Fluoxetine and Methylphenidate in Combination for Treatment of Attention Deficit Disorder and Comorbid Depressive Disorder

Abstract

Children and adolescents with attention deficit disorders (usually with comorbid conditions), who had shown inadequate therapeutic responses to methylphenidate, were treated by the addition of fluoxetine to methylphenidate. After 8 weeks in open trial, all 32 patients showed positive therapeutic responses in attention, behavior, and affect. Thirty of the 32 children showed clinically significant responses and the other two had statistically but not clinically significant responses. After 12 weeks of treatment, one patient showed a deterioration in clinical status. The children had improved report card grades in major academic subjects {p < 0.0001), and showed significant improvements (p < 0.0001) on the Children's Global Assessment Scale (C-GAS), Conners Parents Rating Scales (CPRS), and Children's Depression Inventory (CDI). Children who initially appeared more impaired on the C-GAS, CDI, CPRS, and GPA showed more improvement on the combined regimen. No significant side effects were observed, using a gradual elevation of fluoxetine dosage. About 40% of the patients showed substantial clinical effects with doses of fluoxetine below 20 mg daily. These preliminary results suggest that fluoxetine and methylphenidate in combination may be safe and effective for some children with attention-deficit hyperactivity disorder (and with comorbid anxiety or depressive symptoms) who do not show adequate responses to methylphenidate or fluoxetine alone.

Hospitalisation prolongée et sécuritaire d’adolescents du continuum « narcissique-limite » : de l’approche psychodynamique à l’approche cognitive

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Depressão e doença bipolar na infância e adolescência

“…21,22,[60][61][62][63][64][65] Lithium carbonate, carbamazepine and valproic acid are used for mood stabilization and improvement of irritability in cases of bipolar disorder. These drugs are widely accepted by physicians; however, clinical and laboratory assessments should be considered before the use of these drugs.…”

Troubles hyperactifs avec déficit de l'attention chez les enfants et les adolescents: situation actuelle et perspectives de traitements médicamenteux

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