Canadian Guidelines on Pharmacotherapy for Disruptive and Aggressive Behaviour in Children and Adolescents With Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, or Conduct Disorder

被引:61
作者
Gorman, Daniel A. [1 ,2 ]
Gardner, David M. [3 ,4 ]
Murphy, Andrea L. [3 ,4 ]
Feldman, Mark [2 ,5 ,6 ]
Belanger, Stacey A. [7 ,8 ]
Steele, Margaret M. [9 ,10 ,11 ]
Boylan, Khrista [12 ]
Cochrane-Brink, Kate [1 ,13 ]
Goldade, Roxanne [14 ]
Soper, Paul R. [15 ]
Ustina, Judy [16 ]
Pringsheim, Tamara [17 ,18 ]
机构
[1] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[2] Hosp Sick Children, Toronto, ON M5G 1X8, Canada
[3] Dalhousie Univ, Dept Psychiat, Halifax, NS, Canada
[4] Dalhousie Univ, Coll Pharm, Halifax, NS B3H 3J5, Canada
[5] Univ Toronto, Dept Paediat, Toronto, ON M5S 1A1, Canada
[6] St Josephs Hlth Ctr, Toronto, ON, Canada
[7] Univ Montreal, Dept Paediat, Montreal, PQ, Canada
[8] Ctr Hosp Univ St Justine, Diplome Etud Specialisees Paediat Neurol, Montreal, PQ, Canada
[9] Univ Western Ontario, Dept Psychiat, Schulich Sch Med & Dent, London, ON N6A 3K7, Canada
[10] Univ Western Ontario, Dept Family Med, Schulich Sch Med & Dent, London, ON, Canada
[11] Univ Western Ontario, Dept Paediat, Schulich Sch Med & Dent, London, ON, Canada
[12] McMaster Univ, Dept Psychiat & Behav Neurosci, Hamilton, ON, Canada
[13] Youthdale Treatment Ctr, Toronto, ON, Canada
[14] Univ Calgary, Dept Paediat, Calgary, AB T2N 1N4, Canada
[15] Glenrose Attent Deficit Hyperact Disorder Clin, Edmonton, AB, Canada
[16] Univ Alberta, Dept Psychiat, Edmonton, AB, Canada
[17] Univ Calgary, Dept Clin Neurosci Psychiat Community Hlth Sci &, Calgary, AB, Canada
[18] Calgary Tourette & Paediat Movement Disorders Cli, Calgary, AB, Canada
来源
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE | 2015年 / 60卷 / 02期
关键词
clinical guidelines; children; adolescents; aggression; disruptive behaviour; psychosocial therapy; pharmacotherapy; attention-deficit hyperactivity disorder; oppositional defiant disorder; conduct disorder; GUANFACINE EXTENDED-RELEASE; 2ND-GENERATION ANTIPSYCHOTIC USE; DOUBLE-BLIND; DEFICIT/HYPERACTIVITY DISORDER; CARDIOVASCULAR EVENTS; LONG-TERM; PHARMACOLOGICAL MANAGEMENT; MALADAPTIVE AGGRESSION; STIMULANT MEDICATION; BIPOLAR DISORDER;
D O I
10.1177/070674371506000204
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To develop evidence-based guidelines on pharmacotherapy for severe disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or conduct disorder (CD). The guidelines assume that psychosocial interventions have been pursued but did not achieve sufficient improvement. Method: A multidisciplinary consensus group used the Grading of Recommendations Assessment, Development and Evaluation approach for rating evidence quality and for grading recommendations. We conducted a systematic review of medications studied in placebo-controlled trials for treating disruptive and aggressive behaviour in children and adolescents with ADHD, ODD, or CD. We followed consensus procedures to make 1 of 4 recommendations for each medication: strong, in favour (up arrow up arrow); conditional, in favour (up arrow?); conditional, against (down arrow?); and strong, against (down arrow down arrow). Results: For children and adolescents with disruptive or aggressive behaviour associated with ADHD, psychostimulants received a strong recommendation in favour of use, while atomoxetine and alpha-2 agonists received a conditional recommendation in favour of use. If these patients do poorly with ADHD medications, the medication with the most evidence is risperidone. Risperidone also has the most evidence for treating disruptive or aggressive behaviour in the absence of ADHD. However, given risperidone's major adverse effects, it received only a conditional recommendation in favour of use. We recommended against using quetiapine, haloperidol, lithium, or carbamazepine because of the poor quality of evidence and their major adverse effects. Conclusion: When severe disruptive or aggressive behaviour occurs with ADHD, medications for ADHD should be used first. Other medications have major adverse effects and, with the exception of risperidone, very limited evidence to support their use.
引用
收藏
页码:62 / 76
页数:15
相关论文
共 101 条
[1]  
Abbott Canada, 2013, EP DIV SOD ENT COAT
[2]   Double-blind, placebo-controlled study of risperidone for the treatment of disruptive behaviors in children with subaverage intelligence [J].
Aman, MG ;
De Smedt, G ;
Derivan, A ;
Lyons, B ;
Findling, RL .
AMERICAN JOURNAL OF PSYCHIATRY, 2002, 159 (08) :1337-1346
[3]   CLINICAL EFFECTS OF METHYLPHENIDATE AND THIORIDAZINE IN INTELLECTUALLY SUBAVERAGE CHILDREN [J].
AMAN, MG ;
MARKS, RE ;
TURBOTT, SH ;
WILSHER, CP ;
MERRY, SN .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1991, 30 (02) :246-256
[4]   What Does Risperidone Add to Parent Training and Stimulant for Severe Aggression in Child Attention-Deficit/Hyperactivity Disorder? [J].
Aman, Michael G. ;
Bukstein, Oscar G. ;
Gadow, Kenneth D. ;
Arnold, L. Eugene ;
Molina, Brooke S. G. ;
McNamara, Nora K. ;
Rundberg-Rivera, E. Victoria ;
Li, Xiaobai ;
Kipp, Heidi ;
Schneider, Jayne ;
Butter, Eric M. ;
Baker, Jennifer ;
Sprafkin, Joyce ;
Rice, Robert R., Jr. ;
Bangalore, Srihari S. ;
Farmer, Cristan A. ;
Austin, Adrienne B. ;
Buchan-Page, Kristin A. ;
Brown, Nicole V. ;
Hurt, Elizabeth A. ;
Grondhuis, Sabrina N. ;
Findling, Robert L. .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 2014, 53 (01) :47-60
[5]   GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations [J].
Andrews, Jeff ;
Guyatt, Gordon ;
Oxman, Andrew D. ;
Alderson, Phil ;
Dahm, Philipp ;
Falck-Ytter, Yngve ;
Nasser, Mona ;
Meerpohl, Joerg ;
Post, Piet N. ;
Kunz, Regina ;
Brozek, Jan ;
Vist, Gunn ;
Rind, David ;
Akl, Elie A. ;
Schuenemann, Holger J. .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2013, 66 (07) :719-725
[6]  
[Anonymous], 2003, MEDSCAPE PSYCHIAT ME
[7]  
[Anonymous], NEWSL INT SOC EVID B
[8]   Risperidone augmentation for treatment-resistant aggression in attention-deficit/hyperactivity disorder: A placebo-controlled pilot study [J].
Armenteros, Jorge L. ;
Lewis, John E. ;
Davalos, Marisabel .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 2007, 46 (05) :558-565
[9]  
Arnold L., 2000, Journal of Attention Disorders, V3, P200
[10]  
AztraZeneca Canada Inc, 2013, SER QUET FUM IMM REL