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Drug Combination Helps Reduce Aggressive Behaviour in Children with ADHD

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Researchers at Ohio State University Wexner Medical Center have found that prescribing two different drugs- a stimulant and an antipsychotic - helps control aggressive behavior in children with ADHD.

The research was done in association with the University of Pittsburgh, Stony Brook University in New York and Case Western Reserve University in Ohio.

The study authors said that parents of kids with the condition should be taught behavior management techniques, which could help ease the condition.

"Combination pharmacotherapy is becoming common in child and adolescent psychiatry, but there has been little research evaluating it," said Michael Aman, Ph.D., director of clinical trials at Ohio State's Nisonger Center and emeritus professor of psychology.

"Our findings may be considered somewhat controversial because they appear to support the use of two drugs over one for treating children with aggression and disruptive behavior when things do not seem to be going well. Many practitioners have been taught to 'Keep things simple and safe' in their medical training. In general, this is good advice."

For the study, researchers examined data of 168 children with ADHD, aged between 6 and 12. They were reported to have had "significant" physical aggression before the start of the study.

These children were treated with a psychostimulant drug OROS methylphenidate and their parents received behavioral parent training for nine weeks. The researchers called this combination "basic" as both were evidence-based and found to be helpful for improving both ADHD and aggression, the authors explained in a press release.

In the third week, the researchers gave some "basic" group participants placebo. The rest were put in the "augmented" group that were given antipsychotic drug.

The results showed that children in the "augmented" group displayed a moderately better behavior and better scores on the Nisonger Child Behavior Rating Form (NCBRF) Disruptive-Total Scale, the NCBRF Social Competence subscale and the Reactive Aggression part of the Antisocial Behavior Scale.

Although, there is a risk of two different drugs for the treatment, the researchers said this particular combo neutralized each one's potential side effects.

Furthermore, the children from the "augmented" group had little or no problems falling asleep once the risperidone was added.

"We conducted this study because we viewed the combination of ADHD and significant physical aggression - especially the aggression - as a serious situation," Aman said.

"It is not uncommon to use more than one medicine for other serious situations, such as when treating cancer or epilepsy, for instance. Although doctors have often used stimulants and antipsychotics together in recent years, we did not have good evidence until now that they would work more effectively when carefully staged and given together," Aman added.

The findings were published in the 'Journal of the American Academy of Child and Adolescent Psychiatry.'

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