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Aggressive Kids With ADHD May Not Need Antipsychotic Meds
Date:9/17/2010

By Madonna Behen
HealthDay Reporter

FRIDAY, Sept. 17 (HealthDay News) -- More and more children with attention-deficit/hyperactivity disorder (ADHD) who act out aggressively are being given antipsychotic drugs in addition to stimulant medications to help control their volatile outbursts.

It's a trend that many parents and child mental health professionals find worrisome.

However, a new study by researchers at New York's Stony Brook University School of Medicine suggests that, with careful tweaking, use of stimulant medication alone can significantly reduce or eliminate aggressive behavior in at least half of these children.

"There's a big push in this country to have pediatricians manage these kinds of behavioral difficulties in children because there's such a shortage of child psychiatrists," noted the study's lead author, Joseph C. Blader, an assistant professor of psychiatry at Stony Brook. "I hope our study will embolden more primary care physicians to push the limits of first-line [stimulant] treatment for ADHD before going on to the next thing."

The study findings were released online Sept. 13 in advance of publication in the October print issue of Pediatrics.

Blader said the results were an unexpected finding that occurred during the lead-in phase of a study designed to look at whether it was beneficial to give the antipsychotic medication divalproex (Depakote) to aggressive kids with ADHD whose volatile behavior wasn't controlled by stimulant medication alone.

The researchers followed 65 children between the ages of 6 and 13 to determine the most effective and best-tolerated stimulant regimen for each of them. All of the kids had ADHD plus either oppositional defiant disorder or conduct disorder, with significant aggressive behavior. The children were started on a low dose of triphasic-release methylphenidate (Concerta), the longest acting form of Ritalin.

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