Efficacy and safety of mixed amphetamine salts extended release (adderall XR) in the management of oppositional defiant disorder with or without comorbid attention-deficit/hyperactivity disorder in school-aged children and adolescents: A 4-week, multicenter, randomized, double-blind, parallel-group, placebo-controlled, forced-dose-escalation study

Spencer, Thomas; Abikoff, Howard; Connor, Daniel F.; Biederman, Joseph; Pliszka, Steven R.; Boellner, Samuel W.; Read, Stephanie C; Pratt, Raymond D.

doi:10.1016/j.clinthera.2006.03.006

Cited by 71 publications

(55 citation statements)

References 20 publications

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“…Furthermore, the adverse event profile is similar to that observed in middle childhood [109]. Studies examining AMF in adolescent samples have similarly confirmed its efficacy and tolerability in this age group [110,111]. Lack of adherence is a particular challenge in adolescence [45].…”

Section: Are Stimulants Efficacious and Well Tolerated By Both Sexes?mentioning

confidence: 62%

Stimulant Drug Effects on Attention Deficit/Hyperactivity Disorder: A Review of the Effects of Age and Sex of Patients

Cornforth¹,

Sonuga‐Barke²,

Coghill³

2010

CPD

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Objective: Because dopamine functioning varies by sex and age it might be expected that the effects of methylphenidate or amfetamine, the psychostimulants used for the treatment of Attention Deficit /Hyperactivity Disorder (ADHD), will also be moderated by these factors.Here we review the published literature on whether stimulant effects in ADHD symptoms vary by age and sex. Results: Randomised controlled trials confirm that stimulant medication is efficacious for, and well tolerated by, males and females and patients across the age range; although preschoolers appear to have a less beneficial response and more side effects. Few studies that specifically examined the moderating effect of age and/or sex were identified. For sex, no effects on overall response were found, although one study reported that sex moderated methylphenidate pharmacodynamics. The few effects found for age were small and inconsistent. Conclusions:The available evidence suggests that stimulant medication, when appropriately administered, has efficacy as an ADHD treatment for both sexes and across all ages. There are currently too few published papers examining the effects of sex and age to draw strong conclusions about moderation. Further studies of the pharmacodynamics of stimulants on ADHD MEDICATION MODERATORS 3 symptoms measured using objective tests in the laboratory or classroom setting need to be undertaken.

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Section: Are Stimulants Efficacious and Well Tolerated By Both Sexes?mentioning

confidence: 62%

Stimulant Drug Effects on Attention Deficit/Hyperactivity Disorder: A Review of the Effects of Age and Sex of Patients

Cornforth¹,

Sonuga‐Barke²,

Coghill³

2010

CPD

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“…They also suppress the appetite [54]. The efficacy of the stimulants for treating the symptoms of ADHD has been well established in placebo controlled trials [48,55]. In the Multimodal Treatment study of ADHD (MTA Study), it was shown that for the core features of ADHD (inattention, hyperactivity and impulsivity), stimulant medication was more effective than behaviour therapy [18].…”

Section: Clinical Effects Of the Stimulantsmentioning

confidence: 99%

“…Children treated only with stimulant medication required higher doses for optimal improvement than those randomised to a combination of medication and behaviour therapy, suggesting an interaction between behavioural strategies and medication, with differential effects on the different symptom types. The stimulants have been shown to be effective in reducing the symptoms of ADHD in pre-schoolers [56], schoolaged children [18], adolescents [55] and adults [57].…”

Section: Clinical Effects Of the Stimulantsmentioning

confidence: 99%

Therapy for ADHD Directed Towards Addressing the Dual Imbalances in Mental Effort and Reward as Illustrated in the Mental Effort-Reward Imbalances Model (MERIM)

Poulton¹

2015

ADHD - New Directions in Diagnosis and Treatment

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In this chapter we describe a clinical model for ADHD: the Mental Effort Reward Imbalances Model (MERIM). We use this model to explain some of the behaviour commonly observed in children with ADHD and to guide approaches to treatment.The MERIM views the behaviour associated with ADHD as an outcome of two unfavourable imbalances: 1.Imbalance of the level of mental effort required for achievement. 2.Imbalance in the level of reward experienced. These imbalances each contribute to lower levels of achievement and fewer rewarding experiences in ADHD.This results in a poorer mood with less tolerance for frustration, together with seeking rewards that do not involve high levels of effort. The concept of ADHD as dual imbalances in mental effort and reward gives a useful framework for understanding the behaviour and the strategies that individuals use to compensate and improve their mood.Keywords: attention deficit hyperactivity disorder, oppositional defiant disorder, mental effort reward imbalances model, emotional self regulation, reward deficiency syndrome

