Children with attention-deficit/hyperactivity disorder who took twice-daily atomoxetine fall asleep nearly 10 times faster than children taking three-times-daily methylphenidate, according to a presentation at the annual meeting of the American Psychiatric Association. The results (3.36 minutes versus 30.14 minutes, p<.001) were based on evaluations before and during treatment.

Parent and child diaries also showed that children on atomoxetine had less difficulty getting out of bed in the morning than children taking methylphenidate. Additionally, parent diaries showed an advantage with atomoxetine for irritability.
"Sleep difficulties related to methylphenidate therapy can represent a considerable source of concern for patients and families of children with ADHD," said study presenter Judith Owens, M.D., MPH. "The availability of an effective medication option which may help patients to fall asleep faster is useful in the treatment of ADHD."

Although methylphenidate decreased the number of wake bouts (episodes of wakening) (0.2 versus 2.9, p=0.006), atomoxetine allowed patients to sleep longer (10.8 minutes vs. 2.6 minutes, p=0.017).

A total of 85 children were randomized to a double-blind, cross-over trial in which participants were treated with atomoxetine or methylphenidate for 7 weeks and then alternated therapy. After collecting baseline measures, children were treated with atomoxetine (mean dose 1.56 mg/kg) or methylphenidate (mean dose 1.12 mg/kg) for 7 weeks each separated by a washout period.