Tailored stimulant treatment and behavior therapy can reduce aggression in children with ADHD.
The results of a study, posted online this week before being published in the October issue of Pediatrics, show that nearly one-half of children with ADHD “whose aggressive behaviors had not been effectively controlled during routine outpatient care could achieve near absence of aggressive, explosive behavior when implementing ‘first-line’ stimulant treatments for ADHD tailored to individual needs, along with behavioral therapy.” The finding is contrary to previous analyses of medical claims, which have suggested that such treatment is uncommon in primary care settings and only moderately better when implemented in specialty settings.
“The results of our research strongly suggest that more intensive and methodical approaches to prescribing stimulants may reduce the need to resort to antipsychotic medications to control severe aggression among children with ADHD,” said
Joseph C. Blader, PhD, assistant professor, Department of Psychiatry & Behavioral Science, Stony Brook University School of Medicine. “And our findings are especially significant in light of recent concerns about the proliferation in the use of other medications with greater side effects, such as antipsychotic medication, than standard stimulant medication when treating children with ADHD who display aggressive behavior.”
In 65 children age 6-13 years with a diagnosis of ADHD and either oppositional defiant disorder or conduct disorder—all whom exhibited significant aggressive behavior and were unsuccessfully treated with standard doses of methylphenidate or dextroamphetamine—the researchers reduced aggression in 49% following individualized optimization of stimulant doses and behavioral therapy, all while avoiding any significant side effects.
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