Atomoxetine
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Agitation and suicidal ideation in a child: case report An 11-year-old boy developed agitation and suicidal ideation during treatment with atomoxetine for attention deficit-hyperactivity disorder. The boy was referred for attentional problems and aggressive behaviour. As well as exhibiting oppositional defiant behaviour, significant obsessive-compulsive symptoms and a very high level of anxiety, he also fulfilled attention deficit-hyperactivity disorder clinical criteria. He started receiving atomoxetine 25 mg/day and over the first days his family observed a marked reduction in his obsessive and anxiety symptoms. Later, they reported that he became more emotionally labile with apparent "cycling" of his agitation and mood, and his usually neat writing became "tiny" and messy [duration of treatment to reaction onset not clearly stated]. As scheduled on day 14, his dose was increased to 60 mg/day. Increasing agitation was observed, with more rapid cycling and a greater degree of mood swings. On day 16, he threw a cricket stump "javelin style" at a teacher. At home the following day he threatened to kill himself, and was uncontrollably agitated and crying. His family confined him to the house by locking all the doors. The boy’s family stopped the atomoxetine. After his agitation settled over the following 1–2 days, his family stopped being concerned for his safety. He was virtually back to normal, apart from being described as "touchy". His repetitive checking and questioning returned, and his handwriting normalised. Author comment: "Applying the Naranjo Adverse Drug Reaction Probability Scale to the case indicated a probable relationship between the adverse effect and the atomoxetine therapy in this patient (score = 6)." Paxton GA, et al. Acute suicidality after commencing atomoxetine. Journal of Paediatrics and Child Health 44: 596-598, No. 10, Oct 2008 801124480 Australia
0114-9954/10/1228-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Nov 2008 No. 1228
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