years of age, including adults with wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. Total score ranges from 0 to 5.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inhibit SectionBaseline, 12 weeksThe BRIEF-A Inhibit rates an individual's inhibition in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Initiate SectionBaseline, 12 weeksThe BRIEF-A Initiate rates an individual's initiative behaviors in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Metacognition SectionBaseline, 12 weeksBRIEF-A Metacognition subscale is a standardized measure assessing individual's ability to systematically solve problems via planning and organization while sustaining these task-completion efforts in active working memory. Form is designed to be completed by adults, including adults with wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior never observed, 2=behavior sometimes observed, and 3=behavior often observed - higher ratings indicate greater perceived impairment. Total score ranges from 40 to 120.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Negativity SectionBaseline, 12 weeksThe BRIEF-A Negativity asseses an indivduals' perceived negativity in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 0 to 10.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Organization of Materials SectionBaseline, 12 weeksThe BRIEF-A Organization of Materials assesses an individuals' organizing skills in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Plan/Organize SectionBaseline, 12 weeksThe BRIEF-A Plan/Organize asseses an individuals' capabilities to plan and organize in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 10 to 30.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - SHIFT SectionBaseline, 12 weeksThe BRIEF-A Shift assess an individuals' shifting between different behaviors in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Self Monitor SectionBaseline, 12 weeksThe BRIEF-A Self Monitor assesses an individuals' capacity to self monitor in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Task Monitor SectionBaseline, 12 weeksThe BRIEF-A Task Monitor assesses an individuals's ability to monitor a task in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.
Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Working Memory SectionBaseline, 12 weeksThe BRIEF-A Working Memory assesses an individuals' memory function in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.
Mean Change From Baseline to 12-Week Endpoint on the Epworth Sleepiness Scale (ESS)Baseline, 12 weeksUsed to determine the level of daytime sleepiness. The ESS is a self-rated questionnaire with 8 items that describe normative daily situations known to vary in their soporific qualities. Subjects rate the likelihood of dozing off or falling asleep in each of these situations. Each item is rated on a 4-point scale from 0 (would never doze) to 3 (high chance of dozing). The item scores are summed to produce a total score (range of 0-24). Score \>10 (95th percentile) are considered to be suggestive of significant daytime sleepiness.
Responders by Baseline Smoking Status12 weeksBaseline smoking status was recorded and associations to response to treatment were determined. Response was defined as 25% or greater decrease in ADHD symptoms as measured by the CAARS-Inv:SV total ADHD symptom score. The 18-item total CAARS-Inv:SV ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.
Strong Responders by Baseline Smoking Status12 weeksBaseline smoking status was recorded and associations to response to treatment were determined. Strong response was defined as 40% or greater decrease in ADHD symptoms as measured by the CAARS-Inv:SV total ADHD symptom score. The 18-item total CAARS-Inv:SV ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.
Mean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey Self-ReportBaseline, 12 weeks26 item self-rated driving survey with examples of driving behaviors, e.g.: putting on seat belt, driving within speed limits, yielding the right of way to other drivers. Items are rated on a 4-point scale (1 = not at all or rarely, 2 = sometimes, 3 = often, 4 = very often). The total score is the sum of the 26 items. A driving history is completed by self-report the first time a rater completes the Driving Behavior Survey (Self-Report). The total score ranges from 26 to 104.

Countries

Puerto Rico, United States

Participant flow

Recruitment details

The recruitment period was from 16 August 2007 until 19 August 2008 in medical clinics.

Pre-assignment details

Study Period 1 was a screening/washout period. Subjects who did not meet enrollment criteria were excluded from the trial before randomization. 584 participants entered the screening phase, 139 were screen failures. There was an optional 12-week open-label atomoxetine extension phase after the 12-week acute double-blind phase.

Participants by arm

ArmCount
Atomoxetine
20-50 mg twice a day for 12 weeks, then up to an additional 12 weeks
220
Placebo
twice a day for 12 weeks
225
Total445

Withdrawals & dropouts

PeriodReasonFG000FG001
Acute Double-Blind PhaseAdverse Event216
Acute Double-Blind PhaseEntry Criteria Not Met11
Acute Double-Blind PhaseLack of Efficacy34
Acute Double-Blind PhaseLost to Follow-up4849
Acute Double-Blind PhasePhysician Decision03
Acute Double-Blind PhaseProtocol Violation43
Acute Double-Blind PhaseSponsor Decision21
Acute Double-Blind PhaseSubject Decision2628
Extension Open-Label PhaseAdverse Event918
Extension Open-Label PhaseLack of Efficacy27
Extension Open-Label PhaseLost to Follow-up1210
Extension Open-Label PhasePhysician Decision23
Extension Open-Label PhaseProtocol Violation01
Extension Open-Label PhaseSponsor Decision10
Extension Open-Label PhaseSubject Decision79

