TY - JOUR
T1 - The Impact of Persistent Irritability on the Medication Treatment of Paediatric Attention Deficit Hyperactivity Disorder
AU - Baweja, Raman
AU - Waschbusch, Daniel A.
AU - Pelham, William E.
AU - Pelham, William E.
AU - Waxmonsky, James G.
N1 - Funding Information:
This trial was funded by the National Institute of Mental Health (NIMH; R01 MH083692). Funders had no role in the conduct of the research or preparation of the article. During the study, authors
Funding Information:
Funding. This trial was funded by the National Institute of Mental Health (NIMH; R01 MH083692). Funders had no role in the conduct of the research or preparation of the article. During the study, authors also received support from the National Institute on Drug Abuse (NIDA; WP (3rd author): T32 DA039772; WP (4th author): R01DA034731, MH101096), the National Institute on Alcohol Abuse and Alcoholism (NIAAA; WP (3rd author): F31 AA026768), the NIMH (JW: MH80791; WP (4th author): MH099030; DW: MH085796), the Institute of Education Sciences (IES; WP (4th author): R324A180175, R305A170523), and Shire Pharmaceuticals (DW and JW). Some study medication was donated by Janssen Pharmaceuticals.
Funding Information:
Conflict of Interest: JW has received research funding from the National Institutes of Health, Supernus, and Pfizer in the past 3 years. WP (4th author) has received funding from NIMH, NIAAA, NIDA, and the Institute of Education Sciences.
Publisher Copyright:
© Copyright © 2021 Baweja, Waschbusch, Pelham, Pelham and Waxmonsky.
PY - 2021/7/21
Y1 - 2021/7/21
N2 - This study compares the efficacy and tolerability of central nervous system (CNS) stimulants in children with attention deficit hyperactivity disorder (ADHD) with and without prominent irritability (IRR) over the course of 30 months. This is a secondary analysis of a study examining growth patterns in medication naïve children with ADHD subsequently treated with CNS stimulants (predominantly OROS-Methylphenidate, up to 54 mg per day) for 30 months. Participants had to meet full diagnostic criteria for ADHD and been treated with CNS stimulants for under 30 days. Children were classified as IRR if they were rated as pretty much or very much on either of the “often angry” or easily annoyed” items plus “lose temper,” items of the Disruptive Behavior Disorders Rating Scale (DBDRS). Structured ratings of ADHD symptoms, impairment, side effects, and symptoms of oppositional defiant disorder (ODD) were collected every 2–12 weeks for the duration of the study. Medication use was measured by pill count and parent report. The IRR group comprised 28% of all participants. The IRR group had significantly higher levels of ADHD and ODD symptoms, impairment, and side effects ratings at baseline. In the IRR group, ODD symptoms, emotional lability, and impairment significantly decreased for participants with higher medication use. Total side effects increased for non-IRR participants with higher medication use. Emotional side effects decreased for IRR participants with higher medication use. Central nervous system stimulants were a tolerable and efficacious treatment in treatment naïve youth with ADHD with irritability. Clinical Trials Registration: NCT01109849
AB - This study compares the efficacy and tolerability of central nervous system (CNS) stimulants in children with attention deficit hyperactivity disorder (ADHD) with and without prominent irritability (IRR) over the course of 30 months. This is a secondary analysis of a study examining growth patterns in medication naïve children with ADHD subsequently treated with CNS stimulants (predominantly OROS-Methylphenidate, up to 54 mg per day) for 30 months. Participants had to meet full diagnostic criteria for ADHD and been treated with CNS stimulants for under 30 days. Children were classified as IRR if they were rated as pretty much or very much on either of the “often angry” or easily annoyed” items plus “lose temper,” items of the Disruptive Behavior Disorders Rating Scale (DBDRS). Structured ratings of ADHD symptoms, impairment, side effects, and symptoms of oppositional defiant disorder (ODD) were collected every 2–12 weeks for the duration of the study. Medication use was measured by pill count and parent report. The IRR group comprised 28% of all participants. The IRR group had significantly higher levels of ADHD and ODD symptoms, impairment, and side effects ratings at baseline. In the IRR group, ODD symptoms, emotional lability, and impairment significantly decreased for participants with higher medication use. Total side effects increased for non-IRR participants with higher medication use. Emotional side effects decreased for IRR participants with higher medication use. Central nervous system stimulants were a tolerable and efficacious treatment in treatment naïve youth with ADHD with irritability. Clinical Trials Registration: NCT01109849
UR - http://www.scopus.com/inward/record.url?scp=85111925602&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85111925602&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2021.699687
DO - 10.3389/fpsyt.2021.699687
M3 - Article
C2 - 34366928
AN - SCOPUS:85111925602
VL - 12
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
SN - 1664-0640
M1 - 699687
ER -