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Our aim was to directly investigate these, focusing on impulsivity during response inhibition and decision making. Patients completed an extensive battery of neuropsychological tests addressing response inhibition, decision-making, attention, planning and verbal short term memory. At clinical onset, patients present with unilateral motor deficits largely reflecting dopaminergic and cholinergic dysfunction due to degenerative events in the substantia nigra and midbrain nuclei commencing up to 5 years earlier Braak and Braak, ; Braak et al. As the largest group of noradrenergic neurons, the locus coeruleus is the main source of noradrenergic innervation to order atomoxetine neocortex, hippocampus and cerebellum Moore and Bloom, This early noradrenergic hallmark manifests prodromally as a host of non-motor symptoms including sleep and mood disturbance Remy et al.
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Initial and continuing treatment of attention deficit hyperactivity disorder ADHD diagnosed at age 6—18 years. Atomoxetine was approved as treatment for ADHD in people who cannot take psychostimulants on the basis of cost-effectiveness compared with placebo. When drugs are required for managing ADHD, the psychostimulants methylphenidate and dexamphetamine are first line, combined with non-drug interventions according to individual needs. The noradrenaline reuptake inhibitor atomoxetine is also effective and may be useful for people who cannot take psychostimulants because of contraindications or adverse reactions, or who do not respond to them. However, the PBS listing of atomoxetine does not order atomoxetine treatment for psychostimulant non-responders.
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