title: Children with ADHD and symptoms of oppositional defiant disorder improved in behavior when treated with methylphenidate and adjuvant risperidone, though weight gain was also observed - Results from a randomized, double-blind, placebo-controlled clinical trial.
abstract: Children with ADHD often show symptoms of oppositional defiant disorders (ODD). We investigated the impact of adjuvant risperidone (RISP) to a standard treatment with methylphenidate (MPH) in children with ADHD and symptoms of ODD. Eighty-four children with ADHD and ODD (age: M=8.55; range: 7.28-9.95 years; 73.8% males) took part in a double-blind, randomized, placebo-controlled, clinical trial lasting eight weeks. Participants were randomly assigned either to the MPH+RISP (1mg/kg/d+0.5mg/d) or to the MPH+PLCO (1mg/kg/d+placebo) condition. Symptoms of ADHD, weight, height, and blood pressure were assessed at baseline, and at weeks 2, 4, 6 and 8. Symptoms of ADHD decreased over time, but more so in the MPH+RISP than in the MPH only condition. In the MPH+RISP condition weight, waist circumference and prolactine levels increased over time. Data suggest that adjuvant RISP improved symptoms in children with ADHD and ODD, but weight gain and higher prolactine levels were also observed, which are two alarming side effects. This may become an issue, once children become adolescents, a period of life in which body shape and body self-image are closely linked to self-confidence and peer acceptance. Health care professionals should carefully balance the short-term and long-term costs and benefits of administration of RISP.
authors.affiliation: Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Jahangard
authors.affiliation: Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Akbarian
authors.affiliation: Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Haghighi
authors.affiliation: Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ahmadpanah
authors.affiliation: Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Keshavarzi
authors.affiliation: Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hafez
authors.initials: H
authors.lastname: Bajoghli
authors.affiliation: University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
authors.forename: Dena
authors.initials: D
authors.lastname: Sadeghi Bahmani
authors.affiliation: University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.
authors.forename: Edith
authors.initials: E
authors.lastname: Holsboer-Trachsler
authors.affiliation: University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Basel, Switzerland.
authors.forename: Serge
authors.initials: S
authors.lastname: Brand
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000008:administration & dosage* / Q000009:adverse effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage* / Q000009:adverse effects; D018967:Risperidone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects* / Q000502:physiology
chemical_list: D000277:Adjuvants, Pharmaceutic; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D018967:Risperidone
keywords: Attention-deficit/hyperactivity disorder; Methylphenidate; Oppositional defiant disorder; Prolactine; Risperidone; Side-effects; Weight gain