Journal
MOVEMENT DISORDERS
Volume 24, Issue 2, Pages 277-282Publisher
WILEY
DOI: 10.1002/mds.22307
Keywords
executive dysfunction; Parkinson's disease; cognition; norepinephrine reuptake inhibition; atomoxetine
Categories
Funding
- Eli Lilly
- Mori-is K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins [NIH P50-NS-58377]
- General Clinical Research Center at Johns Hopkins University School of Medicine [NIH M01-RR00052]
- Donna Jeanne Gault Baumann Fund
- Weldon Hall Trust
- Parkinson's Disease Foundation Student Fellowship Program
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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 or 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. (C) 2008 Movement Disorder Society
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