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Viloxazine More Effective Than Atomoxetine

Published on 10/07/2023 in CNS Drugs (Springer)
  1. The study compared the effectiveness and tolerability of extended-release viloxazine ER (VER) to atomoxetine in the treatment of pediatric and adult attention deficit hyperactivity disorder (ADHD).
  2. Patients taking atomoxetine for DSM-5-TR ADHD combined type experienced significant improvement in ADHD symptoms following a voluntary, open-label switch to VER.
  3. A total of 50 patients (35 children) were included in the study, with mean doses of atomoxetine 60 mg followed by VER 300 mg after a 5-day atomoxetine washout.
  4. The results showed that improvements were greater on VER than atomoxetine in inattention and in hyperactivity/impulsivity, with 86% of patients reporting positive response by 2 weeks on VER.
  5. 36% of patients discontinued atomoxetine for side effects, versus 4% discontinuing VER for fatigue. 96% of patients preferred VER over atomoxetine, with 85% choosing to taper psychostimulants following stabilization on VER.
  6. The study highlighted the rising pediatric and adult ADHD diagnoses and the need for non-stimulant options with less side effects and high efficacy.
  7. VER demonstrated superior efficacy for both inattentive and hyperactivity/impulsivity symptoms, rapid onset, and tolerability compared to atomoxetine.
  8. The study acknowledged limitations such as the small sample size and lack of comparison group or placebo control, indicating the need for future double-blind studies with larger sample sizes.
  9. Patients who had experienced less-than-optimal response to atomoxetine benefited from rapid improvement in inattention and hyperactivity/impulsivity with greater tolerability on extended-release viloxazine.

The study was conducted retrospectively with data obtained for clinical purposes and received no specific grant from funding agencies. The authors disclosed no conflicts of interest and provided substantial contributions to the conception and design of the work.


References:

Price, Maxwell Zachary, and Richard L. Price. “Extended-Release Viloxazine Compared With Atomoxetine for Attention Deficit Hyperactivity Disorder.” CNS Drugs, vol. 37, no. 7, July 2023, pp. 655–60, doi:10.1007/s40263-023-01023-6.


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