Newswise — Joseph C. Blader, Ph.D., Assistant Professor, Department of Psychiatry & Behavioral Science at Stony Brook University School of Medicine, and colleagues, received a $4 million grant from the National Institute of Mental Health (NIMH) to launch a study to compare treatment options for children with Attention Deficit Hyperactivity Disorder (ADHD) and severe behavioral problems. Physicians often treat these children with several medications at once. This is the first collaborative study nationwide to evaluate whether all these medicines are necessary and how much good they do when combined.
ADHD affects approximately 3% to 6% of children and adolescents in the U.S. About one-third to one-half of children with ADHD also have significant disruptive behaviors that are detrimental to child development, family life, and school and social adjustment. The goals of the five-year SBUMC-led study are to evaluate the effectiveness of adding medications to treat explosive, aggressive, and volatile behavior among children with ADHD who continue to have these problems after treatment with standard stimulant medication.
"There are a great many studies that demonstrate the benefits of stimulant medication as first-line therapy for ADHD, and aggressive behavior often improves too," says Dr. Blader, who has researched ADHD treatment for the past 12 years. "However, there has been a large increase in children receiving treatment for behavioral disorders with potent antipsychotic and mood-stabilizer medications, which has become a major concern because evidence of the effectiveness of these drug regimens is slim and the adverse effect burden is often large."
Dr. Blader points out that children receiving antipsychotic medication are more prone to adverse effects than adults. Major problems include metabolic changes, weight gain, and problems with muscle control.
"Because of these problems, doctors and families are desperate for research-based guidance on medication for children who do not benefit fully from these first-line medications," continues Dr. Blader. "Adding another medication to target aggression may be helpful, but the lack of knowledge on the benefits and liabilities of commonly used 'add-on' treatments is a huge gap between evidence and current practice."
The three collaborating institutions will compare treatment strategies for children with ADHD and severe behavioral problems who have not benefitted enough from standard treatment, and the adverse effect profiles of the treatments. These include Stony Brook University Medical Center, the project's lead grantee, the North Shore-LIJ Health System's Feinstein Institute for Medical Research in New York, and the University of Texas Health Science Center at San Antonio.
Dr. Blader expects the study will fill worrisome gaps of knowledge on the sequencing, benefits, and liabilities of current medication treatment strategies for highly impaired children with ADAD. He believes that the study results could ultimately lead to a more individualized approach in deciding which treatment to use for aggressive children with ADHD.
NIMH is a component of the National Institutes of Health and is a Federal agency who describes its mission "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure."
The Division of Child & Adolescent Psychiatry within SBU's Department of Psychiatry & Behavioral Science, includes clinicians and researchers. The Division is nationally known for its research and treatment programs in ADHD, Tourette's Syndrome, bipolar disorder, and other psychiatric problems among youth.
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