Optimizing Stimulant Treatment May Help Reduce Aggression in Children With ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) who also have aggression problems might benefit from adjustments to their stimulant regimen and behavioral therapy, reports astudy in theJournal of the American Academy of Child and Adolescent Psychiatry. If these interventions do not adequately reduce aggressive behaviors, additional treatment with the antipsychotic risperidone or the mood stabilizer divalproex may be advised, the study found.Joseph Blader, Ph.D., of the University of Texas Health Science Center at San Antonio and colleagues enrolled 175 children aged 6 to 12 with ADHD and either oppositional defiant disorder or conduct disorder for the study. Although the children had been taking stimulant medication for at least 30 days, all the children had clinically significant aggressive behavior —defined as a score of>24 on the parent-reported Retrospective-Modified Overt Aggression Scale (R-MOAS).At the beginning of the trial, all children received extended-release methylphenidate tablets whose effects last up to 12 hours. The researchers adjusted the stimulant dose for each child weekly until they found the most effective dose. Children who were experiencing problems in the evening (poor appetite or sleep) while taking the extended-release methylphenidate were switched to a shorter eight-hour methylphenidate formulation; children who experienced negative side effects on methylphenidate were switched to extended-release amphetamine tablets. All childr...
Source: Psychiatr News - Category: Psychiatry Tags: ADHD aggression behavioral therapy conduct disorder divalproex Joseph Blader Journal of the American Academy of Child and Adolescent Psychiatry oppositional defiant disorder risperidone stimulant Source Type: research