Trial reportJournal of child and adolescent psychopharmacology2009
Lack of effect of stimulant combination with second-generation antipsychotics on weight gain, metabolic changes, prolactin levels, and sedation in youth with clinically relevant aggression or oppositionality.
Trial report in Journal of child and adolescent psychopharmacology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- Antipsychotic and psychostimulant drug combination therapy in attention deficit/hyperactivity and disruptive behavior disorders: a systematic review of efficacy and tolerability.Current psychiatry reports · 2013Pooled it
- Metformin add-on vs. antipsychotic switch vs. continued antipsychotic treatment plus healthy lifestyle education in overweight or obese youth with severe mental illness: results from the IMPACT trial.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2020Article
- Concomitant Use of Psychotropic Medication With Stimulants for the Treatment of ADHD in Children and Adolescents: A Retrospective Insurance Claims Study in the United States.Journal of attention disorders · 2020Article
- The effects of antipsychotics on weight gain, weight-related hormones and homocysteine in children and adolescents: a 1-year follow-up study.European child & adolescent psychiatry · 2017Article
- Activating and Tranquilizing Effects of First-Time Treatment with Aripiprazole, Olanzapine, Quetiapine, and Risperidone in Youth.Journal of child and adolescent psychopharmacology · 2016Article
- Behavioral Weight Loss Treatment in Antipsychotic Treated Youth.Scandinavian journal of child and adolescent psychiatry and psychology · 2016Article
- Impulsive Aggression as a Comorbidity of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.Journal of child and adolescent psychopharmacology · 2016Article
- Adiposity and Cardiometabolic Risk in Children With and Without Antipsychotic Drug Treatment.The Journal of clinical endocrinology and metabolism · 2015Article
- Predictors of concomitant use of antipsychotics and stimulants and its impact on stimulant persistence in pediatric attention deficit hyperactivity disorder.Journal of managed care & specialty pharmacy · 2015Article
- Wake-promoting pharmacotherapy for psychiatric disorders.Current psychiatry reports · 2014Review
- Obesity Prevention for Children with Developmental Disabilities.Current obesity reports · 2014Article
- Managing ADHD and disruptive behaviour disorders with combination psychostimulant and antipsychotic treatment.Journal of psychiatry & neuroscience : JPN · 2014Article
- Combination pharmacotherapy for psychiatric disorders in children and adolescents: prevalence, efficacy, risks and research needs.Paediatric drugs · 2013Review
- Prolactin serum concentrations during aripiprazole treatment in youth.Journal of child and adolescent psychopharmacology · 2013Review
- Polypharmacy in attention deficit hyperactivity disorder treatment: current status, challenges and next steps.Current psychiatry reports · 2012Article
- Correlates of weight gain during long-term risperidone treatment in children and adolescents.Child and adolescent psychiatry and mental health · 2012Article
- Recent advances in understanding and mitigating adipogenic and metabolic effects of antipsychotic drugs.Frontiers in psychiatry · 2012Article
- The treatment of severe child aggression (TOSCA) study: Design challenges.Child and adolescent psychiatry and mental health · 2011Article
- [Psychopharmacology of autism spectrum disorders].Der Nervenarzt · 2011Review
- First do no harm: promoting an evidence-based approach to atypical antipsychotic use in children and adolescents.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSecond-generation antipsychotics (SGAs) are associated with weight gain, metabolic abnormalities, sedation/sleep disturbance, and prolactin abnormalities, especially in youths. Although stimulants have opposing dopamine receptor and adverse effects, it is unclear whether stimulant co-treatment counteracts the therapeutic or side effects of antipsychotics.
methodsThis was a naturalistic cohort study including 153 antipsychotic trials in youths aged 4-19 (mean, 11.3 +/- 3.0) years, started on an SGA for clinically significant aggression or oppositionality associated with oppositional defiant disorder, conduct disorder, disruptive behavior disorder not otherwise specified (NOS), impulse control disorder NOS, intermittent explosive disorder, Tourette's disorder, autistic disorder, and pervasive developmental disorder NOS. Patients underwent fasting assessments of body composition, lipids, glucose, insulin, prolactin, sedation, and general efficacy at baseline, weeks 4, 8, and 12, comparing patients co-prescribed stimulants (n = 71) with those not co-prescribed stimulants (n = 82).
resultsPatients received risperidone (33.3%), aripiprazole (29.4%), quetiapine (18.4%), olanzapine (11.8%), ziprasidone (5.9%), or clozapine (0.7%). With and without adjustment for differences in baseline variables (sex, prior stimulant use, primary Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition [DSM-IV] disorders, co-morbid attention-deficit/hyperactivity disorder [ADHD], present in 46.3% of youths not receiving stimulants, and some body composition parameters), patients on versus off stimulants did not differ on any of the assessed outcomes (all p values > or = 0.1).
conclusionsIn contrast to guidelines, stimulant use did not precede or accompany antipsychotic use during the current episode of aggression/oppositionality in almost half of those youths who had aggressive/oppositional behavior and a DSM-IV diagnosis of ADHD. At the clinically prescribed doses, stimulant co-treatment of SGAs did not seem to significantly reduce antipsychotic effects on body composition, metabolic parameters, prolactin, sedation, and broad efficacy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.