Stimulant, antipsychotic combo improves aggressive behavior

(HealthDay)—For children with attention deficit/hyperactivity disorder (ADHD) and aggressive disorders, the addition of risperidone to a combination of parent training and psychostimulant is associated with moderate improvement in aggressive and disruptive behaviors, according to a study published in the January issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

Michael G. Aman, Ph.D., from The Ohio State University in Columbus, and colleagues randomized 168 children aged 6 to 12 years old with ADHD and oppositional-defiant disorder (124 children) or conduct disorder (44 children) with severe physical aggression to a nine-week trial of parent training, stimulant, and either placebo (basic treatment; 84 participants) or risperidone (augmented treatment; 84 participants). For three weeks, parents received training and their children received the psychostimulant, titrated for optimal effect, with the placebo or risperidone added if there was room for improvement.

The researchers found that, compared with basic treatment, there were significant improvements on the Nisonger Child Behavior Rating Form Disruptive-Total subscale (P = 0.0016), the Nisonger Child Behavior Rating Form Social Competence subscale (P = 0.0049), and the Antisocial Behavior Scale Reactive Aggression subscale (P = 0.01) with augmented treatment. Both groups showed substantial improvements in the Clinical Global Impressions scores with no difference between the treatments.

"Risperidone provided moderate but variable improvement in aggressive and other seriously disruptive child behaviors when added to parent training and optimized stimulant treatment," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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