Abstract
T
Shaywitz et al. bring a methodical eye to two interconnected questions: What is the relationship between ADHD symptoms and dyslexia, which so often present together? And how can medication treatment for ADHD affect (or not affect) reading ability? The authors' post-hoc analysis of atomoxetine treatment data yields quite intriguing results that should be the basis of future investigations. Their most exciting finding is not that atomoxetine treatment appears to improve dyslexia symptoms, but rather that this improvement “cannot be explained by reduced ADHD symptoms alone,” they write. As such, an investigation aimed at “explaining comorbidity of the disorders” in the hopes that this will “lead to the discovery of the underlying mechanisms” has yielded a new mystery, and fertile new ground for inquiry.
Young et al. look at another non-stimulant medication therapy for ADHD, guanfacine, and reach a conclusion that should have fairly immediate clinical impact. Their study of once-daily administration shows not only that the therapy is effective but that the effect is consistent and long-lasting regardless of whether it is taken in the morning or evening. This information should be of great utility to clinicians and the patients they treat, particularly for patients who have difficulty complying with a guanfacine regimen because of sedative side effects during the day.
Bangs et al. approach another question about atomoxetine that has surely concerned many prescribing physicians and patients: Is the black box warning really warranted? The authors undertake a much-needed review of Eli Lilly's data on 23 pediatric and 9 adult trials. Their conclusion is heartening and in line with clinical experience: Suicidal ideation appears to be more common in atomoxetine-treated youth compared with placebo, but the difference is not significant; and there is no indication that suicidal behavior increases with atomoxetine treatment.
Finally, from overseas comes welcome evidence of interest in ADHD, treatment, and side effects and complications. From South Korea, Kim et al. address the persistent question of stimulant medication's effect on height and weight in children. And from Turkey, Ayaz et al. present findings on medication persistence and factors that appear to encourage compliance, which is particularly interesting given the different and variable attitudes towards medication we see everywhere, from Europe to Asia and beyond.
I hope you will enjoy these articles.