Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-19T20:32:40.177Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of atomoxetine on cardiovascular functions and on QT dispersion in children with attention deficit hyperactivity disorder

Published online by Cambridge University Press:  25 August 2011

Ahmet Sert ,
Cem Gokcen ,
Ebru Aypar  and
Dursun Odabas
Ahmet Sert*
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Gaziantep University, Gaziantep, Turkey
Cem Gokcen
Affiliation:
Medical Faculty, Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
Ebru Aypar
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Gaziantep University, Gaziantep, Turkey
Dursun Odabas
Affiliation:
Department of Pediatric Cardiology, Konya Training and Research Hospital, Gaziantep University, Gaziantep, Turkey
*
Correspondence to: Dr A. Sert, Department of Pediatric Cardiology, Konya Training and Research Hospital, 42080, Konya, Turkey. Tel: +90 332 323 67 09, Fax:+90 332 323 6723; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Atomoxetine is a central norepinephrine reuptake inhibitor used to treat attention deficit/hyperactivity disorder. The effects of atomoxetine on cardiovascular functions and QT dispersion in children with attention deficit/hyperactivity disorder have not been previously reported. The aim of this study was to analyse cardiovascular functions and QT dispersion on the surface electrocardiogram of children with attention deficit/hyperactivity disorder during atomoxetine therapy.

Methods

A total of 40 children – with a mean age of 8.6 plus or minus 2.3 years and a median age of 11 years; ranged from 8 to 14 years – with attention deficit/hyperactivity disorder – with six girls and 34 boys – were included in the study. We recorded the mean systolic and diastolic blood pressure, heart rate, corrected QT interval, QT dispersion, and left ventricular systolic functions at baseline and 5 weeks after atomoxetine therapy.

Results

Atomoxetine decreased baseline mean systolic and diastolic blood pressure; baseline mean heart rate decreased; and baseline mean corrected QT interval and QT dispersion mildly increased. Atomoxetine decreased baseline mean ejection fraction and baseline mean shortening fraction.

Conclusion

The results of our study suggest that atomoxetine does not cause clinically significant alterations in QT dispersion, systolic and diastolic blood pressure, heart rate, corrected QT interval, and left ventricular systolic functions during short-term treatment in children with attention deficit/hyperactivity disorder.

