title: Stimulant drug treatment in childhood-onset schizophrenia with comorbid ADHD: an open-label case series.
abstract: The administration of psychostimulants to children with psychotic symptoms is controversial. This study reports the stimulant drug response of 5 children, aged 8-15 years, with childhood-onset schizophrenia (COS) and comorbid attention deficit hyperactivity disorder (ADHD). Four COS inpatients were given stimulants for comorbid ADHD after stabilization of psychosis on antipsychotic medication. A fifth COS inpatient received stimulants while still actively psychotic, despite concurrent neuroleptic treatment. Data from the 10-item Brief Conners Teachers Ratings Scale (BCTRS) were examined the week before, and the week after, stimulant addition. A paired t test, conducted using Conners Teachers data from these 4 subjects, indicated significant improvement in ADHD symptoms (p = 0.02). Data obtained from a retrospective chart review indicated no significant worsening of psychosis. The 2 subjects treated with mixed salts of dextroamphetamine sulfate and amphetamine sulfate remained on that medication at 6 months and at the 2-year follow-up. Our results suggest that ADHD comorbid with COS may be safely treated with a stimulant, once the psychosis is stabilized. A systematic investigation of this question may be warranted.
authors.affiliation: Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Building 10, Room 3N202, Bethesda, MD 20892, USA. tossellj@intra.nimh.nih.gov
authors.forename: Julia W
authors.initials: JW
authors.lastname: Tossell
authors.forename: Deanna K
authors.initials: DK
authors.lastname: Greenstein
authors.forename: Anna L
authors.initials: AL
authors.lastname: Davidson
authors.forename: Susan B
authors.initials: SB
authors.lastname: Job
authors.forename: Peter
authors.initials: P
authors.lastname: Gochman
authors.forename: Marge
authors.initials: M
authors.lastname: Lenane
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Nugent Iii
authors.forename: Nitin
authors.initials: N
authors.lastname: Gogtay
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Sporn
authors.forename: Judith L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D015897:Comorbidity; D003913:Dextroamphetamine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine