Skip to main content

REVIEW article

Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1484512
This article is part of the Research Topic Precision Medicine in Pediatrics - Volume II View all 9 articles

Precision pharmacotherapy of atomoxetine in children with ADHD: How to ensure the right dose for the right person?

Provisionally accepted
Hong-Li Guo Hong-Li Guo *Jian Huang Jian Huang Wang Jie Wang Jie Lin Fan Lin Fan Yue Li Yue Li Dan-Dan Wu Dan-Dan Wu Qianqi Liu Qianqi Liu Feng Chen Feng Chen *
  • Children's Hospital of NanJing Medicial University, Nanjing, China

The final, formatted version of the article will be published soon.

    Non-stimulant atomoxetine is recognized in various current clinical guidelines as an important alternative to stimulants for the pharmacological treatment of attention deficit/hyperactivity disorder (ADHD) in children. While its efficacy and tolerability for core symptoms are established, there is considerable inter-individual variability in response and exposure, highlighting the need for personalized dosing. In this review, we evaluated existing studies and summarized comprehensive evidence supporting the clinical implementation of therapeutic drug monitoring (TDM) and personalized dosing of atomoxetine, organized around a series of logically structured questions. Although there are notable gaps in achieving personalized dosing across multiple critical elements, the available evidence is helpful to endorse personalized dose adjustments based on TDM and CYP2D6 genotyping "whenever possible". We advocate for ongoing improvement and enhancement in clinical practice. Future advancements will rely on a deeper understanding of ADHD, facilitating more precise diagnoses and personalized treatment strategies.

    Keywords: atomoxetine, Attention deficit/hyperactivity disorder (ADHD), Children, Therapeutic drug monitoring (TDM), CYP2D6, inter-individual variability, Precision pharmacotherapy, biomarkers

    Received: 22 Aug 2024; Accepted: 11 Oct 2024.

    Copyright: © 2024 Guo, Huang, Jie, Fan, Li, Wu, Liu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hong-Li Guo, Children's Hospital of NanJing Medicial University, Nanjing, China
    Feng Chen, Children's Hospital of NanJing Medicial University, Nanjing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.