ADouble-Blind, Placebo-Controlled Study of Valproate for Aggression in Youth with Pervasive Developmental Disorders

Hellings, Jessica A.; Weckbaugh, Marilyn; Nickel, Elizabeth J.; Cain, Sharon; Zarcone, Jennifer R.; Reese, R. Matthew; Hall, Sandra; Ermer, D; Tsai, Luke Y.; Schroeder, Stephen R.; Cook, Edwin H.

doi:10.1089/cap.2005.15.682

Cited by 160 publications

(149 citation statements)

References 20 publications

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“…We therefore included Hellings 2005 with an inclusion criterion of significant aggression to self, others, or property at least three times a week, and Gardner 1986 who recruited on the basis of an extensive history of 'behavioural dyscontrol' which included aggression towards the self as well as towards others and property. In eight of the 14 included studies, participants were recruited on the basis of meeting criteria for a formal clinical diagnosis in addition to having displayed recurrent aggression: pervasive developmental disorder (Hellings 2005), conduct disorder (Cueva 1996), conduct disorder or oppositional defiant disorder (Donovan 2000), borderline personality disorder , personality disorder , intermittent explosive disorder (Mattes 2005;Mattes 2008), and either intermittent explosive disorder, post-traumatic stress disorder or cluster B personality disorder .…”

Section: Class Of Antiepileptic Drugmentioning

confidence: 99%

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Antiepileptics for aggression and associated impulsivity

Huband¹,

Ferriter²,

Nathan³

et al. 2008

Cochrane Database of Systematic Reviews

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Section: Class Of Antiepileptic Drugmentioning

confidence: 99%

“…One was restricted to children, aged 5 to 12 years (Cueva 1996). Three involved young people described by the authors at 'youths' or 'juveniles' in which age ranges were 9 to 14 years (Conners 1971), 10 to 12 years (Hellings 2005) and 10 to 18 years (Donovan 2000).…”

Section: Class Of Antiepileptic Drugmentioning

confidence: 99%

Antiepileptics for aggression and associated impulsivity

Huband¹,

Ferriter²,

Nathan³

et al. 2008

Cochrane Database of Systematic Reviews

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“…One major concern here is the absence of double blind designs in the respective studies. In fact, in a recent study in which a double-blind, placebo design was employed, involving children and adolescents with pervasive developmental disorders, no differences were reported between valproate and placebo treated groups over an eight week period [42]. A second concern is that the doses of drug administered ranged widely from study to study.…”

Section: Gabamentioning

confidence: 99%

The Neurobiological Bases for Development of Pharmacological Treatments of Aggressive Disorders

Siegel

Bhatt²,

Bhatt³

et al. 2007

123

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Violence and aggression are major causes of death and injury, thus constituting primary public health problems throughout much of the world costing billions of dollars to society. The present review relates our understanding of the neurobiology of aggression and rage to pharmacological treatment strategies that have been utilized and those which may be applied in the future. Knowledge of the neural mechanisms governing aggression and rage is derived from studies in cat and rodents. The primary brain structures involved in the expression of rage behavior include the hypothalamus and midbrain periaqueductal gray. Limbic structures, which include amygdala, hippocampal formation, septal area, prefrontal cortex and anterior cingulate gyrus serve important modulating functions. Excitatory neurotransmitters that potentiate rage behavior include excitatory amino acids, substance P, catecholamines, cholecystokinin, vasopressin, and serotonin that act through 5-HT2 receptors. Inhibitory neurotransmitters include GABA, enkephalins, and serotonin that act through 5-HT1 receptors. Recent studies have demonstrated that brain cytokines, including IL-1 and IL-2, powerfully modulate rage behavior. IL-1 exerts its actions by acting through 5-HT2 receptors, while IL-2 acts through GABAA or NK1 receptors. Pharmacological treatment strategies utilized for control of violent behavior have met with varying degrees of success. The most common approach has been to apply serotonergic compounds. Others included the application of antipsychotic, GABAergic (anti-epileptic) and dopaminergic drugs. Present and futures studies on the neurobiology of aggression may provide the basis for new and novel treatment strategies for the control of aggression and violence as well as the continuation of existing pharmacological approaches.

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“…Behavioral benefits of valproic scid, lamotrigine, and carbamazepine have been looked at in a small number of patients in combination with epileptic discharges. 48,49 No clear results were determined. Other studies looking at memantine hydrochloride in children to increase language production are currently underway.…”

Section: Review Of the Literaturementioning

confidence: 99%

Intervention for autistic spectrum disorders

Filipek

Steinberg-Epstein

Book

2006

NeuroRX

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Summary:A comprehensive approach to the assessment of any child with autism must be matched specifically to each individual child and family. This premise holds for medical therapies and special education services as well as psychopharmacologic interventions. Behavioral, as opposed to pharmacologic, treatment is the hallmark of effective intervention for autism. Physicians involved in the care of children with autism need to become familiar with educational law and intervention recommendations. Goals should include improved functional verbal and nonverbal communication and social skills, increased engagement in developmentally appropriate activities, improved fine and gross motor skills, and the development of independent academic and organizations skills, as well as replacement of problem behaviors with developmentally appropriate behaviors.. Medicating children with autism is difficult, but is often necessary for chronic behavioral difficulties. In the absence of clear and present guidelines, we have attempted to use evidence and clinical experience to suggest an algorithm based on symptom clusters. Although children with autism may be responsive to medications at lower doses and more susceptible to side effects than other children, medical intervention can produce a significant improvement in the quality of life for the child and family. Careful thought leading to correct identification of target behaviors can appropriately direct better alternatives for medication. Although these approaches are costly and time-consuming endeavors, the expenditure of such efforts is the only available pathway to improve the potential outcomes for individuals with autism as well as decrease the lifetime societal costs for each individual.

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ADouble-Blind, Placebo-Controlled Study of Valproate for Aggression in Youth with Pervasive Developmental Disorders

Abstract: The present negative findings cannot be viewed as conclusive, partly owing to the large placebo response, subject heterogeneity, and size of the groups. Larger studies are needed to expand upon these findings.

Cited by 160 publications

References 20 publications

Antiepileptics for aggression and associated impulsivity

Antiepileptics for aggression and associated impulsivity

The Neurobiological Bases for Development of Pharmacological Treatments of Aggressive Disorders

Intervention for autistic spectrum disorders

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