Baseline characteristics

CharacteristicTotalAtomoxetinePlacebo
Adult Attention-Deficit/Hyperactivity Disorder Quality of Life 29 - Life Outlook Subscale53.44 units on a scale
STANDARD_DEVIATION 15.43
54.40 units on a scale
STANDARD_DEVIATION 15.42
52.49 units on a scale
STANDARD_DEVIATION 15.41
Adult Attention-Deficit/Hyperactivity Disorder Quality of Life 29 - Psychological Health Subscale50.44 units on a scale
STANDARD_DEVIATION 18.56
49.89 units on a scale
STANDARD_DEVIATION 18.95
50.98 units on a scale
STANDARD_DEVIATION 18.2
Adult Attention-Deficit/Hyperactivity Disorder Quality of Life 29 - relationship subscale52.61 units on a scale
STANDARD_DEVIATION 19.49
52.76 units on a scale
STANDARD_DEVIATION 19.35
52.47 units on a scale
STANDARD_DEVIATION 19.67
Adult Attention-Deficit/Hyperactivity Disorder Quality of Life 29 - Total Score45.62 units on a scale
STANDARD_DEVIATION 13.62
45.95 units on a scale
STANDARD_DEVIATION 13.74
45.30 units on a scale
STANDARD_DEVIATION 13.53
Age Continuous24.69 years
STANDARD_DEVIATION 3.42
24.71 years
STANDARD_DEVIATION 3.35
24.68 years
STANDARD_DEVIATION 3.48
Beck Anxiety Inventory (BAI)10.07 units on a scale
STANDARD_DEVIATION 9.13
10.98 units on a scale
STANDARD_DEVIATION 9.69
9.18 units on a scale
STANDARD_DEVIATION 8.47
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Behavioral Regulation61.66 units on a scale
STANDARD_DEVIATION 11.36
62.40 units on a scale
STANDARD_DEVIATION 11.91
60.94 units on a scale
STANDARD_DEVIATION 10.77
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Emotional Control18.49 units on a scale
STANDARD_DEVIATION 5.53
18.76 units on a scale
STANDARD_DEVIATION 5.73
18.22 units on a scale
STANDARD_DEVIATION 5.33
Behavior Rating Inventory of Executive Function-Adult Version Self Report - GEC156.61 units on a scale
STANDARD_DEVIATION 21.89
157.11 units on a scale
STANDARD_DEVIATION 22.8
156.12 units on a scale
STANDARD_DEVIATION 21
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Inconsistency3.36 units on a scale
STANDARD_DEVIATION 1.92
3.22 units on a scale
STANDARD_DEVIATION 1.86
3.50 units on a scale
STANDARD_DEVIATION 1.97
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Infrequency0.14 units on a scale
STANDARD_DEVIATION 0.39
0.13 units on a scale
STANDARD_DEVIATION 0.4
0.15 units on a scale
STANDARD_DEVIATION 0.38
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Inhibit18.19 units on a scale
STANDARD_DEVIATION 2.74
18.28 units on a scale
STANDARD_DEVIATION 2.77
18.11 units on a scale
STANDARD_DEVIATION 2.72
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Initiate18.33 units on a scale
STANDARD_DEVIATION 3.05
18.33 units on a scale
STANDARD_DEVIATION 3.11
18.32 units on a scale
STANDARD_DEVIATION 3
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Metacognition Index94.95 units on a scale
STANDARD_DEVIATION 13.22
94.71 units on a scale
STANDARD_DEVIATION 13.69
95.18 units on a scale
STANDARD_DEVIATION 12.77
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Negativity2.14 units on a scale
STANDARD_DEVIATION 2.1
2.22 units on a scale
STANDARD_DEVIATION 2.16
2.06 units on a scale
STANDARD_DEVIATION 2.03
Behavior Rating Inventory of Executive Function-Adult Version Self Report- Organization of Materials18.91 units on a scale
STANDARD_DEVIATION 3.97
18.82 units on a scale
STANDARD_DEVIATION 4.07
19.00 units on a scale
STANDARD_DEVIATION 3.87
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Plan/Organize23.28 units on a scale
STANDARD_DEVIATION 3.96
23.25 units on a scale
STANDARD_DEVIATION 4.02
23.31 units on a scale
STANDARD_DEVIATION 3.91
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Self Monitor12.52 units on a scale
STANDARD_DEVIATION 2.96
12.80 units on a scale
STANDARD_DEVIATION 3.01
12.25 units on a scale
STANDARD_DEVIATION 2.89
