Liver enzymes and bilirubin levels during atomoxetine treatment in children and adolescents

Liver enzymes and bilirubin levels during atomoxetine treatment in children and adolescents Objective: Atomoxetine is the first non stimulant medication approved by FDA for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). The objective of this study was to investigate the changes in the liver enzymes levels associated with one month atomoxetine treatment in children with ADHD. Methods: A retrospective chart review was done to evaluate patients treated with only atomoxetine in Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry and Neurological Disease, Child and Adolescent Psychiatry Clinic outpatient unit between September 2010 and December 2010. A total of 62 patients between 6-15 years of age were eligible for the study. Patients' baseline and one month follow-up hepatobiliary function tests including alanine aminotransferase (ALT) and aspartat aminotransferase (AST), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP) and total serum bilirubin levels were noted. Results: No case of jaundice or hepatic failure was seen during the one month treatment period. ALT levels in the first month were significantly lower than baseline. The mean levels of other liver enzymes and bilirubin levels of the patients at the first month were not significantly different than baseline. Clinically nonsignificant elevation of liver enzymes and bilirubin from the defined normal levels were observed in 8 (12.9%) patients. Conclusion: Taking into account the limitations of a retrospective chart review in nonrandomized samples, it appears that atomoxetine treatment in short term does not lead to abnormal liver function changes at therapeutic doses in children and adolescents. Prospective studies are needed to assess liver function tests abnormalities in youth population using atomoxetine.