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ADHD drug may have important new use

Roby Hill | MUSC News Center | November 17, 2014

Rick SchnellmanSarah Pack
Rick Schnellmann, Ph.D., found that a drug already on the market has life-altering potential for people with debilitating chronic health problems. 

Withering away.

Watching someone’s strength and vitality dwindle is a heartbreaking hallmark of chronic diseases. Such severe muscle atrophy is more than a symptom - it can prevent continued treatments, destroy quality of life and hasten death. What could be worse than this?

New research suggests a drug commonly used for attention-deficit hyperactivity disorder (ADHD) may help prevent skeletal muscular atrophy, a condition that affects millions of chronically ill patients.

In a study published in the Journal of Pharmacology and Experimental Therapeutics, scientists at the Medical University of South Carolina described research that suggested atomoxetine could prevent skeletal muscular atrophy in mice. Atomoxetine (brand name: Strattera) is a norepinephrine reuptake inhibitor approved for treatment of ADHD.

If the discovery can be applied to humans, it would have life-altering potential for patients with chronic diseases such as diabetes, kidney disease, sepsis, or cachexia—a specific and dramatic muscle-wasting syndrome associated with AIDS as well as a wasting that affects more than half of all cancer patients, killing at least 20 percent before the cancer does.

The study’s senior author, professor Rick Schnellmann, is chairman of the Department of Drug Discovery and Biomedical Sciences at the South Carolina College of Pharmacy, which has a campus at MUSC.

“Skeletal muscular atrophy is a clinical problem for numerous pathological conditions,” Schnellmann said. “Our research suggests we may have found that we don’t need a new drug to treat it. We just need to use an existing drug in a new way. ”

In 2013, MUSC’s drug discovery group conducted an experiment that identified atomoxetine as a potent inducer of mitochondrial biogenesis, which prevents muscle atrophy.

Other drugs such as clenbuterol and formoterol can prevent atrophy, but high doses can cause cardiovascular problems.

Schnellmann’s team included MUSC scientists Sean Jesinkey, Midhun Korrapati and Kyle Rasbach along with drug discovery professor Craig Beeson. The researchers evaluated atomoxetine and compared its efficacy and signaling mechanisms to formoterol.

The result: chronic treatment with either atomoxetine or formoterol blocked skeletal muscle loss and preserved leg muscle mass. The atomoxetine dose was actually lower than the clinically approved dose for ADHD treatment and had fewer cardiovascular side effects.

“Many patients with atrophy are already on a complex regimen of medications and can’t handle anything that puts additional stress on their cardiovascular systems,” Schnellmann said. “It leaves them with no effective treatment for a pathology that will certainly lower their quality of life and likely complicate their recovery.”

Since the findings involve using a lower dose of a drug with an existing safety profile, patients will probably not have to spend years waiting for a new indication approval.

“While this is still early research, the ability to 'repurpose' an older drug for an important new clinical need is an exciting opportunity and could greatly facilitate its future clinical investigation,” said Larry Olanoff, member of the MUSC Foundation for Research Development Board and former president of Forest Laboratories Inc.

Schnellmann’s lab previously discovered that a century-old drug for African Sleeping Sickness, suramin, could be used to treat acute renal failure and reduce kidney disease in diabetic patients.
“If we can find a new use for an existing drug, everyone wins,” Schnellmann said. “Clinical trials start sooner, there’s less burden on regulators, physicians get a new weapon to fight disease and patients benefit from a safe treatment they otherwise won’t get.”

For the full study, see

Roby Hill is director of communications for the South Carolina College of Pharmacy.



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Resources >>

Journal of Pharmacology and Experimental Therapeutics article

Muscle atrophy

What causes muscle wasting?


Rick Schnellmann, Ph.D.

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