Keywords

Echocardiographynorepinephrine reuptake inhibitorQT interval
Type
Original Articles
Information
Cardiology in the Young , Volume 22 , Issue 2 , 02 March 2012 , pp. 158 - 161
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ralston, SJ, Lorenzo, MJ, ADORE Study Group. ADORE – Attention-Deficit Hyperactivity Disorder Observational Research in Europe. Eur Child Adolesc Psychiatr 2004; 13: 136–142.CrossRefGoogle ScholarPubMed
2.Li, WY, Strang, SE, Brown, DR, et al. Atomoxetine changes rat's HR response to stress from tachycardia to bradycardia via alterations in autonomic function. Auton Neurosci 2010; 154: 48–53.CrossRefGoogle ScholarPubMed
3.Wernicke, JF, Faries, D, Girod, D, et al. Cardiovascular effects of atomoxetine in children, adolescents, and adults. Drug Safe 2003; 26: 729–740.CrossRefGoogle ScholarPubMed
4.Barr, CS, Naas, A, Freeman, M, Lang, CC, Struthers, AD. QT Dispersion and sudden unexpected death in chronic heart failure. The Lancet 1994; 343: 327–329.CrossRefGoogle ScholarPubMed
5.Merx, W, Yoon, MS, Han, J. The role of local disparity in conduction and recovery time on ventricular vulnerability to fibrillation. Am Heart J 1977; 94: 603–610.CrossRefGoogle ScholarPubMed
6.Etheridge, SP, Shaddy, RE. QT dispersion after beta-blocker therapy in children with heart failure. Am J Cardiol 2003; 91: 1–5.CrossRefGoogle ScholarPubMed
7.Zabel, M, Klingenheben, T, Franz, M, Hohnloser, S. Assessment of QT dispersion for prediction of mortality or arrhythmic events after myocardial infarction. Circulation 1998; 97: 2543–2550.CrossRefGoogle ScholarPubMed
8.Tutar, HE, Ocal, B, Imamoglu, A, Atalay, S. Dispersion of QT and QTc interval in healthy children, and effects of sinus arrhythmia on QT dispersion. Heart 1998; 80: 77–79.CrossRefGoogle ScholarPubMed
9.Kaufman, J, Birmaher, B, Brent, D. Schedule for affective disorders and schizophrenia for school age children – present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatr 1997; 36: 980–988.CrossRefGoogle ScholarPubMed
10.Bazett, HC. An analysis of the time relations of electrocardiograms. Heart 1920; 7: 353.Google Scholar
11.Kimball, TR, Michelfelder, EC. Echocardiography. In: Allen, HD, Driscoll, DJ, Shaddy, RE, Feltes, TF (eds). Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult, 7th edn. Lippincott Williams & Wilkins, Philadelphia, PA, 2008, pp 95–163.Google Scholar
12.Walsh, EP, Saul, P. Cardiac arrhythmias. In: Fyler, DC (ed.). Nadas’ pediatric cardiology. Hanley and Belfus Inc., Philadelphia, PA, 1992, pp 377–434.Google Scholar
13.Bednar, MM, Harrigan, EP, Ruskin, JN. Torsade de pointes associated with nonantiarrhythmic drugs and observations on gender and QTc. Am J Cardiol 2002; 89: 1316–1319.CrossRefGoogle ScholarPubMed
14.Spencer, T, Biederman, J, Heiligenstein, J, et al. An open label, dose-ranging study of atomoxetine in children with attention deficit hyperactivity disorder. J Child Adolesc Psychopharmacol 2001; 11: 251–265.CrossRefGoogle ScholarPubMed
15.Kratochvil, CJ, Wilens, TE, Greenhill, LL, et al. Effects of long-term atomoxetine treatment for young children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatr 2006; 45: 919–927.CrossRefGoogle ScholarPubMed
16.Allen, AJ, Kurlan, RM, Gilbert, DL, et al. Atomoxetine treatment in children and adolescents with ADHD and comorbid tic disorders. Neurology 2005; 65: 1941–1949.CrossRefGoogle ScholarPubMed
17.Kautzner, J, Malik, M. QT interval dispersion and its clinical utility. Pacing Clin Electrophysiol 1997; 20: 2625–2640.CrossRefGoogle ScholarPubMed
18.Statters, DJ, Malik, M, Ward, DE, Camm, AJ. QT dispersion: problems of methodology and clinical significance. J Cardiovasc Electrophysiol 1994; 5: 672–685.CrossRefGoogle ScholarPubMed
19.Davey, PP, Bateman, J, Mulligan, IP, Forfar, C, Barlow, C, Hart, G. QT interval dispersion in chronic heart failure and left ventricular hypertrophy: relation to autonomic nervous system and Holter tape abnormalities. Br Heart J 1994; 71: 268–273.CrossRefGoogle ScholarPubMed
20.Shah, CP, Thakur, RK, Reisdorff, EJ, Lane, E, Aufderheide, TP, Hayes, OW. QT dispersion may be a useful adjunct for detection of myocardial infarction in the chest pain center. Am Heart J 1998; 136: 496–498.CrossRefGoogle ScholarPubMed
21.Day, CP, McComb, JM, Campbell, RWF. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. Br Heart J 1990; 63: 342–344.CrossRefGoogle ScholarPubMed
22.Grimm, W, Steder, U, Menz, V, Hoffmann, J, Maisch, B. QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy. Am J Cardiol 1996; 78: 458–461.CrossRefGoogle ScholarPubMed
23.Michelson, D, Read, HA, Ruff, DD, Witcher, J, Zhang, S, McCracken, J. CYP2D6 and clinical response to atomoxetine in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatr 2007; 46: 242–251.CrossRefGoogle ScholarPubMed
24.Spencer, T, Heiligenstein, JH, Biederman, J, et al. Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyperactivity disorder. J Clin Psychiatr 2002; 63: 1140–1147.CrossRefGoogle ScholarPubMed
25.Donnelly, C, Bangs, M, Trzepacz, P, et al. Safety and tolerability of atomoxetine over 3 to 4 years in children and adolescents with ADHD. J Am Acad Child Adolesc Psychiatr 2009; 48: 176–185.CrossRefGoogle ScholarPubMed