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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ter Laak, Maureen A. Temmink, Alphons H. Koeken, Ankie Van 't Veer, Nils E. Van Hattum, Paul R. M. Cobbaert, Christa M. |
| Description | Country affiliation: Netherlands Author Affiliation: ter Laak MA ( Department of Clinical Pharmacy, Amphia Hospital, Breda, The Netherlands. mtlaak@tsz.nl) |
| Abstract | Ten out of 100 children treated for attention deficit hyperactivity disorder with standard doses of atomoxetine were selected by a neurologist for cytochrome P450 2D6 and cytochrome P450 2C19 genotyping, based on late response (>9 weeks) and adverse effects (gastrointestinal problems, sleeping disorders, malaise, inactivity, and mood instabilities). After genotyping, eight children were confirmed to have compromised cytochrome P450 2D6 activity because of at least one nonfunctional or less functional allele. Cytochrome P450 C19 is a minor pathway in atomoxetine metabolism and therefore of less importance. Tailored therapeutic advice was given to the neurologist. Four children with compromised cytochrome P450 2D6 activity responded better after decreasing their atomoxetine dose. The other four ceased treatment because of initial adverse effects. These cases indicate that compromised atomoxetine metabolism can be recognized, based on adverse effects and late response to atomoxetine. Physicians should be aware of the typical pattern of adverse effects and late response in atomoxetine treatment, possibly indicating compromised cytochrome P450 2D6 activity. Cytochrome P450 2D6 genotyping before atomoxetine treatment may be beneficial in preventing overdosing or early cessation. Further research is needed to establish the cost versus benefit ratio of prospective cytochrome P450 2D6 genotyping in atomoxetine treatment. |
| File Format | HTM / HTML |
| ISSN | 08878994 |
| Issue Number | 3 |
| Volume Number | 43 |
| e-ISSN | 18735150 |
| Journal | Pediatric Neurology |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2010-09-01 |
| Publisher Place | United States |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Neurology Discipline Pediatrics Adrenergic Uptake Inhibitors Adverse Effects Attention Deficit Disorder With Hyperactivity Drug Therapy Genetics Cytochrome P-450 Cyp2d6 Propylamines Adolescent Atomoxetine Hydrochloride Child Dose-response Relationship, Drug Genotype Humans Pharmacogenetics Metabolism Retrospective Studies Journal Article |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology Neurology (clinical) Pediatrics, Perinatology and Child Health Developmental Neuroscience |
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