Objective: Perimenopausal and postmenopausal women frequently report midlife onset of impairments of attention, organization, and short-term memory. We sought to determine whether these cognitive symptoms in healthy women in the menopause transition without a history of attention-deficit/hyperactivity disorder (ADHD) would respond to treatment with atomoxetine (ATX), a medication demonstrated to be effective in reducing similar cognitive impairments in adults with ADHD.
Methods: Sixteen healthy women with complaints of midlife-onset subjective difficulties in memory and concentration/attention and without a history of ADHD or other psychiatric disorders were enrolled in a double-blind, placebo-controlled crossover study of ATX 80 mg/day. Treatment arms were 6 weeks long, separated by a 4-week washout. The Brown Attention Deficit Disorder Scale (BADDS) was used to systematically elicit self-report of perceived cognitive difficulties in executive function. Participants also underwent neuropsychological testing, behavioral assessments, and vital signs monitoring.
Results: Mean baseline BADDS scores were 37.9 for all 16 participants and 42.3 for the 12 who completed both arms of the study. Total BADDS scores decreased significantly from baseline during ATX treatment but not placebo treatment. ATX treatment was superior to placebo in reducing the BADDS working memory cluster score, whereas there was a trend for ATX superiority for the BADDS attention/concentration cluster score. ATX did not differ from placebo with respect to effects on neuropsychological tests, behavioral assessments, or cardiac vital signs.
Conclusions: Perimenopausal and postmenopausal women presenting with midlife-onset subjective cognitive difficulties may experience significant subjective improvement in memory and attention/concentration with ATX treatment.
Received July 7, 2010; revised and accepted September 15, 2010.
From the Departments of 1Psychiatry and 2Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA; and 3Yale University School of Medicine Department of Psychiatry, New Haven, CT.
Funding/support: This study was funded by an investigator-initiated grant from Eli Lilly & Company (C.N.E.) and in part by the National Institute ofMental Health K02MH73090 (C.N.E.).
Financial disclosure/conflicts of interest: Dr. Brown has the following relationships to disclose: Eli Lilly-consultant, research support, speaker and advisory board; Shire-consultant, research support, speaker and advisory board; Novartis-consultant; and Shionoga-consultant. Dr. Brown is also the author of the Brown Attention Deficit Disorder Scale. Dr.Epperson has the following relationships to disclose: Eli Lilly-research support, speaker; GlaxoSmithKline-consultant; Johnson & Johnson-stocks. Other authors do not have any disclosures.
Address correspondence to: C. Neill Epperson, MD, 3535 Market Street, Rm 3001, Philadelphia, PA 19104. E-mail: firstname.lastname@example.org