Stimulant Drug Treatment in Childhood-Onset Schizophrenia with Comorbid ADHD: An Open-Label Case Series
Abstract
The administration of psychostimulants to children with psychotic symptoms is controversial. This study reports the stimulant drug response of 5 children, aged 8-15 years, with childhood-onset schizophrenia (COS) and comorbid attention deficit hyperactivity disorder (ADHD). Four COS inpatients were given stimulants for comorbid ADHD after stabilization of psychosis on antipsychotic medication. A fifth COS inpatient received stimulants while still actively psychotic, despite concurrent neuroleptic treatment. Data from the 10-item Brief Conners Teachers Ratings Scale (BCTRS) were examined the week before, and the week after, stimulant addition. A paired t test, conducted using Conners Teachers data from these 4 subjects, indicated significant improvement in ADHD symptoms (p = 0.02). Data obtained from a retrospective chart review indicated no significant worsening of psychosis. The 2 subjects treated with mixed salts of dextroamphetamine sulfate and amphetamine sulfate remained on that medication at 6 months and at the 2-year follow-up. Our results suggest that ADHD comorbid with COS may be safely treated with a stimulant, once the psychosis is stabilized. A systematic investigation of this question may be warranted.
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Stimulants are not advised during pregnancy or breastfeeding and are contraindicated in psychotic disorders up to now.
“Stimulants are not advised during pregnancy or breastfeeding and are contraindicated in psychotic disorders up to now; although some specialists have treated ADHD successfully in stable patients with schizophrenia maintained on antipsychotics [271].”
From European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD (2010) · cites this paper as [271]
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- Authors
- Tossell, J. W., Greenstein, D. K., Davidson, A. L., Job, S. B., Gochman, P., Lenane, M., Nugent III, T. F., Gogtay, N., Sporn, A. L., & Rapoport, J. L.
- Affiliations
- National Institutes of Health (US)
- Child Psychiatry Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Building 10, Room 3N202, Bethesda, Maryland.
- ORCID
- Gochman, Peter
- Venue
- Journal of Child and Adolescent Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2004-09
- Volume
- 14
- Issue
- 3
- Pages
- 448-454
- ISSN
- 1044-5463 (ISSN-L)
- 1557-8992
- OpenAlex
- W1981138747
- Cited by
- 25
- References
- 10
- Citations by year
- 2020: 2 · 2018: 1 · 2016: 3 · 2015: 4 · 2014: 3 · 2012: 2
- FWCI
- 0.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child and Adolescent Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- childhood schizophrenia, attention deficit hyperactivity disorder, comorbidities, psychostimulants, d-amphetamine, amphetamine, ADHD symptom improvement, antipsychotic drugs
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Dextroamphetamine, Female, Follow-Up Studies, Humans, Male, Psychiatric Status Rating Scales, Retrospective Studies, Schizophrenia, Comorbidity
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