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“…Historically, monotherapy studies of psychostimulants and of atomoxetine for the treatment of oppositional symptoms have yielded mixed efficacy results (Kaplan et al 2004;Spencer et al 2006;Bangs et al 2008;Lopez et al 2008;Dell'Agnello et al 2009;Hazell et al 2009;Waxmonsky et al 2010;Dittmann et al 2011;Marchant et al 2011;Waxmonsky et al 2011;van Wyk et al 2012). For example, in a randomized, double-blind, parallelgroup, placebo-controlled study conducted in children and adolescents with ODD with or without coexisting ADHD (n = 308), in the overall study population, mixed amphetamine salts (extended release) were associated with significant improvements in parent and teacher ratings on the ODD subscale of the Swanson, Nolan, and Pelham-IV ( p < 0.05) (Spencer et al 2006).…”

mentioning

confidence: 99%

“…For example, in a randomized, double-blind, parallelgroup, placebo-controlled study conducted in children and adolescents with ODD with or without coexisting ADHD (n = 308), in the overall study population, mixed amphetamine salts (extended release) were associated with significant improvements in parent and teacher ratings on the ODD subscale of the Swanson, Nolan, and Pelham-IV ( p < 0.05) (Spencer et al 2006). In subjects with ODD without ADHD, however, the treatment effect was not statistically significant.…”

mentioning

confidence: 99%

Guanfacine Extended Release Adjunctive to a Psychostimulant in the Treatment of Comorbid Oppositional Symptoms in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

Findling

McBurnett

White

et al. 2014

Journal of Child and Adolescent Psychopharmacology

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Objective: The purpose of this study was to assess the effect of guanfacine extended release (GXR) adjunctive to a psychostimulant on oppositional symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Methods: A multicenter, double-blind, placebo-controlled dose-optimization study of GXR (1-4 mg/d) or placebo administered morning (a.m.) or evening (p.m.) adjunctive to psychostimulant was conducted in subjects ages 6-17 with suboptimal response to psychostimulant alone. Suboptimal response was defined as treatment with a stable dose of psychostimulant for ‡ 4 weeks with ADHD Rating Scale IV total score ‡ 24 and Clinical Global Impressions-Severity of Illness score ‡ 3, as well as investigator opinion. Primary efficacy and safety results have been reported previously. Secondary efficacy measures included the oppositional subscale of the Conners' Parent Rating Scale-Revised: Long Form (CPRS-R:L); these are reported herein. Results: Significant reductions from baseline to the final on-treatment assessment on the oppositional subscale of the CPRS-R:L were seen with GXR plus psychostimulant compared with placebo plus psychostimulant, both in the overall study population (placebo-adjusted least squares [LS] mean change from baseline to the final on-treatment assessment: GXR a.m. + psychostimulant, -2.4, p = 0.001; GXR p.m. + psychostimulant, -2.2, p = 0.003) as well as in the subgroup of subjects with significant baseline oppositional symptoms (GXR a.m. + psychostimulant, -3.6, p = 0.001; GXR p.m. + psychostimulant, -2.7, p = 0.013). Treatment-emergent adverse events were reported by 77.3%, 76.3%, and 63.4% of subjects in the GXR a.m., GXR p.m., and placebo groups, respectively, in the overall study population. Conclusions: GXR adjunctive to a psychostimulant significantly reduced oppositional symptoms compared with placebo plus a psychostimulant in subjects with ADHD and a suboptimal response to psychostimulant alone.

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Cited by 71 publications

References 20 publications

Stimulant Drug Effects on Attention Deficit/Hyperactivity Disorder: A Review of the Effects of Age and Sex of Patients

Stimulant Drug Effects on Attention Deficit/Hyperactivity Disorder: A Review of the Effects of Age and Sex of Patients

Therapy for ADHD Directed Towards Addressing the Dual Imbalances in Mental Effort and Reward as Illustrated in the Mental Effort-Reward Imbalances Model (MERIM)

Guanfacine Extended Release Adjunctive to a Psychostimulant in the Treatment of Comorbid Oppositional Symptoms in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

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