Research Article

Atomoxetine Does Not Improve Complex Attention in Idiopathic Parkinson’s Disease Patients with Cognitive Deficits: A Meta-Analysis

Table 1

Characteristics of the included studies.

Author, year (country)Type of studyDemographic detailsAssessment of cognitive functions
Age (years) (mean ± SD)Dose of atomoxetine (duration)Concomitant medicationsComparatorCognitive domain (DSM-5)Scale and subscale used

Hinson et al. 2016 (USA)Double-blind randomized control trial68 ± 840 mg/d (weeks 1-2); 80 mg/d (weeks 3–10); no dose adjustmentsMemantine, anticholinergics, MAO inhibitors, neuroleptics, and acetylcholinesterase inhibitors excludedPlaceboComplex attentionPaced Auditory Serial Addition Test
Complex attentionNeuropsychological Assessment Battery: Part A and Part D
Social cognitionNeuropsychological Assessment Battery: Judgement
Executive functionDelis–Kaplan Executive Function System—Inhibition Time
Executive functionDelis–Kaplan Executive Function System—Inhibition-Switching Time
Executive functionDelis–Kaplan Executive Function System—Number-Letter Switching Time
Executive functionDelis–Kaplan Executive Function System—Proverbs
Executive functionWechsler Adult Intelligence Scale: Digit Span
LanguageExpressive Language/Confrontation Naming
Perceptual-motor functionVisuospatial Perception
Complex attentionConners’ Adult ADHD Rating Scale (Inattention)
Complex attentionConners’ Adult ADHD Rating Scale (Hyperactivity)
Complex attentionConners’ Adult ADHD Rating Scale (Impulsivity)
Complex attentionConners’ Adult ADHD Rating Scale (Problems with self-concept)
Complex attentionConners’ Adult ADHD Rating Scale (ADHD index)

Marsh et al. 2009 (USA)Open-label single-arm trial57.3 ± 7.225 mg/d (week 1), 50 mg/d (weeks 2–4), 75 mg/d (week 5), 100 mg/d (weeks 6–8); minimum 2.5 mg/d dose reductions for intoleranceDopamine agonists, levodopa, apomorphine, COMT inhibitors, anticholinergics, selegiline, amantadine, antidepressants, atypical antipsychotics, benzodiazepine/hypnotics allowedPretreatment vs. posttreatmentLearning and memoryHopkins Verbal Learning Test-Revised Recognition Discrimination score
Complex attentionConners’ Adult ADHD Rating Scale Long Form (Inattention/Memory)
Complex attentionConners’ Adult ADHD Rating Scales Long Form (Hyperactivity)
Complex attentionConners’ Adult ADHD Rating Scales Long Form (Impulsivity/Emotional Lability)
Complex attentionConners’ Adult ADHD Rating Scales Long Form (Self-concept)
Complex attentionConners’ Adult ADHD Rating Scales Long Form (Total ADHD Symptoms)

Weintraub et al. 2010 (USA)Double-blind randomized control trial64.3 ± 10.540 mg/d (weeks 1-2), 80 mg/d (weeks 3–8); 40 mg/d allowed if indicatedAntidepressants allowed; MAO inhibitors excludedPlaceboGlobal cognitive functionMini-Mental State Examination

ADHD: attention-deficit hyperactivity disorder; COMT: catechol-O-methyl transferase; DSM-5: Diagnostic and Statistical Manual of Mental Disorders-5; MAO: monoamine oxidase; NRI: norepinephrine reuptake inhibitor.