Comparison between atomoxetine and OROS methylphenidate as an adjunctive to SSRIs in attention-deficit/hyperactivity disorder adults with comorbid partially responsive major depressive disorder: A head-to-head, 12-week, randomized, rater-blinded clinical trial
Se-hoon Shim 1, Young Sup Woo 2, Ji Sun Kim 1, In Soo Heo 1, Hee-jung Yoon 3, Hyoung-Mo Sung 4, Jonghun Lee 5, Won-Myong Bahk 2*
1Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea , 2Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea,, 3Korean Society of Infectious Diseases, Seoul, Republic of Korea , 4Department of Psychiatry, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Republic of Korea , 5Department of Psychiatry, Catholic University of Daegu College of Medicine, Daegu, Republic of Korea
Received: January 29, 2021; Revised: February 26, 2021; Accepted: February 26, 2021; Published online: February 26, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: This study aimed to compare the efficacy and safety of atomoxetine (ATX) and OROS methylphenidate (MPH) as adjunctive to selective serotonin reuptake inhibitors (SSRIs) in adults with attention-deficit hyperactivity disorder (ADHD) with comorbid partially responsive major depressive disorder (MDD).
Methods: Sixty Korean adults with ADHD and comorbid partially responsive MDD were recruited in a 12-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to ATX or OROS MPH treatment.
Results: Depressive symptoms measured using the Hamilton Depression Rating Scale and Clinically Useful Depression Outcome Scale, and ADHD symptoms measured using the Adult ADHD Self-Report Scale, as well as the Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and the Sheehan Disability Scale scores were significantly improved in both groups during the 12 weeks of treatment. The changes in all outcome measures during the 12-week treatment were not significantly different between the two groups (all p>0.05). No serious adverse events were reported and there were no significant differences in systolic and diastolic blood pressure, pulse rate, weight, or body mass index between the ATX and MPH groups.
Conclusion: Our findings suggest that ATX and MPH can be used as adjunctive treatments in adults with ADHD and comorbid partially responsive MDD. The efficacy and tolerability of ATX and MPH in adults with ADHD did not differ significantly. Further studies should be conducted to draw a definitive conclusion.
Keywords: depression, ADHD, atomoxetine, OROS methylphenidate, SSRIs

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