Several medications are reported to be effective in treatment of encopresis. However, mechanisms of action related to these drugs are not known. We report a patient with ADHD and encopresis whose encopretic signs have disappeared with long acting methylphenidate while they have not changed with atomoxetine.
Encopresis* ; Humans ; Methylphenidate* ; Atomoxetine Hydrochloride

Although lisdexamfetamine is used as a recreational drug, little research exists regarding its potential for dependence or its precise mechanisms of action. This study aims to evaluate the psychoactivity and dependence profile of lisdexamfetamine using conditioned place preference and self-administration paradigms in rodents. Additionally, biochemical techniques are used to assess alterations in the dopamine levels in striatal synaptosomes following administration of lisdexamfetamine. Lisdexamfetamine increased both conditioned place preference and self-administration. Moreover, after administration of the lisdexamfetamine, dopamine levels in the striatal synaptosomes were significantly increased. Although some modifications should be made to the analytical methods, performing high performance liquid chromatography studies on synaptosomes can aid in predicting dependence liability when studying new psychoactive substances in the future. Collectively, lisdexamfetamine has potential for dependence possible via dopaminergic pathway.
Chromatography, Liquid ; Dopamine ; In Vitro Techniques* ; Lisdexamfetamine Dimesylate* ; Rodentia ; Synaptosomes

Although lisdexamfetamine is used as a recreational drug, little research exists regarding its potential for dependence or its precise mechanisms of action. This study aims to evaluate the psychoactivity and dependence profile of lisdexamfetamine using conditioned place preference and self-administration paradigms in rodents. Additionally, biochemical techniques are used to assess alterations in the dopamine levels in striatal synaptosomes following administration of lisdexamfetamine. Lisdexamfetamine increased both conditioned place preference and self-administration. Moreover, after administration of the lisdexamfetamine, dopamine levels in the striatal synaptosomes were significantly increased. Although some modifications should be made to the analytical methods, performing high performance liquid chromatography studies on synaptosomes can aid in predicting dependence liability when studying new psychoactive substances in the future. Collectively, lisdexamfetamine has potential for dependence possible via dopaminergic pathway.
Chromatography, Liquid ; Dopamine ; In Vitro Techniques* ; Lisdexamfetamine Dimesylate* ; Rodentia ; Synaptosomes

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.
Adult ; Bupropion ; Comorbidity ; Humans ; Propylamines ; Atomoxetine Hydrochloride

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.
Adult ; Bupropion ; Comorbidity ; Humans ; Propylamines ; Atomoxetine Hydrochloride

OBJECTIVE: This multicenter, randomized, open-label, parallel trial aimed to provide a detailed dose-response profile for atomoxetine in Korean pediatric outpatients with attention-deficit/hyperactivity disorder (ADHD). METHODS: Male and female outpatients aged 6-18 years with ADHD meeting symptom severity criteria of 1.5 standard deviations above age and gender norms on the ADHD Rating Scale-IV-Parent: Investigator-Administered and Scored (ADHDRS-IV-Parent: Inv), and a Clinical Global Impression-ADHD-Severity score > or =4 were randomized to atomoxetine (mg/kg/day) 0.2 fixed, 0.5 fixed or 0.5 (7 days), 0.8 (7 days) then 1.2 for 28 days. The primary efficacy measure was change in ADHDRS-IV-Parent: Inv total score after 6 weeks of atomoxetine treatment. RESULTS: Of 153 randomized patients, 83.7% were male and mean age was 9.8 (SD+/-2.4) years. The completion rate was 86.9%. A graded dose response was apparent with mean change in ADHDRS-IV-Parent: Inv total scores of -9.6, -12.3 and -14.5 with atomoxetine 0.2, 0.5 and 1.2 mg/kg/day, respectively (p=0.024 - F-test). Moreover, a greater reduction in ADHD symptoms, as assessed by mean change from baseline to endpoint CGI-S and mean CGI-ADHD-Improvement at endpoint, was also observed with increasing atomoxetine dose. More patients receiving atomoxetine 1.2 mg/kg/day reported > or =1 treatment-emergent adverse event/s (58.3%) compared with 0.5 (40.7%; p=0.11) or 0.2 mg/kg/day (29.4%; p=0.005). These were generally mild to moderate. CONCLUSION: Atomoxetine was found to be safe and well tolerated at all doses administered in Korean pediatric ADHD patients, and 1.2 mg/kg/day was an efficacious dose in this population.
Aged ; Female ; Humans ; Korea ; Male ; Outpatients ; Propylamines ; Atomoxetine Hydrochloride