Behavior Rating Inventory of Executive Function-Adult Version Self Report - SHIFT12.46 units on a scale
STANDARD_DEVIATION 2.73
12.56 units on a scale
STANDARD_DEVIATION 2.82
12.36 units on a scale
STANDARD_DEVIATION 2.64
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Task Monitor14.56 units on a scale
STANDARD_DEVIATION 2.33
14.44 units on a scale
STANDARD_DEVIATION 2.36
14.68 units on a scale
STANDARD_DEVIATION 2.31
Behavior Rating Inventory of Executive Function-Adult Version Self Report - Working Memory19.87 units on a scale
STANDARD_DEVIATION 2.71
19.87 units on a scale
STANDARD_DEVIATION 2.73
19.87 units on a scale
STANDARD_DEVIATION 2.69
Clinical Global Impression-ADHD- Severity (CGI-ADHD-S)4.74 units on a scale
STANDARD_DEVIATION 0.65
4.79 units on a scale
STANDARD_DEVIATION 0.66
4.68 units on a scale
STANDARD_DEVIATION 0.64
Conners' ADHD Rating Scale Self Report (CAARS-S:SV) Total Score35.36 units on a scale
STANDARD_DEVIATION 8.78
35.01 units on a scale
STANDARD_DEVIATION 8.97
35.69 units on a scale
STANDARD_DEVIATION 8.6
Conners' Adult ADHD Rating Scale - Investigator Rated:Screening Version Total Score39.05 units on a scale
STANDARD_DEVIATION 7.59
39.15 units on a scale
STANDARD_DEVIATION 7.48
38.95 units on a scale
STANDARD_DEVIATION 7.72
Driving Behavior Survey-Other Report74.77 units on a scale
STANDARD_DEVIATION 11.21
70.90 units on a scale
STANDARD_DEVIATION 10.13
78.00 units on a scale
STANDARD_DEVIATION 11.24
Driving Behavior Survey Self-Report79.41 units on a scale
STANDARD_DEVIATION 12.67
79.86 units on a scale
STANDARD_DEVIATION 12.89
78.95 units on a scale
STANDARD_DEVIATION 12.46
Epworth Sleepiness Scale (ESS)9.71 units on a scale
STANDARD_DEVIATION 4.72
9.82 units on a scale
STANDARD_DEVIATION 4.71
9.60 units on a scale
STANDARD_DEVIATION 4.74
Fagerstrom Test for Nicotine Dependence (FTND)2.20 units on a scale
STANDARD_DEVIATION 2.16
2.08 units on a scale
STANDARD_DEVIATION 2.1
2.33 units on a scale
STANDARD_DEVIATION 2.22
Habits Timeline Followback (TLFB) Incidence for Use of Alcohol1.03 number of alcoholic drinks per day
STANDARD_DEVIATION 1.38
0.98 number of alcoholic drinks per day
STANDARD_DEVIATION 1.33
1.08 number of alcoholic drinks per day
STANDARD_DEVIATION 1.44
Habits Timeline Followback (TLFB) Incidence for Use of Caffeine1.82 number of caffeinated drinks per day
STANDARD_DEVIATION 2.55
1.78 number of caffeinated drinks per day
STANDARD_DEVIATION 1.72
1.87 number of caffeinated drinks per day
STANDARD_DEVIATION 3.19
Habits Timeline Followback (TLFB) Incidence for Use of Drugs0.18 ratio
STANDARD_DEVIATION 0.24
0.13 ratio
STANDARD_DEVIATION 0.15
0.27 ratio
STANDARD_DEVIATION 0.37
Habits Timeline Followback (TLFB) Incidence for Use of Marijuana0.34 number of joints smoked per day
STANDARD_DEVIATION 0.5
0.39 number of joints smoked per day
STANDARD_DEVIATION 0.59
0.28 number of joints smoked per day
STANDARD_DEVIATION 0.38
Habits Timeline Followback (TLFB) Incidence for Use of Nicotine6.65 number of nicotine-products used per day
STANDARD_DEVIATION 7.57
6.91 number of nicotine-products used per day
STANDARD_DEVIATION 7.73
6.41 number of nicotine-products used per day
STANDARD_DEVIATION 7.44
Montgomery Asberg Depression Rating Scale (MADRS)6.48 units on a scale
STANDARD_DEVIATION 4.14
6.68 units on a scale
STANDARD_DEVIATION 4.28
6.29 units on a scale
STANDARD_DEVIATION 4.01
Region of Enrollment
Puerto Rico
15 participants10 participants5 participants
Region of Enrollment
United States
430 participants210 participants220 participants
Sex: Female, Male
Female
190 Participants92 Participants98 Participants
Sex: Female, Male
Male
255 Participants128 Participants127 Participants
Social Adaptation Self-Evaluation Scale (SASS)37.14 units on a scale
STANDARD_DEVIATION 6.04
36.99 units on a scale
STANDARD_DEVIATION 6.17
37.28 units on a scale
STANDARD_DEVIATION 5.93

