Acute atomoxetine effects on the EEG of children with attention-deficit/hyperactivity disorder

Although stimulant medications are the most commonly-used treatments for Attention-Deficit/Hyperactivity Disorder (AD/HD), as many as 20% of treated children do not respond clinically to stimulants. This study investigated the effects of an acute dose of atomoxetine, a selective noradrenaline reuptake inhibitor (SNRI), on the electroencephalogram (EEG) and performance of children with AD/HD. An initial pre-medication EEG was recorded during an eyes-closed resting condition. Within two weeks, a second EEG was recorded 1 h after ingestion of 20 mg of atomoxetine. Data were Fourier transformed to provide absolute and relative power estimates for the delta, theta, alpha, beta and gamma bands. Compared to controls, the unmedicated AD/HD children had significantly elevated global absolute and relative delta, with reduced global relative alpha, and absolute and relative gamma, and many topographic differences. Atomoxetine produced significant global increases in absolute and relative beta, with several topographic changes in other bands, and a significant reduction in omission errors on a Continuous Performance Task. These results indicate that SNRIs can produce substantial normalisation of the AD/HD EEG profile, together with behavioural performance improvements. Although EEG changes induced by acute administration of psychostimulants (methylphenidate/dexamphetamine) and atomoxetine are not identical, both classes of AD/HD drugs produce similar EEG band changes. Further analysis of EEG responses to SNRIs and psychostimulants could reveal common neurophysiological processes closely linked to clinical improvement of AD/HD symptoms in response to pharmacotherapy, providing translational markers for clinical efficacy studies and potential translational biomarkers for AD/HD drug discovery.