Adjunctive divalproex versus placebo for children with ADHD and aggression refractory to stimulant monotherapy

Joseph C. Blader, Nina R. Schooler, Peter S. Jensen, Steven R. Pliszka, Vivian Kafantaris

Producción científica: Articlerevisión exhaustiva

102 Citas (Scopus)

Resumen

Objective: The purpose of the present study was to evaluate the efficacy of divalproex for reducing aggressive behavior among children 6 to 13 years old with attention deficit hyperactivity disorder (ADHD) and a disruptive disorder whose chronic aggression was underresponsive to a prospective psychostimulant trial. Method: Children received open stimulant treatment during a lead-in phase that averaged 5 weeks. Agent and dose were assessed weekly and modified to optimize response. Children whose aggressive behavior persisted at the conclusion of the lead-in phase were randomly assigned to receive double-blind, flexibly dosed divalproex or a placebo adjunctive to stimulant for 8 weeks. Families received weekly behavioral therapy throughout the trial. The primary outcome measure was the proportion of children whose aggressive behavior remitted, defined by post-trial ratings of negligible or absent aggression. Result: A significantly higher proportion of children randomly assigned to divalproex met remission criteria (eight out of 14 [57%]) than those randomly assigned to placebo (two out of 13 [15%]). Divalproex was generally well tolerated. Conclusions: Among children with ADHD whose chronic aggressive behavior is refractory to optimized stimulant treatment, the addition of divalproex increases the likelihood that aggression will remit. A larger trial is necessary to specify with greater precision the magnitude of benefit for adjuvant divalproex.

Idioma originalEnglish (US)
Páginas (desde-hasta)1392-1401
Número de páginas10
PublicaciónAmerican Journal of Psychiatry
Volumen166
N.º12
DOI
EstadoPublished - dic 2009

ASJC Scopus subject areas

  • Psychiatry and Mental health

Huella

Profundice en los temas de investigación de 'Adjunctive divalproex versus placebo for children with ADHD and aggression refractory to stimulant monotherapy'. En conjunto forman una huella única.

Citar esto