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
147 / 220121 / 225
serious
Total, serious adverse events
1 / 2201 / 225

Outcome results

Primary

Mean Change in the Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) Total ADHD Symptom Score From Baseline to 12 Week Endpoint

CAARS-Inv:SV is a 30-item scale containing 3 subscales: the Inattention subscale, the Hyperactivity-Impulsivity subscale, and the ADHD Index. The 18-item total ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.

Time frame: Baseline, Week 12

Population: Intent-to-treat population was analyzed, including all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change in the Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) Total ADHD Symptom Score From Baseline to 12 Week Endpoint-14.88 units on a scaleStandard Error 0.88
PlaceboMean Change in the Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV) Total ADHD Symptom Score From Baseline to 12 Week Endpoint-9.82 units on a scaleStandard Error 0.85
Comparison: Tested was the null hypothesis that there is no difference in CAARS-Inv:SV score changes from baseline to 12-week endpoint between the atomoxetine group and the placebo group. With approximately 220 patients per arm, assuming a 68% completion rate and an estimated effect size of atomoxetine over placebo of 0.35, using a 5% significance level, the analysis was expected to have 90% power to detect a difference between atomoxetine and placebo at week 12.p-value: <0.00195% CI: [-7.39, -2.72]Mixed Models Analysis
Secondary

Correlation of Mean Changes From Baseline to 12 Week on the Adult ADHD Quality of Life-29 Total Score and of Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated:Screening Version Total Score

AAQOL-29: Patient-reported outcome measure examining disease-specific functional impariments and quality of life for adults with ADHD. The domains included in the AAQOL are life productivity, psychological health, quality of relationships, and life outlook. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning. CAARS-Inv:SV: Inattention subscale, Impulsivity subscale, and ADHD Index. Each item is scored on a 0 to 3 scale, assessing symptom severity over the past week. The total score is the sum of all subscale scores.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (NUMBER)
AtomoxetineCorrelation of Mean Changes From Baseline to 12 Week on the Adult ADHD Quality of Life-29 Total Score and of Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated:Screening Version Total Score-0.591 correlation coefficient
Comparison: Tested was the null hypothesis that AAQOL-29 total score and CAARS-Inv:SV total score are not correlated.p-value: <0.001Pearson's Correlation Coefficient
Secondary

Endpoint Scores in Patient Global Impression - Improvement (PGI-I)

7-point scale modeled after the CGI on which patients rate any change in their overall status that they had experienced since beginning the study drug. The score on this scale ranges from 1 (very much improved) to 7 (very much worse).

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineEndpoint Scores in Patient Global Impression - Improvement (PGI-I)3.17 units on a scaleStandard Error 0.08
PlaceboEndpoint Scores in Patient Global Impression - Improvement (PGI-I)3.42 units on a scaleStandard Error 0.08
Comparison: Tested was the null hypothesis that there is no statistically significant difference in PGI-I scores at 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.0295% CI: [-0.45, -0.04]ANCOVA
Secondary

Mean Change From Baseline to 12 Week Endpoint in CAARS Self Report (CAARS-S:SV) Total Score

30-item patient-reported scale with 3 subscales: Inattention subscale, Hyperactivity-Impulsivity subscale, and ADHD Index. 18-item total ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each individual item is scored on a 0 to 3 scale (0 = not at all, never; 1 = just a little, once in a while; 2 = Pretty much, often; 3 = very much, very frequently). The rating scale assesses symptom severity over the past week. The total score ranges from 0 to 54.

Time frame: Baseline, 12 weeks

Population: An intent-to-treat population was analyzed using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint in CAARS Self Report (CAARS-S:SV) Total Score-11.88 units on a scaleStandard Error 0.75
PlaceboMean Change From Baseline to 12 Week Endpoint in CAARS Self Report (CAARS-S:SV) Total Score-7.84 units on a scaleStandard Error 0.73
Comparison: Tested was the null hypothesis that there is no statistically significant difference in CAARS-S:SV score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: <0.00195% CI: [-5.94, -2.15]Mixed Models Analysis
Secondary

Mean Change From Baseline to 12 Week Endpoint in Clinical Global Impression-ADHD- Severity (CGI-ADHD-S)

Single-item clinician rating of the clinician's assessment of the patient's severity of the ADHD symptoms in relation to the clinician's total experience with ADHD patients. Severity is rated on a 7-point scale (1 = normal, not at all ill; 7 = among the most extremely ill patients). The total score ranges from 1 to 7.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint in Clinical Global Impression-ADHD- Severity (CGI-ADHD-S)-1.10 units on a scaleStandard Error 0.08
PlaceboMean Change From Baseline to 12 Week Endpoint in Clinical Global Impression-ADHD- Severity (CGI-ADHD-S)-0.67 units on a scaleStandard Error 0.08
Comparison: Tested was the null hypothesis that there is no statistically significant difference in CGI-ADHD-S score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: <0.00195% CI: [-0.63, -0.24]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Outlook Subscale

Patient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale asseses life outlook. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.

