Strattera Treatment in Children With ADHD Who Have Poor Response to Stimulant Therapy

Inclusion Criteria: * Male and female outpatients 6-17 years of age. * Subjects with the diagnosis of attention deficit hyperactivity disorder (ADHD), by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), as manifested in clinical evaluation and confirmed by structured interview. * ADHD rating scale-symptom checklist \> 24 * Subjects with a past history of depression, bipolar disorder, anxiety disorder (including obsessive compulsive disorder \[OCD\]) without current disorder for \> 3 months as ascertained through structured diagnostic interview and clinical exam. * Subjects treated for anxiety disorders and depression (with non-MAOI antidepressants \[e.g., SSRIs, bupropion, venlafaxine\] or benzodiazepines) who are on a stable medication regimen for at least three months, and who have a disorder specific Clinical Global Impression (CGI)-severity score ≤ 3 (mildly ill) and who have a score on the Hamilton-Depression and Hamilton-Anxiety Rating Scale below 15 (mild range) will be included in the study. * Subjects with a past or present history of tics will be eligible. * Subjects with a past history of substance use disorders but drug and alcohol free for \> 6 months. * Subjects with mild cases of asthma and allergy will be included. * Potential subjects will have failed an adequate trial of a stimulant as defined by: * Subjects who had intolerable side effects on a stimulant, or * Poor response (an ADHD CGI-I of \> 3) on at least 4 weeks of \> 1.0 mg/kg/day of a methylphenidate product; or \> 0.5 mg/kg/day of an amphetamine product. * Only English-speaking subjects will be allowed into the study for the following reasons: 1. the assessment instruments are not available and have not been adequately standardized in other languages; 2. the clinical trials facility is located in Cambridge and not in the Massachusetts General Hospital (MGH) main campus without the availability of translators; 3. psychiatric questionnaires and evaluations are taxing and adding the complexity of a translator has the potential to make the patient experience even more exhausting. Exclusion Criteria: * Any clinically unstable psychiatric conditions including the following: * acute psychosis, * acute panic, * acute OCD, * acute mania, * acute suicidality, * acute substance use disorders (alcohol or drugs), * sociopathy, * criminality. * Any metabolic, neurological, hepatic, renal, cardiovascular, hematological, ophthalmic, or endocrine disease. * Clinically significant abnormal baseline laboratory values which include the following: * Values which deviate greater than 20% from the normal ranges of the laboratory standard for a basic metabolic screen and complete blood count. * Exclusionary blood pressure parameters will include any values above 140 (systolic) and 90 (diastolic). * Exclusionary electrocardiogram (ECG) parameters will include a QTC \> 460 msec, QRS \>120 msec, and PR \> 200 msec. Subjects having ECG evidence of ischemia or arrhythmia as reviewed by an independent cardiologist. * Mental retardation (intelligence quotient \[I.Q.\] \< 75). * Organic brain disorders. * Seizures. * Pregnant or nursing females. * Subjects with current adequate treatment for ADHD or a history of a previous adequate trial of Strattera. * Prior hypersensitivity to atomoxetine. * MAOI antidepressant use currently or within two weeks of starting study. * Urinary retention or bladder dysfunction. * Narrow angle glaucoma.