Atomoxetine
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Hyperadrenergic postural orthostatic tachycardia syndrome: 3 case reports In a retrospective observational study of 98 patients, 3 patients [ages and sexes not stated] were described who developed hyperadrenergic postural orthostatic tachycardia syndrome (POTS) during treatment with atomoxetine for attentiondeficit/hyperactivity disorder (ADHD) [dosages, routes, durations of treatment to reactions onset and outcomes not stated]. All the patients with ADHD, had been receiving treatment with atomoxetine. Subsequently, the patients were admitted due to an unspecified condition and the stand test were performed. To perform the test, the patients were rested in supine position for 10 min, followed by stand up within 3s and remained in standing position for 10 min. Blood samples were collected from all patients during the resting phase and at 10 min after standing. In all patients, the laboratory tests revealed increased HR and significantly higher blood noradrenaline (NE) level exceeding 600 pg/mL after standing compared to resting phase. After standing, the blood NE levels was 2061 pg/mL (1 patient), 663 pg/mL (1 patient) and 676 pg/mL (1 patient), indicating hyperadrenergic POTS. In one patient with highest blood NE level after standing, genetic analysis revealed the presence of NM_001172501.2(SLC6A2):c.1402G> A (NP_001165972.1:p.Val468Ile) variant. The allele frequency of this variant was highest among East Asians, especially persons with Japanese descent. Therefore, in patients receiving atomoxetine, there was a possibility of increased NE level following weakened NE reuptake function due to ethnicity-linked genetic factors. However, genetic study was not performed in all patients. Go S, et al. Retrospective observation of children with the diagnosis of postural tachycardia syndrome while on atomoxetine. Clinical Autonomic Research 30: 351-353, No. 4, 803504152 Aug 2020. Available from: URL: http://doi.org/10.1007/s10286-020-00701-5
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Editorial comment: Details of one patient with NE level of 2061 pg/mL have previously been published and processed for Adis PV [see Reactions 1695 p65; 803308496] and [see Reactions 1698 p56; 803314428].
0114-9954/20/1824-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 3 Oct 2020 No. 1824
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