Time frame: Baseline, 12 weeks

Population: An intent-to-treat population was analyzed. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Outlook Subscale9.27 units on a scaleStandard Error 1.4
PlaceboMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Outlook Subscale5.87 units on a scaleStandard Error 1.33
Comparison: Tested was the null hypothesis that there is no statistically significant difference in AAQOL-29 life outlook subscale score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.07495% CI: [-0.33, 7.12]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Productivity Subscale

Patient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale assesses life productivity. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.

Time frame: Baseline, 12 weeks

Population: An intent-to-treat population was analyzed. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Productivity Subscale20.92 units on a scaleStandard Error 1.79
PlaceboMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Life Productivity Subscale15.18 units on a scaleStandard Error 1.72
Comparison: Tested was the null hypothesis that there is no statistically significant difference in AAQOL-29 relationship subscale score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.01895% CI: [1, 10.46]Mixed Models Analysis
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Psychological Health Subscale

Patient-reported outcome measure used to examine the disease specific functional impairments and quality of life for adults with ADHD. This subscale asseses the psychological health. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.

Time frame: Baseline, 12 weeks

Population: An intent-to-treat population was analyzed. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Psychological Health Subscale14.57 units on a scaleStandard Error 1.53
PlaceboMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Psychological Health Subscale10.21 units on a scaleStandard Error 1.47
Comparison: Tested was the null hypothesis that there is no statistically significant difference in AAQOL-29 psychological health subscale score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.03495% CI: [0.33, 8.39]Mixed Models Analysis
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Relationship Subscale

Patient-reported outcome measure used to examine the disease-specific functional impariments and quality of life for adults with ADHD. This subscale asseses quality of relationships. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores for this subscale is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.

Time frame: Baseline, 12 weeks

Population: Intent-to-treat population was used for analysis. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Relationship Subscale15.51 units on a scaleStandard Error 1.6
PlaceboMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Relationship Subscale9.61 units on a scaleStandard Error 1.54
Comparison: Tested was the null hypothesis that there is no statistically significant difference in AAQOL-29 relationship subscale score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00695% CI: [1.68, 10.12]Mixed Models Analysis
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Total Score

Patient-reported outcome measure used to examine the disease-specific functional impariments and quality of life for adults with ADHD. The domains included in the AAQOL are life productivity, psychological health, quality of relationships, and life outlook. Individual items are scored on a five-point Likert-like scale from not at all/never=1 to extremely/very often=5. The range of scores is 0 to 100. Consistent with the majority of existing quality of life measures, higher scores on the AAQOL-29 indicate better functioning.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Total Score15.76 units on a scaleStandard Error 1.28
PlaceboMean Change From Baseline to 12-Week Endpoint on the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Quality of Life-29 (AAQOL-29) Total Score10.95 units on a scaleStandard Error 1.23
Comparison: Tested was the null hypothesis that there is no statistically significant difference in AAQOL-29 score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00595% CI: [1.44, 8.2]Mixed Models Analysis
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Beck Anxiety Inventory (BAI)

21-item self-reported screening tool for measuring anxiety severity. Each item is rated on a 4-point Likert scale ranging from 0 (not at all) to 3 (severely; I could barely stand it). Each item is descriptive of subjective, somatic, or panic-related symptoms of anxiety. Patients record how much they have been bothered by each symptom during the past week, including the day the questionnaire is administered. The total score ranges from 0 to 63.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward as imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Beck Anxiety Inventory (BAI)-2.58 units on a scaleStandard Error 0.66
PlaceboMean Change From Baseline to 12 Week Endpoint on the Beck Anxiety Inventory (BAI)-2.07 units on a scaleStandard Error 0.66
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BAI score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.55695% CI: [-2.21, 1.19]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Behavioral Regulation Section Score

The BRIEF-A behavioral regulation subscale measures an individuals control over behavior in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 30 to 90.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Behavioral Regulation Section Score-8.15 units on a scaleStandard Error 0.83
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Behavioral Regulation Section Score-5.20 units on a scaleStandard Error 0.83
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Behavioral regulation score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00795% CI: [-5.09, -0.81]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Emotional Control Section Score

The BRIEF-A emotional control subscale assesses an individuals emotional control in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 10 to 30.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Emotional Control Section Score-1.98 units on a scaleStandard Error 0.36
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Emotional Control Section Score-1.40 units on a scaleStandard Error 0.36
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A emotional control section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.21995% CI: [-1.5, 0.35]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - GEC Section Score

The BRIEF-A GEC rates the global executive composite of the patient in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 75 to 225.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - GEC Section Score-22.41 units on a scaleStandard Error 1.86
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - GEC Section Score-14.83 units on a scaleStandard Error 1.85
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A GEC section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00295% CI: [-12.37, -2.78]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inconsistency Section

