A Meta-analysis of tomoxetine hydrochloride in the treatment of attention-deficit hyperactivity disorder

GUO Yu-jing; HUANG Ya-ling

Abstract：Objective: To assess the efficacy and tolerability of tomoxetine hydrochloride in the treatment of attention-deficit hyperactivity disorder(ADHD)with Meta-analysis. Method: A thorough literature search was performed among Medline/PubMed, Embas, SCI, Elsevier and Chinese Biomedical Literature Disk Database(CB-Mdisk).The information about the efficacy and tolerability of tomoxetine hydrochloride in the treatment of ADHD were extracted from randomized, doubleblind, placebo-controlled trials(RCT),and then assessed with Review Manager 4.2.Results: A total of 14 RCTs were included. All of them were done abroad and their Jadad scores were≥4.The sample size was 1995 patients in the 14 RCTs, the ages were less 18 years, and the dosage of tomoxetine hydrochloride was 0.5-1.8 mg·kg~(-1)·d~(-1).As the efficacy results, the mean reductions in ADHD-RS and CGI.S were[WMD-7.26(-8.28,-6.24),P<0.01]and[WMD-0.62(-0.75,-0.48),P<0.01] in patients randomized to tomoxetine hydrochloride as compared to patients with placebo. As adverse events, the decreased appetite[RR: 4.46(2.89,6.89)],nausea[RR:2.97(2.00,4.41)],vomiting[RR: 2.14(1.42,3.21)1 and weight decrease[WMD-1.88(-2.23,-1.52)]were significantly more frequent in patients with tomoxetine hydrochloride. Conclusion: The clinical evidence available so far indicates that tomoxetine hydrochloride treatment appears to be generally effective and safe in the treatment of ADHD.