TY  - JOUR
PY  - 2005//
TI  - Atomoxetine Ingestions in Children: A Report from Poison Centers
JO  - Annals of pharmacotherapy
A1  - Spiller, Henry A.
A1  - Lintner, Chris P.
A1  - Winter, Mark L.
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N2  - BACKGROUND: Atomoxetine uses a novel nonstimulant approach to the treatment of attention deficit hyperactivity disorder. There is limited information on overdose of atomoxetine in children or adults. OBJECTIVE: To provide information on atomoxetine in overdose. METHODS: Case series were conducted at 3 regional poison centers for atomoxetine ingestion in children (age </=17 y). Exclusion criteria were polypharmacy or lack of follow-up. RESULTS: Forty patients were included (25 boys; 63%) in the study. The mean +/- SD age was 6.1 +/- 4.9 years (range 9 mo-17 y). Twenty-five patients were managed at home, 14 in hospital emergency departments (3 children were admitted), and 1 patient was managed in a physician's office. Symptoms reported were tachycardia, drowsiness, nausea, hypertension, and vomiting. A seizure was reported in one child who had recently started atomoxetine therapy. No arrhythmias beyond sinus tachycardia were reported. Mean maximum heart rate in patients with tachycardia was 131 +/- 14 beats/min. The mean dose ingested, categorized by medical outcome, was: no effect (n = 22), 40 +/- 32 mg; minor effect (n = 14), 167 +/- 221 mg; and moderate effect (n = 4), 249 +/- 326 mg. There were no major outcomes or fatalities. The lowest dose ingested that resulted in hypertension was 480 mg, in a 14-year-old girl (BP 136/95 mm Hg). CONCLUSIONS: In this case series, clinically significant cardiovascular effects requiring direct intervention did not occur. Activated charcoal and/or observation appear to be sufficient for accidental ingestion. Further investigation may be needed to indicate whether seizures occur from atomoxetine ingestion.
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SN  - 1060-0280
UR  - http://dx.doi.org/10.1345/aph.1E646
ID  - ref1
ER  -