The BRIEF-A Inconsistency rates the behavioral inconsistency displayed by the patient in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 0 to 20.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inconsistency Section-0.51 units on a scaleStandard Error 0.15
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inconsistency Section-0.42 units on a scaleStandard Error 0.15
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Inconsistency section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.64495% CI: [-0.47, 0.29]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Infrequency Section

Standardized measure assessing adult executive functioning/self-regulation in his/her everyday environment. Extent to which respondent answers additional items in an unusual and infrequent direction. Form is designed to be completed by adults 18-90 years of age, including adults with wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. Total score ranges from 0 to 5.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Infrequency Section0.27 units on a scaleStandard Error 0.05
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Infrequency Section0.16 units on a scaleStandard Error 0.05
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEFS-A infrequency score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.09795% CI: [-0.02, 0.25]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inhibit Section

The BRIEF-A Inhibit rates an individual's inhibition in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inhibit Section-2.62 units on a scaleStandard Error 0.23
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Inhibit Section-1.65 units on a scaleStandard Error 0.23
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Inhibit Section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00295% CI: [-1.57, -0.37]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Initiate Section

The BRIEF-A Initiate rates an individual's initiative behaviors in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Initiate Section-2.41 units on a scaleStandard Error 0.25
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Initiate Section-1.74 units on a scaleStandard Error 0.25
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Initiate section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.04495% CI: [-1.33, -0.02]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Metacognition Section

BRIEF-A Metacognition subscale is a standardized measure assessing individual's ability to systematically solve problems via planning and organization while sustaining these task-completion efforts in active working memory. Form is designed to be completed by adults, including adults with wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior never observed, 2=behavior sometimes observed, and 3=behavior often observed - higher ratings indicate greater perceived impairment. Total score ranges from 40 to 120.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Metacognition Section-14.13 units on a scaleStandard Error 1.14
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Metacognition Section-9.64 units on a scaleStandard Error 1.13
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Metacognition section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00395% CI: [-7.43, -1.55]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Negativity Section

The BRIEF-A Negativity asseses an indivduals' perceived negativity in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 0 to 10.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Negativity Section-0.85 units on a scaleStandard Error 0.14
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Negativity Section-0.71 units on a scaleStandard Error 0.14
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A negativity section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.45695% CI: [-0.51, 0.23]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Organization of Materials Section

The BRIEF-A Organization of Materials assesses an individuals' organizing skills in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Organization of Materials Section-2.50 units on a scaleStandard Error 0.25
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Organization of Materials Section-1.85 units on a scaleStandard Error 0.25
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Organization of Materials section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.05195% CI: [-1.31, 0]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Plan/Organize Section

The BRIEF-A Plan/Organize asseses an individuals' capabilities to plan and organize in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Behavior is rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 10 to 30.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Plan/Organize Section-3.62 units on a scaleStandard Error 0.33
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Plan/Organize Section-2.28 units on a scaleStandard Error 0.33
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Plan/Organize section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00295% CI: [-2.19, -0.47]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Self Monitor Section

The BRIEF-A Self Monitor assesses an individuals' capacity to self monitor in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Self Monitor Section-2.03 units on a scaleStandard Error 0.2
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Self Monitor Section-1.20 units on a scaleStandard Error 0.2
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Self Monitor Section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00195% CI: [-1.35, -0.32]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - SHIFT Section

The BRIEF-A Shift assess an individuals' shifting between different behaviors in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - SHIFT Section-1.49 units on a scaleStandard Error 0.2
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - SHIFT Section-0.96 units on a scaleStandard Error 0.2
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A SHIFT section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.04595% CI: [-1.04, -0.01]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Task Monitor Section

The BRIEF-A Task Monitor assesses an individuals's ability to monitor a task in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 6 to 18.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Task Monitor Section-2.28 units on a scaleStandard Error 0.2
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Task Monitor Section-1.57 units on a scaleStandard Error 0.2
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Task Monitor section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.00895% CI: [-1.23, -0.19]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Working Memory Section

The BRIEF-A Working Memory assesses an individuals' memory function in his or her everyday environment. The self-report form is designed to be completed by adults 18-90 years of age, including adults with a wide variety of developmental, systemic, neurological, and psychiatric disorders. Observations are rated on a 3-point Likert scale, with 1=behavior is never observed, 2=behavior is sometimes observed, and 3=behavior is often observed - higher ratings indicate greater perceived impairment. The total score ranges from 8 to 24.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Working Memory Section-3.48 units on a scaleStandard Error 0.26
PlaceboMean Change From Baseline to 12-Week Endpoint on the Behavior Rating Inventory of Executive Function-Adult Version Self Report (BRIEF-A) - Working Memory Section-2.18 units on a scaleStandard Error 0.26
Comparison: Tested was the null hypothesis that there is no statistically significant difference in BRIEF-A Working Memory section score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: <0.00195% CI: [-1.98, -0.63]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey-Other Report

