Impact of atomoxetine on health-related quality of life and functional status in patients with ADHD.

In children and adults, attention-deficit hyperactivity disorder is strongly associated with impairment in health-related quality of life as well as social, academic and occupational functioning. Thus, evaluation of treatment for attention-deficit hyperactivity disorder should assess the impact on functional status and health-related quality of life as well as potential symptom improvement. Atomoxetine is a relatively new nonstimulant medication indicated for the treatment of attention-deficit hyperactivity disorder in children and adults. The purpose of the current paper is to review studies examining the functional and health-related quality of life outcomes of atomoxetine treatment. Studies in this review included four types of measures: generic health-related quality of life instruments, condition-specific health-related quality of life instruments, functional status measures and utility-based assessments. A literature search identified 11 relevant outcome studies and two additional studies using a utility approach. Among children and adolescents, atomoxetine was associated with greater benefits than placebo on generic and condition-specific health-related quality of life measures (domains included children's behavior, mental health, self-esteem and parental impact) as well as measures of classroom behavior and evening behavior. Although findings from adult trials were not as consistent, initial results suggest that adults may also experience functional improvement (e.g., work, social and family functioning) associated with atomoxetine treatment. Overall, findings provide compelling support for the hypothesis that treatment of attention-deficit hyperactivity disorder can have broad positive effects beyond symptom improvement. Studies with active comparators are needed to determine whether the health-related quality of life benefits of atomoxetine are superior or comparable to those of stimulant medications.