Combining Atomoxetine with Alpha, 2 Receptor Agonists Treating ADHD

Aims: Atomoxetine (ATX) and Methylphenidate (MPH) are first line agents in treatment of Attention Deficit Hyperactivity disorder (ADHD). ATX focuses on the frontal lobe, where disattention is situated, MPH on the amygdala, where also hyperacticity is situated. Sometimes, especially for ADHD combined type, both drugs are used contemporarily. Since there are some non responders, adjunctive strategies are required. Alpha agonists have a lower effect size than MPH or ATX. There are only scarse data about the effect of a combination of alpha agonists and MPH [1] or ATX [2]. This trial investigates, if a combination of ATX and Clonidine may also provoke related treatment-emergent adverse events, like MPH and Clonidine do.
Study Design: We observed the effect of a combination of ATX and Clonidine in a 12 year old male patient, suffering from ADHD.
Place and Duration: We observed an outpatient for 4 weeks.
Methodology: Clonidine was added to ATX, because of modest tachycardia.
Results: This case report shows that Alpha agonists do not seem to improve ATX/MPH effect, on the contrary, they seem to diminish ATX/MPH efficacy.