The aim of this paper is to evaluate the use of non-stimulants, including atomoxetine, bupropion and modafinil, as alternative approaches to the treatment of children with attention-deficit hyperactivity disorder. A comprehensive review of the empirically based literature regarding the efficacy and the safety of the non-stimulants was performed. There is a large and increasing body of data supporting the efficacy and the safety of non-stimulants. Although the treatment effect sizes for non-stimulants may be smaller than those for stimulants, non-stimulants alone have been shown to be effective in the treatment of attention-deficit hyperactivity disorder as well as several comorbidities. These results suggest that nonstimulants are effective in the treatment of attention-deficit hyperactivity disorder. Further studies are needed to improve our understanding of alternative pharmacological medications in the treatment of attention-deficit hyperactivity disorder.
Benzhydryl Compounds ; Bupropion ; Child ; Comorbidity ; Humans ; Propylamines ; Atomoxetine Hydrochloride

This article presents the knowledges regarding the evaluation and the management of attention-deficit/hyperactivity disorder (ADHD). Probably the most important components to a comprehensive evaluation of patients with ADHD, are the clinical interview, the medical examination, and the completion and scoring of behavior rating scales. The treatments of ADHD are followings: pharmacologic treatment such as stimulants, atomoxetine, modafinil, and bupropionn, and non-pharmacologic treatment such as parental education/training and cognitivebehavioral treatment.
Atomoxetine Hydrochloride ; Benzhydryl Compounds ; Humans ; Parents ; Propylamines ; Weights and Measures

OBJECTIVE: Disturbances in the biogenic amine pathways have been hypothesized to be the biochemical basis of schizophrenia. Catechol-O-methyl transferase (COMT) gene is an important candidate gene due to its function to metabolically inactivating these amines. We investigated the association between 472 G/A (158val/met) and -287 A/G polymorphisms of COMT gene with response to clozapine treatment in refractory schizophrenia. METHODS: One hundred twenty patients of refractory schizophrenia, who were treated with clozapine longer than six months, were participated in this study. We evaluated treatment response on the basis of the difference of re-hospitalization frequency and hospitalization duration before and after the first clozapine administration day. Genotyping of the 472 G/A and -287 A/G polymorphisms was performed by SNapShot method. RESULTS: In 472 G/A polymor-phism, there were no significant differences of the re-hospitalization frequency and the hospitalization duration between the A (-) group and A (+) group, and also no differences among GG, GA, and AA groups. In -287 A/G polymorphism, there were no significant differences between G (-) group and G (+) group. However, we observed significant differences in the re-hospitalization frequency (F=4.38, p=0.015) and in the hospitalization duration (F=3.90, p=0.024) among three genotype groups. CONCLUSION: We found that the treatment response to clozapine was not associated with COMT 472 G/A polymorphism but was positively associated with -287 A/G polymorphism in refractory schizophrenia. However, This association is not strong enough to conclude the association between -287 A/G polymorphism in COMT gene and clozapine response. Further studies with a large sample are required to verify this positive finding more clearly.
Amines ; Biogenic Amines ; Clozapine* ; Genotype ; Hospitalization ; Humans ; Schizophrenia* ; Transferases*

OBJECTIVES: The objective of this study was to investigate the effect of pharmacological treatments for attention-deficit hyperactivity disorder (ADHD) on motor coordination, using the Developmental Coordination Disorder Questionnaire (DCDQ). METHODS: The participants were recruited from April 2015 to November 2016 from the Department of Psychiatry of Asan Medical Center and were treated for 3 months with methylphenidate or atomoxetine. The illness severity at baseline and 3 months were scored using the ADHD Rating Scale (ARS), Clinical Global Impression-Severity Scale (CGI-S) and/or Clinical Global Impression-Improvement Scale (CGI-I). A total of 39 children with ADHD (age 8.0±1.4 years, 36 boys) completed the Advanced Test of Attention (ATA) and their parents completed the DCDQ at baseline and 3 months. The paired t-test, mixed between-within analysis of variance and correlation analysis were used. RESULTS: The CGI-S (p<0.001), ARS (p<0.001), and fine motor/hand writing (p=0.005) on the DCDQ were significantly changed between pre-treatment and post-treatment. When the participants were divided into those who were suspected of having developmental coordination disorder (DCD) (n=23) and those who probably did not (n=16), the control during movement, fine motor/hand writing and general coordination scores on the DCDQ showed the main effects for group (p<0.001, p<0.001 and p<0.001, respectively). The fine motor/hand writing on the DCDQ has a significant main effect for time [F(1,37)=7.31, p=0.010, η2=0.405] and the interaction effect between group and time was also significant [F(1,37)=4.63, p=0.038, η2=0.111]. The baseline visual commission error on the ATA is significantly correlated with the changes in the DCDQ total scores (r=0.330, p=0.040). CONCLUSION: Our results provide preliminary evidence that pharmacological treatment for ADHD improves not only the core symptoms of ADHD, but also the motor coordination. Further studies are needed to confirm the effect of the pharmacological treatment for ADHD on the motor coordination.
Atomoxetine Hydrochloride ; Child ; Chungcheongnam-do ; Drug Therapy ; Humans ; Methylphenidate ; Motor Skills Disorders ; Parents ; Writing