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Aripiprazole/Methylphenidate Combination in Children and Adolescents with Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: An Open-Label Study.
J Child Adolesc Psychopharmacol. 2018 12; 28(10):682-689.JC

Abstract

OBJECTIVES

Disruptive mood dysregulation disorder (DMDD) is characterized by nonepisodic irritability and has a high rate of comorbidity with attention-deficit/hyperactivity disorder (ADHD). This is the first study to explore the effects of aripiprazole combined with methylphenidate on clinical symptoms and cognitive functions in patients with DMDD and ADHD.

METHODS

Patients with DMDD and ADHD (the DMDD-ADHD Group, n = 24; aged 7-17 years) completed a 6-week, open-label trial of aripiprazole and methylphenidate. The pre- and posttreatment outcome measures included the parent-rated Swanson, Nolan, and Pelham Scale-version IV, Child Behavior Checklist, and self-reported Beck Youth Inventories-II, as well as a neuropsychological battery composed of the Children's Color Trail Test and Conner's Continuous Performance Test. The comparison group consisting of patients with ADHD (the ADHD Group, n = 27) was recruited to investigate the differences in clinical and neuropsychological profiles between the two groups at baseline.

RESULTS

The DMDD-ADHD Group showed worse irritability, disruptive behaviors, anxious/depressed symptoms, and social problems relative to the ADHD Group at baseline assessments. The combination treatment significantly improved irritability, externalizing symptoms, depression, anxiety, attention, social problems, and reaction time variability. The effect sizes of reductions in parent-rated irritability, oppositional defiant symptoms, and inattention were comparable (Cohen's d = 1.26, 1.11, and 1.40, respectively).

CONCLUSIONS

This pilot study showed the tolerability of the aripiprazole/methylphenidate combination by patients with DMDD and ADHD and its efficaciousness for treating clinical symptoms and for improving cognitive function. Further randomized, controlled, cross-over studies are needed.

Authors+Show Affiliations

Department of Psychiatry, National Defense Medical Center , Tri-Service General Hospital, Taipei, Taiwan .Department of Psychiatry, National Defense Medical Center , Tri-Service General Hospital, Taipei, Taiwan .Department of Psychiatry, National Defense Medical Center , Tri-Service General Hospital, Taipei, Taiwan .

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30148656

Citation

Pan, Pei-Yin, et al. "Aripiprazole/Methylphenidate Combination in Children and Adolescents With Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: an Open-Label Study." Journal of Child and Adolescent Psychopharmacology, vol. 28, no. 10, 2018, pp. 682-689.
Pan PY, Fu AT, Yeh CB. Aripiprazole/Methylphenidate Combination in Children and Adolescents with Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: An Open-Label Study. J Child Adolesc Psychopharmacol. 2018;28(10):682-689.
Pan, P. Y., Fu, A. T., & Yeh, C. B. (2018). Aripiprazole/Methylphenidate Combination in Children and Adolescents with Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: An Open-Label Study. Journal of Child and Adolescent Psychopharmacology, 28(10), 682-689. https://doi.org/10.1089/cap.2018.0068
Pan PY, Fu AT, Yeh CB. Aripiprazole/Methylphenidate Combination in Children and Adolescents With Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: an Open-Label Study. J Child Adolesc Psychopharmacol. 2018;28(10):682-689. PubMed PMID: 30148656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Aripiprazole/Methylphenidate Combination in Children and Adolescents with Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder: An Open-Label Study. AU - Pan,Pei-Yin, AU - Fu,An-Ting, AU - Yeh,Chin-Bin, Y1 - 2018/08/27/ PY - 2018/8/28/pubmed PY - 2019/10/8/medline PY - 2018/8/28/entrez KW - aripiprazole KW - attention-deficit/hyperactivity disorder KW - disruptive mood dysregulation disorder KW - irritability KW - methylphenidate SP - 682 EP - 689 JF - Journal of child and adolescent psychopharmacology JO - J Child Adolesc Psychopharmacol VL - 28 IS - 10 N2 - OBJECTIVES: Disruptive mood dysregulation disorder (DMDD) is characterized by nonepisodic irritability and has a high rate of comorbidity with attention-deficit/hyperactivity disorder (ADHD). This is the first study to explore the effects of aripiprazole combined with methylphenidate on clinical symptoms and cognitive functions in patients with DMDD and ADHD. METHODS: Patients with DMDD and ADHD (the DMDD-ADHD Group, n = 24; aged 7-17 years) completed a 6-week, open-label trial of aripiprazole and methylphenidate. The pre- and posttreatment outcome measures included the parent-rated Swanson, Nolan, and Pelham Scale-version IV, Child Behavior Checklist, and self-reported Beck Youth Inventories-II, as well as a neuropsychological battery composed of the Children's Color Trail Test and Conner's Continuous Performance Test. The comparison group consisting of patients with ADHD (the ADHD Group, n = 27) was recruited to investigate the differences in clinical and neuropsychological profiles between the two groups at baseline. RESULTS: The DMDD-ADHD Group showed worse irritability, disruptive behaviors, anxious/depressed symptoms, and social problems relative to the ADHD Group at baseline assessments. The combination treatment significantly improved irritability, externalizing symptoms, depression, anxiety, attention, social problems, and reaction time variability. The effect sizes of reductions in parent-rated irritability, oppositional defiant symptoms, and inattention were comparable (Cohen's d = 1.26, 1.11, and 1.40, respectively). CONCLUSIONS: This pilot study showed the tolerability of the aripiprazole/methylphenidate combination by patients with DMDD and ADHD and its efficaciousness for treating clinical symptoms and for improving cognitive function. Further randomized, controlled, cross-over studies are needed. SN - 1557-8992 UR - https://www.unboundmedicine.com/medline/citation/30148656/Aripiprazole/Methylphenidate_Combination_in_Children_and_Adolescents_with_Disruptive_Mood_Dysregulation_Disorder_and_Attention_Deficit/Hyperactivity_Disorder:_An_Open_Label_Study_ L2 - https://www.liebertpub.com/doi/full/10.1089/cap.2018.0068?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -