Bupropion Sustained Release in Adolescents With Comorbid Attention-Deficit/Hyperactivity Disorder and Depression

Daviss, W. Burleson; Bentivoglio, Paolo; Racusin, Robert; Brown, Kenneth M.; Bostic, Jeff Q.; Wiley, Lynn

doi:10.1097/00004583-200103000-00010

Cited by 139 publications

(43 citation statements)

References 18 publications

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“…However, in a later doubleblind, placebo-controlled study, atomoxetine improved ADHD symptoms, but did not significantly differ from placebo in improving depressive symptoms (Atomoxetine ADHD and Comorbid MDD Study Group et al 2007). In an open-label trial of bupropion sustained-release, 14 of 24 adolescents were rated as responders in both depression and ADHD, providing data supportive of further placebo-controlled studies of bupropion (Daviss et al 2001).…”

Section: Introductionmentioning

confidence: 75%

Treatment Response in Depressed Adolescents With and Without Co-Morbid Attention-Deficit/Hyperactivity Disorder in the Treatment for Adolescents with Depression Study

Kratochvil

May

Silva

et al. 2009

Journal of Child and Adolescent Psychopharmacology

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Objective: In the Treatment for Adolescents with Depression Study (TADS), fluoxetine (FLX) and the combination of fluoxetine with cognitive-behavioral therapy (COMB) had superior improvement trajectories compared to pill placebo (PBO), whereas cognitive-behavioral therapy (CBT) was not significantly different from PBO. Because attention-deficit= hyperactivity disorder (ADHD) and major depressive disorder (MDD) frequently co-exist, we examined whether ADHD moderated these outcomes in TADS. Method: A total of 439 adolescents with MDD, 12-17 years old, were randomized to FLX, CBT, COMB, or PBO. Random coefficients regression models examined depression improvement in 377 depressed youths without ADHD and 62 with ADHD, including 20 who were treated with a psychostimulant. Results: Within the ADHD group, the improvement trajectories of the three active treatments were similar, all with rates of improvement greater than PBO. For those without ADHD, only COMB had a rate of improvement that was superior to PBO. Conclusions: Co-morbid ADHD moderated treatment of MDD. CBT alone or FLX alone may offer benefits similar to COMB in the treatment of MDD in youths with co-morbid MDD and ADHD, whereas monotherapy may not match the benefits of COMB for those without ADHD. The ADHD subgroup analysis presented in this paper is exploratory in nature because of the small number of youths with ADHD in the sample. Clinical Trial Registry: www.clinicaltrials.gov Identifier: NCT00006286. The TADS protocol and all of the TADS manuals are available on the Internet at https:==trialweb.dcri.duke.edu=tads=index.html.

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Section: Introductionmentioning

confidence: 75%

Treatment Response in Depressed Adolescents With and Without Co-Morbid Attention-Deficit/Hyperactivity Disorder in the Treatment for Adolescents with Depression Study

Kratochvil

May

Silva

et al. 2009

Journal of Child and Adolescent Psychopharmacology

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“…MTA findings were limited by the poor agreement between the DISC and the CBCL proxies, the lack of mania-specific assessment tools, and the retrospective nature of the review. In contrast, other trials have found that youths with affective co-morbidity have a reduced response to ADHD medications (Biederman et al 1998;Daviss et al 2001;Gadow et al 2002).…”

mentioning

confidence: 86%

The Efficacy and Tolerability of Methylphenidate and Behavior Modification in Children with Attention-Deficit/Hyperactivity Disorder and Severe Mood Dysregulation

Waxmonsky

Pelham

Gnagy

et al. 2008

Journal of Child and Adolescent Psychopharmacology

125

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Objectives: This study examines the tolerability and efficacy of methylphenidate (MPH) and behavior modification therapy (BMOD) in children with attention-deficity/hyperactivity disorder (ADHD) and severe mood dysregulation (SMD). Methods: Children (ages 5-12) from a summer program for ADHD were screened for SMD and additional manic-like symptoms using structured assessments and direct clinical interview with the Young Mania Rating Scale (YMRS). The SMD group was comprised of 33 subjects with SMD and elevated YMRS scores (mean ϭ 23.7). They underwent weekly mood assessments plus the daily ADHD measures that are part of the program. The comparison group (n ϭ 68) was comprised of the rest of the program participants. Using a crossover design, all subjects in both groups were treated with three varying intensities of BMOD (no, low, high) each lasting 3 weeks, with MPH dose (placebo, 0.15 mg/kg t.i.d., 0.3mg/kg t.i.d., and 0.6mg/kg t.i.d.) varying daily within each behavioral treatment. Results: Groups had comparable ADHD symptoms at baseline, with the SMD group manifesting more oppositional defiant disorder/conduct disorder (ODD/CD) symptoms (p Ͻ 0.001). Both groups showed robust improvement in externalizing symptoms (p Ͻ 0.001). There was no evidence of differential treatment efficacy or tolerability. Treatment produced a 34% reduction in YMRS ratings in SMD subjects (p -0.001). However, they still exhibited elevated YMRS ratings, more ODD/CD symptoms (p Ͻ 0.001), and were more likely to remain significantly impaired at home than non-SMD subjects (p Ͻ 0.05). Conclusions: MPH and BMOD are tolerable and effective treatments for children with ADHD and SMD, but additional treatments may be needed to optimize their functioning. 573

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“…Although some drugs could be useful as monotherapy for the treatment of co-morbid ADHD and depressive or anxiety disorders (Daviss et al 2001 ;Geller et al 2007), high prevalence and severity of co-morbidity between the two disorders often call for the use of additional strategies (Larson et al 2011). However, it remains unclear whether the combination of stimulants and antidepressants is the optimal strategy for these situations and which particular drugs it is preferable to include in polypharmacy patterns.…”

Section: Increase In the Use Of Polypharmacy Involving Antidepressantsmentioning

confidence: 99%

Polypharmacy with antidepressants in children and adolescents

Díaz‐Caneja

Espliego

Parellada

et al. 2012

Int. J. Neuropsychopharm.

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The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.

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Bupropion Sustained Release in Adolescents With Comorbid Attention-Deficit/Hyperactivity Disorder and Depression

Cited by 139 publications

References 18 publications

Treatment Response in Depressed Adolescents With and Without Co-Morbid Attention-Deficit/Hyperactivity Disorder in the Treatment for Adolescents with Depression Study

Treatment Response in Depressed Adolescents With and Without Co-Morbid Attention-Deficit/Hyperactivity Disorder in the Treatment for Adolescents with Depression Study

The Efficacy and Tolerability of Methylphenidate and Behavior Modification in Children with Attention-Deficit/Hyperactivity Disorder and Severe Mood Dysregulation

Polypharmacy with antidepressants in children and adolescents

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