Methylphenidate-risperidone combination in child psychiatry: A retrospective analysis of 44 cases.
BACKGROUND
Psychotimulant-antipyschotic combinations are frequently used in child psychiatry, but have been rarely described in the literature.


METHODS
We propose here a retrospective study of 44 children who received the combination methylphenidate (MPH)-risperidone (RIS). The sample is composed of children who received either MPH (n=28) or RIS (n=16) as primary treatment. A vast majority of the children had a comorbid attention deficit hyperactivity disorder (ADHD) diagnosis.


RESULTS
For over 60% of patients, regardless of their initial monotherapy, bitherapy decreased the symptoms of ADHD and conduct disorder, sleep disorders and anxiety. Concerning the safety of the bitherapy, a compensation effect on weight gain and appetite was respectively observed in 70% and 50% of patients. Even though iatrogenic tachycardia can be encountered with both drugs, it has never been reported when they are associated and we have reported a total of 3 cases in our study. We have also observed a case of dyskinesia resolved with the discontinuation of the treatment.


CONCLUSIONS
MPH-RIS bitherapy appears to be particularly effective in ADHD with conduct disorder symptoms. Although tolerance may limit its use, the benefit/risk ratio seems favourable for a number of children.
Centre psychothérapeutique de Nancy-Laxou, 54520 Laxou, France; Service de psychiatrie de l'enfant et de l'adolescent, hôpital d'enfants, 54500 Vandœuvre-lès-Nancy, France; ETAP - neuropsychopharmacology department, 54500 Vandœuvre-lès-Nancy, France; Psychiatry II and Inserm unit 1114, university hospital of Strasbourg, 67000 Strasbourg, France; Clinical pharmacy service, établissement public de santé Alsace Nord, 67170 Brumath, France. Electronic address: herve.javelot@ch-epsan.fr.
H
H
Javelot
Centre psychothérapeutique de Nancy-Laxou, 54520 Laxou, France.
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C
Glay-Ribau
Service de psychiatrie de l'enfant et de l'adolescent, hôpital d'enfants, 54500 Vandœuvre-lès-Nancy, France.
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F
Ligier
Psychiatry II and Inserm unit 1114, university hospital of Strasbourg, 67000 Strasbourg, France.
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L
Weiner
Centre sanitaire les Rives du Château, Croix Rouge française, 54450 Blâmont, France.
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N
Didelot
ETAP - neuropsychopharmacology department, 54500 Vandœuvre-lès-Nancy, France.
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M
Messaoudi
Service pharmacie, hôpital Brabois-Adultes, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France.
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M
Socha
Service de psychiatrie de l'enfant et de l'adolescent, hôpital d'enfants, 54500 Vandœuvre-lès-Nancy, France.
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F
Body-Lawson
Centre psychothérapeutique de Nancy-Laxou, 54520 Laxou, France; Service de psychiatrie de l'enfant et de l'adolescent, hôpital d'enfants, 54500 Vandœuvre-lès-Nancy, France.
B
B
Kabuth
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002648:Child; D002665:Child Psychiatry; D019955:Conduct Disorder / Q000188:drug therapy / Q000523:psychology; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D018967:Risperidone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D004338:Drug Combinations; D008774:Methylphenidate; D018967:Risperidone
Associations psychostimulant-antipsychotique; Attention deficit hyperactivity disorder; Child psychiatry; Methylphenidate; Méthylphénidate; Psychiatrie de l’enfant; Psychotimulant-antipyschotic combinations; Risperidone; Rispéridone; Trouble déficitaire de l’attention avec hyperactivité