Academic journal article Journal of Child and Adolescent Psychopharmacology

Risperidone Added to Psychostimulant in Children with Severe Aggression and Attention-Deficit/Hyperactivity Disorder: Lack of Effect on Attention and Short-Term Memory

Academic journal article Journal of Child and Adolescent Psychopharmacology

Risperidone Added to Psychostimulant in Children with Severe Aggression and Attention-Deficit/Hyperactivity Disorder: Lack of Effect on Attention and Short-Term Memory

Article excerpt

[Author Affiliation]

Cristan A. Farmer. 1 Nisonger Center, Ohio State University, Columbus, Ohio.

Jeffery N. Epstein. 2 Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio.

Robert L. Findling. 3 Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio.

Kenneth D. Gadow. 4 Department of Psychiatry, Stony Brook University, Stony Brook, New York.

L. Eugene Arnold. 1 Nisonger Center, Ohio State University, Columbus, Ohio.

Heidi Kipp. 5 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.

David J. Kolko. 5 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.

Eric Butter. 1 Nisonger Center, Ohio State University, Columbus, Ohio.

Jayne Schneider. 4 Department of Psychiatry, Stony Brook University, Stony Brook, New York.

Oscar G. Bukstein. 5 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.

Nora K. McNamara. 3 Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio.

Brooke S.G. Molina. 5 Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.

Michael G. Aman. 1 Nisonger Center, Ohio State University, Columbus, Ohio.

*

Current affiliation: Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland.

[dagger]

Current affiliation: Department Psychiatry and Behavioral Sciences, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Maryland.

[double dagger]

Current affiliation: Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts.

Address correspondence to: Cristan A. Farmer, PhD, Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, 10 Center Drive, Room 1C250, Bethesda, MD 20987, E-mail: farmerca@mail.nih.gov

Introduction

Psychostimulant treatment (e.g., methylphenidate, amphetamine, dextroamphetamine) has been a mainstay of attention-deficit/hyperactivity disorder (ADHD) treatment in youth for the last five decades; clinically, stimulants appear to enhance sustained attention and effort on assigned tasks, to reduce task-irrelevant restlessness, and to improve behavioral noncompliance and oppositional behavior (Barkley et al. 1999). One set of robust findings is that (1) children with ADHD perform poorly on vigilance tasks that measure sustained attention and distractibility and (2) stimulant medication offsets many of these apparent deficits (Douglas 1972; Douglas et al. 1988; Jacobvitz et al. 1990; Losier et al. 1996; Rubia et al. 2007; Riccio et al. 2001).

Indeed, this line of investigation into deficits of attention and impulse control eventually led to a reconceptualization of the condition from one that emphasized hyperactivity (e.g., Hyperkinetic Reaction of Childhood; Diagnostic and Statistical Manual of Mental Disorders [DSM-II]; American Psychiatric Association 1968) to one that emphasizes attention deficits and distractibility (e.g., disorder name changed to Attention Deficit Disorder; Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. [DSM-III]; American Psychiatric Association 1980; Lange et al. 2010). Stimulant medicines have also been shown to have positive, but more modest effects on short-term memory (including digit memorization) and sundry other cognitive effects (Barkley 1977; Aman 1980; Barkley et al. 1999; Epstein et al. 2006; Epstein et al. 2011).

Still, stimulants alone may not address the problem behaviors often comorbid with ADHD; thus, stimulant medications are increasingly being prescribed concomitantly with other psychotropic medications in the Western society. Duffy et al. (2005) found that 52% of 392 2- to 17-year-olds in a network of American psychiatric practices were receiving concomitant psychotropic drugs. …

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