Atomoxetine for the treatment of executive dysfunction in Parkinson's disease: A pilot open‐label study

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Abstract
Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson's disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD‐related ED. Twelve patients with PD and disabling ED completed an 8‐week pilot open‐label, flexible dose (25–100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression‐Change Scale (75% positive response rate; 95% CI: 43–95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials. © 2008 Movement Disorder Society
Funding Information
  • Incorporated Investigator-Initiated Trial Program research
  • Parkinson's Disease Research Center of Excellence (NIH P50-NS-58377)
  • General Clinical Research Center at Johns Hopkins University School of Medicine
  • National Center for Research Resources (NIH M01-RR00052)
  • Donna Jeanne Gault Baumann Fund
  • Weldon Hall Trust
  • Parkinson's Disease Foundation Student Fellowship Program