26-item driving survey completed by someone other than the patient/driver. Examples of driving behaviors included in the survey match those listed in the Self-Report version of the scale. Items are rated on a 4-point scale (1 = not at all or rarely, 2 = sometimes, 3 = often, 4 = very often). The total score is the sum of the 26 items and ranges from 26 to 104.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey-Other Report3.24 units on a scaleStandard Error 3.67
PlaceboMean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey-Other Report2.63 units on a scaleStandard Error 3.96
Comparison: Tested was the null hypothesis that there is no statistically significant difference in Driving Behavior Survey Other-Report score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.93395% CI: [-16.41, 17.63]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey Self-Report

26 item self-rated driving survey with examples of driving behaviors, e.g.: putting on seat belt, driving within speed limits, yielding the right of way to other drivers. Items are rated on a 4-point scale (1 = not at all or rarely, 2 = sometimes, 3 = often, 4 = very often). The total score is the sum of the 26 items. A driving history is completed by self-report the first time a rater completes the Driving Behavior Survey (Self-Report). The total score ranges from 26 to 104.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward as imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey Self-Report1.93 units on a scaleStandard Error 0.98
PlaceboMean Change From Baseline to 12-Week Endpoint on the Driving Behavior Survey Self-Report3.54 units on a scaleStandard Error 1.01
Comparison: Tested was the null hypothesis that there is no statistically significant difference in Driving Behavior Survey Self-Report score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.20195% CI: [-4.08, 0.86]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Epworth Sleepiness Scale (ESS)

Used to determine the level of daytime sleepiness. The ESS is a self-rated questionnaire with 8 items that describe normative daily situations known to vary in their soporific qualities. Subjects rate the likelihood of dozing off or falling asleep in each of these situations. Each item is rated on a 4-point scale from 0 (would never doze) to 3 (high chance of dozing). The item scores are summed to produce a total score (range of 0-24). Score \>10 (95th percentile) are considered to be suggestive of significant daytime sleepiness.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Epworth Sleepiness Scale (ESS)-1.76 units on a scaleStandard Error 0.29
PlaceboMean Change From Baseline to 12-Week Endpoint on the Epworth Sleepiness Scale (ESS)-1.07 units on a scaleStandard Error 0.28
Comparison: Tested was the null hypothesis that there is no statistically significant difference in ESS score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.06595% CI: [-1.42, 0.04]ANCOVA
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Fagerstrom Test for Nicotine Dependence (FTND)

The FTND was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains items that evaluate the quantity of cigarette consumption, the compulsion to use, and dependence. The FTND contains 4 yes-no and 2 multiple choice questions and can be used in a self-report format. The items on FTND are scored 0 to 3 for multiple choice items, the items are summed to yield a total score of 0-10 (0=minimum nicotine dependence; 10=maximum nicotine dependence).

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Fagerstrom Test for Nicotine Dependence (FTND)0.12 units on a scaleStandard Error 0.25
PlaceboMean Change From Baseline to 12 Week Endpoint on the Fagerstrom Test for Nicotine Dependence (FTND)0.43 units on a scaleStandard Error 0.27
Comparison: Tested was the null hypothesis that there is no statistically significant difference in Fagerstorm Test for Nicotine Dependence score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.38295% CI: [-1, 0.39]ANCOVA
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Alcohol

Variation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome. Recorded is the number of standard drinks that have been consumed.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Alcohol-0.21 number of alcoholic drinks per dayStandard Error 0.09
PlaceboMean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Alcohol-0.06 number of alcoholic drinks per dayStandard Error 0.09
Comparison: Tested was the null hypothesis that there is no statistically significant difference in TLFB incidence for use of alcohol score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.19895% CI: [-0.39, 0.08]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Caffeine

Variation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of caffeine consumed by an individual. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Caffeine-0.23 number of caffeinated drinks per dayStandard Error 0.11
PlaceboMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Caffeine-0.20 number of caffeinated drinks per dayStandard Error 0.11
Comparison: Tested was the null hypothesis that there is no statistically significant difference in TLFB incidence for use of caffeine score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.82595% CI: [-0.33, 0.26]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Drugs

Variation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of recreational drugs other than marijuana an individual consumed and is expressed as the ratio of number of days on which drugs were used over the total number of days, resulting in a total score ranging from 0 to 1. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Drugs0.02 ratioStandard Deviation 0.01
PlaceboMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Drugs0.02 ratioStandard Deviation 0.23
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Marijuana

Variation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome. Recorded is the number of joints that have been consumed.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Marijuana0.09 number of joints per dayStandard Error 0.1
PlaceboMean Change From Baseline to 12 Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Marijuana0.03 number of joints per dayStandard Error 0.12
Comparison: Tested was the null hypothesis that there is no statistically significant difference in TLFB incidence for use of marijuana score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.67695% CI: [-0.24, 0.37]ANCOVA
Secondary

