A combination of two drugs - a stimulant and an antipsychotic- can help reduce aggressive behavior in children with attention-deficit/hyperactivity disorder (ADHD) and physical aggression, a study by Ohio researchers states.
"Combination pharmacotherapy is becoming common in child and adolescent psychiatry, but there has been little research evaluating it," said Michael Aman, Ph.D., director of clinical trials at Ohio State's Nisonger Center and emeritus professor of psychology.
The researchers stated that parents of the ADHD children should be taught behavior management skills for their kids.
"Our findings may be considered somewhat controversial because they appear to support the use of two drugs over one for treating children with aggression and disruptive behavior when things do not seem to be going well. Many practitioners have been taught to 'Keep things simple and safe' in their medical training. In general, this is good advice."
The researchers analysed data from 168 children with ADHD. All the participants, aged between 6 and 12, were had "significant" physical aggression prior to the study.
All the participants were given a psychostimulant drug OROS methylphenidate while their parents received behavioral parent training for nine weeks. The researchers named this treatment combination "basic" because both were evidence-based and found to be helpful for improving both ADHD and aggression, the authors explained in a press release.
The researchers then put some of the participants of "basic" group on placebo in the third week while the remaining children, "augmented" group, were given antipsychotic drug.
The study authors found improved results in the "augmented" group compared with the "basic" group. The participants in the "augmented" group were found to display moderately better behaviour. The researchers measured their behaviour quality on Nisonger Child Behavior Rating Form (NCBRF) Disruptive-Total Scale, the NCBRF Social Competence subscale and the Reactive Aggression part of the Antisocial Behavior Scale.
Although, there is a risk of two different drugs for the treatment, the researchers said this particular combo neutralized some of each other's potential side effects.
The researchers found that children in "augmented" group did have much problem falling asleep, after the risperidone was added.
"We conducted this study because we viewed the combination of ADHD and significant physical aggression - especially the aggression - as a serious situation," Aman said.
"It is not uncommon to use more than one medicine for other serious situations, such as when treating cancer or epilepsy, for instance. Although doctors have often used stimulants and antipsychotics together in recent years, we did not have good evidence until now that they would work more effectively when carefully staged and given together," Aman added.
The study was conducted in conjunction with the University of Pittsburgh, Stony Brook University in New York and Case Western Reserve University in Ohio.
The findings were published in the Journal of the American Academy of Child and Adolescent Psychiatry.
