Medication Strategies in Childhood Aggression: A Review

Bassarath, Lindley

doi:10.1177/070674370304800602

Cited by 20 publications

(8 citation statements)

References 52 publications

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“…Although psychosocial, psychotherapeutic and familial approaches are usually first-line treatment options [40], severe behavior disorders are frequently refractory to such approaches [28,34]. In these cases, especially when aggression is the main symptom, and/or when comorbidity is heavier, medications can improve some maladaptive behaviors and increase the person’s ability to benefit from non-pharmacologic interventions [2]. Primary targets of pharmacotherapy include severe aggression toward self and others [42].…”

Section: Introductionmentioning

confidence: 99%

Olanzapine treatment in adolescents with severe conduct disorder

et al. 2006

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The most severe forms of conduct disorder (CD) are highly stable and disabling disorders, more likely to persist in time and to evolve into disruptive or antisocial behaviors. One crucial issue in the prognosis of these forms of CD is the high resistance to both non-pharmacological and pharmacological treatments, with antipsychotic drugs being frequently used in refractory cases. Aim of this study was: (1) to explore efficacy and tolerability of olanzapine treatment in adolescents with severe CD; (2) to identify predictors of olanzapine treatment outcome. This was a retrospective study, based on clinical records of the first 23 adolescents diagnosed as having a CD, diagnosed with a clinical interview (K-SADS), either pure or with comorbid diagnoses, and treated with olanzapine. All these patients did not respond satisfactorily to non-pharmacological intervention and to adequate dosages of mood stabilizers (lithium and/or valproate). The sample consisted of 16 males and seven females, 16 inpatients and seven outpatients (mean age 13.6 +/- 1.9 years, range 11-17.2 years), followed-up for a period ranging from 6 to 12 months (mean 8.8 +/- 2.7 months). Outcome measures included the Modified Overt Aggression Scale (MOAS), Clinical Global Impression-Improvement (CGI-I) and Children Global Assessment Scale (CGAS). During the follow-up, all patients were involved in non-pharmacological treatments (psychotherapy, family therapy, or day-hospital group treatments). Based on both an improvement of at least 50% at MOAS and a score 1 or 2 at CGI-I, 14 out of 23 patients (60.9%) were classified as responders at the end of the follow-up. Significant improvement at the last observation was found in MOAS (P < 0.001) and CGAS (P < 0.001) scores. Olanzapine dosage was 8 +/- 3.2 mg/day (range 5-20 mg/day). Mean weight gain at the end of the follow-up was 4.6 +/- 3 kg. The predictors of a positive treatment response was an impulsive-affective versus controlled-predatory type of aggression. Age at onset of CD and comorbid disorders did not affect treatment response. These preliminary findings suggest that olanzapine may improve behavior in adolescents with severe and treatment-refractory CD and impulsive aggression.

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Section: Introductionmentioning

confidence: 99%

Olanzapine treatment in adolescents with severe conduct disorder

et al. 2006

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“…More recently, this attitude has changed to one of cautious encouragement as research in psychosocial treatments (1,(19)(20)(21)(22), and psychopharmacological interventions (1,(23)(24)(25)(26)(27)(28) document some success in the treatment of early onset aggression, antisocial problems, and conduct disorder. However, children with CD remain difficult to treat quickly, efficiently, and effectively in clinical settings.…”

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confidence: 99%

Conduct Disorder Subtype and Comorbidity

Connor

Ford

Albert

et al. 2007

Annals of Clinical Psychiatry

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“…If subjects were not benefiting from psychostimulants at study entry by parent report, these drugs were discontinued. Clonidine (up to 0.3 µg/kg per day) was allowed as a rescue medication to treat agitation (Bassarath 2003) to a maximum of 3 doses per week for a total of 3 weeks over 12 months. Otherwise, no other medications were allowed.…”

Section: Pharmacotherapymentioning

confidence: 99%