The SNRI atomoxetine is playing a growing role in the treatment of ADHD. Translational studies indicate that this agent modulates prefrontal noradrenaline (and dopamine), and is capable of improving response inhibition, a cognitive function dependent on the right inferior frontal gyrus and under likely noradrenergic control. Further clinical trials are required to explore the efficacy and safety of atomoxetine into the longer term in the treatment of ADHD, in children and in adults, and to evaluate the efficacy of this agent in the treatment of other disorders. For example, registered ongoing trials are exploring the utility of atomoxetine in the treatment of alcohol/substance abuse, Parkinson's disease, and Binge Eating disorder (www.clinicaltrials.gov). In addition to further clinical trials, it will also be important to explore the role of different components of the brain noradrenaline system in cognition (i.e., sub-receptors) in translational research; and to evaluate the effects of atomoxetine on the spectrum of cognitive deficits exhibited across neuropsychiatric disorders.
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