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Evidence Based Answers
Emotional dysregulation in adult ADHD and response to atomoxetine
Summarized by Charles Li, MD
December 9, 2022
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ADHD often comes with challenges in regulating emotions.
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Atomoxetine, a treatment for ADHD can potentially reduce emotional dysregulation symptoms.
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Additionally, it can help improve focus for patients with ADHD and emotional dysregulation.
Background
ADHD can affect how your brain regulates and controls emotions. While not everyone with ADHD has emotional dysregulation, difficulty regulating emotions can be shared among ADHD patients. This can come in the form of overblown or overwhelming emotions, both good and bad
Researchers analyzed data from two clinical trials of atomoxetine to see how common emotional dysregulation was in these patients and how well they responded to atomoxetine, an ADHD medication.
Study Quote
Background: Before 1980, attention-deficit/hyperactivity disorder (ADHD) was called minimal brain dysfunction and included emotional symptoms now listed as "associated features" in DSM-IV. Data from two multicenter, placebo-controlled studies with 536 patients were reexamined to assess: ...
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Methods
They used the WRAADDS, a test of a person's temper and reactivity, to assess which patients had emotional dysregulation along with ADHD.
Researchers measured ADHD outcomes with CAARS, another ADHD diagnostic test, along with WRAADDS.
Study Quote
Methods: The Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) was used to assess temper, affective lability, and emotional overreactivity, thus identifying patients exhibiting "emotional dysregulation." Other DSM-IV Axis I diagnoses were exclusionary. Outcome measures wer...
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Results
They found that patients who started the trial with signs of emotional dysregulation saw significant improvements in the treatment.
They estimated that patients given atomoxetine saw a 42% reduction in their emotional dysregulation, compared to a 19% reduction in those given a placebo control. This difference was statistically significant.
Atomoxetine significantly improved emotional regulation among ADHD patients
Study Quote
Results: Thirty-two percent of the sample met post hoc criteria for emotional dysregulation and had higher baseline scores on ADHD measures, a lower response to placebo, and greater response to atomoxetine (p = .048). Symptoms of emotional dysregulation had a treatment effect (p < .001) ...
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Conclusions
Around 1 in 3 people in this study had ADHD along with emotional dysregulation, suggesting that challenges in regulating emotions can be pretty common among individuals with ADHD.
This study provides some data that atomoxetine can help with emotional regulation. However, since this was a re-analysis of another clinical trial, we'll need more studies in this area before we know this for sure.
Symptoms of emotional dysregulation were present in many patients with ADHD and showed a treatment response similar to other ADHD symptoms.