Mean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Nicotine

Variation of the Alcohol Timeline Followback (TLFB) which is a method for assessing the quantity of alcohol consumption on a daily basis. This subscale assesses the amount of nicotine consumed by an individual. With a calendar as a guide, the interviewee provides a retrospective estimate of daily habits over a specified period of as long as the previous year. The goal is to provide a detailed record of patterns of use that can be used to guide treatment and to assess treatment outcome.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Nicotine0.01 number of nicotine products per dayStandard Error 0.51
PlaceboMean Change From Baseline to 12-Week Endpoint on the Habits Timeline Followback (TLFB) Incidence for Use of Nicotine-0.81 number of nicotine products per dayStandard Error 0.52
Comparison: Tested was the null hypothesis that there is no statistically significant difference in TLFB incidence for use of nicotine score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.23395% CI: [-0.53, 2.17]ANCOVA
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Montgomery Asberg Depression Rating Scale (MADRS)

Rating scale for severity of depressive mood symptoms, administered by the investigator. The scale consists of 10 items, each rated on a scale from 0 to 6. The MADRS total score is the sum of the 10 items and the score ranges from 0 to 60. Higher scores denote more severe depressive symptoms.

Time frame: Baseline, 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Montgomery Asberg Depression Rating Scale (MADRS)-0.72 units on a scaleStandard Error 0.3
PlaceboMean Change From Baseline to 12 Week Endpoint on the Montgomery Asberg Depression Rating Scale (MADRS)-0.30 units on a scaleStandard Error 0.3
Comparison: Tested was the null hypothesis that there is no statistically significant difference in MADRS score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.28295% CI: [-1.19, 0.35]ANCOVA
Secondary

Mean Change From Baseline to 12 Week Endpoint on the Social Adaptation Self-Evaluation Scale (SASS)

Patient completed scale that consists of 21 items that examine behavior and subjective perception, including satisfaction, self-perception and motivation in participating in and maintaining relationships with family and friends, satisfaction in work, home and leisure activities, and intellectual interests. Each item is scored from 0 to 3, corresponding to minimal and maximal social adjustment, with a total score range from 0 to 60.

Time frame: Baseline, 12 weeks

Population: Analyzed was a intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
AtomoxetineMean Change From Baseline to 12 Week Endpoint on the Social Adaptation Self-Evaluation Scale (SASS)1.24 units on a scaleStandard Error 0.39
PlaceboMean Change From Baseline to 12 Week Endpoint on the Social Adaptation Self-Evaluation Scale (SASS)1.46 units on a scaleStandard Error 0.39
Comparison: Tested was the null hypothesis that there is no statistically significant difference in SASS score changes from baseline to 12-week endpoint between atomoxetine and placebo treatment groups.p-value: 0.65695% CI: [-1.24, 0.78]ANCOVA
Secondary

Responders by Baseline Smoking Status

Baseline smoking status was recorded and associations to response to treatment were determined. Response was defined as 25% or greater decrease in ADHD symptoms as measured by the CAARS-Inv:SV total ADHD symptom score. The 18-item total CAARS-Inv:SV ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.

Time frame: 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (NUMBER)
AtomoxetineResponders by Baseline Smoking Status54 participants
PlaceboResponders by Baseline Smoking Status60 participants
Placebo, SmokersResponders by Baseline Smoking Status29 participants
Placebo Non-smokersResponders by Baseline Smoking Status53 participants
Comparison: Tested was the null hypothesis that smoking status is not a predictor of response to atomoxetine treatment compared with placebop-value: 0.788Cochran-Mantel-Haenszel
Secondary

Strong Responders by Baseline Smoking Status

Baseline smoking status was recorded and associations to response to treatment were determined. Strong response was defined as 40% or greater decrease in ADHD symptoms as measured by the CAARS-Inv:SV total ADHD symptom score. The 18-item total CAARS-Inv:SV ADHD symptom score is the sum of the Inattention and Hyperactivity-Impulsivity subscales. Each item is scored on a 0 to 3 scale (0=not at all, never; 1=just a little, once in a while; 2=pretty much, often; 3=very much, very frequently). The scale assesses symptom severity over the past week. The total score ranges from 0 to 54.

Time frame: 12 weeks

Population: Analyzed was an intent-to-treat population using last observation carried forward imputation technique. Included were all randomized patients who had both a baseline and at least 1 post baseline score.

ArmMeasureValue (NUMBER)
AtomoxetineStrong Responders by Baseline Smoking Status38 participants
PlaceboStrong Responders by Baseline Smoking Status41 participants
Placebo, SmokersStrong Responders by Baseline Smoking Status19 participants
Placebo Non-smokersStrong Responders by Baseline Smoking Status31 participants
Comparison: Tested was the null hypothesis that smoking status is not a predictor of strong response to atomoxetine treatment compared with placebop-value: 0.482Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Mar 20, 2026