Stimulant drug treatment in childhood-onset schizophrenia with comorbid ADHD: an open-label case series.
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.
Tossell
Julia W
JW
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
Greenstein
Deanna K
DK
Davidson
Anna L
AL
Job
Susan B
SB
Gochman
Peter
P
Lenane
Marge
M
Nugent Iii
Thomas F
TF
Gogtay
Nitin
N
Sporn
Alexandra L
AL
Rapoport
Judith L
JL
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
D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine