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Cited by 11Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentBehavioral and Psychological Studies

The Impact of Persistent Irritability on the Medication Treatment of Paediatric Attention Deficit Hyperactivity Disorder

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Baweja, Raman, Waschbusch, Daniel A., Pelham, William E., Pelham, William E., Waxmonsky, James G.·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.699687PMC PMC8333707
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Abstract

This study compares the efficacy and tolerability of central nervous system (CNS) stimulants in children with attention deficit hyperactivity disorder (ADHD) with and without prominent irritability (IRR) over the course of 30 months. This is a secondary analysis of a study examining growth patterns in medication naïve children with ADHD subsequently treated with CNS stimulants (predominantly OROS-Methylphenidate, up to 54 mg per day) for 30 months. Participants had to meet full diagnostic criteria for ADHD and been treated with CNS stimulants for under 30 days. Children were classified as IRR if they were rated as pretty much or very much on either of the “often angry” or easily annoyed” items plus “lose temper,” items of the Disruptive Behavior Disorders Rating Scale (DBDRS). Structured ratings of ADHD symptoms, impairment, side effects, and symptoms of oppositional defiant disorder (ODD) were collected every 2–12 weeks for the duration of the study. Medication use was measured by pill count and parent report. The IRR group comprised 28% of all participants. The IRR group had significantly higher levels of ADHD and ODD symptoms, impairment, and side effects ratings at baseline. In the IRR group, ODD symptoms, emotional lability, and impairment significantly decreased for participants with higher medication use. Total side effects increased for non-IRR participants with higher medication use. Emotional side effects decreased for IRR participants with higher medication use. Central nervous system stimulants were a tolerable and efficacious treatment in treatment naïve youth with ADHD with irritability. Clinical Trials Registration: NCT01109849

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Cited by

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Authors
Baweja, R., Waschbusch, D. A., Pelham, W. E., Pelham, W. E., & Waxmonsky, J. G.
Affiliations
Pennsylvania State University (US)
Corresponding author
Baweja, Raman
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-07-21
Volume
12
Pages
699687-699687
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.699687
PMC
PMC8333707
OpenAlex
W3185931668
Cited by
11
References
2
Citations by year
2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 1
FWCI
1.26
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institute of Mental Health
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
Keywords
attention deficit hyperactivity disorder, irritability, psychostimulants, methylphenidate, drug tolerability, drug efficacy, oppositional defiant disorder, emotional lability, treatment-naive children, adverse effects

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