 |
|
A Double-Blind Placebo-Controlled Study of Lithium in Hospitalized Aggressive Children and Adolescents With Conduct Disorder
Richard P. Malone, MD;
Mary Anne Delaney, MD;
James F. Luebbert, MD;
Jacqueline Cater, PhD;
Magda Campbell, MD
Arch Gen Psychiatry. 2000;57:649-654.
Background A subgroup of children and adolescents with conduct disorder are characterized by severe and persistent aggression. Although there is no agreed on treatment for such aggression, lithium carbonate has shown promise in some studies involving children. Our study was designed to critically assess the efficacy of lithium in the treatment of aggression in children and adolescents using a measure specific for aggression.
Methods Subjects were inpatients with conduct disorder hospitalized because of severe and chronic aggression. A parallel-groups design was used in this double-blind, placebo-controlled trial with randomization to lithium or placebo. Only those who met the aggression criterion during the 2-week placebo-baseline period were randomized to 4 weeks of treatment. Outcome measures included Clinical Global Impressions, the Global Clinical Judgements (Consensus) Scale, and the Overt Aggression Scale.
Results Eighty-six inpatients enrolled in the study; 40 (33 male and 7 female; median age, 12.5 years) entered and completed the treatment phase. Lithium was statistically and clinically superior to placebo. Sixteen of 20 subjects in the lithium group were responders on the Consensus ratings vs 6 of 20 in the placebo group (P=.004). Ratings on the Overt Aggression Scale decreased significantly for the lithium group vs the placebo group (P=.04). More than half of the subjects in the lithium group experienced nausea, vomiting, and urinary frequency.
Conclusions Lithium is a safe and effective short-term treatment for aggression in inpatients with conduct disorder, although its use is associated with adverse effects.
From the Department of Psychiatry, MCP Hahnemann University, Philadelphia, Pa (Drs Malone, Delaney, and Luebbert); Biomedical Statistical Consulting, Wynnewood, Pa (Dr Cater); and the Department of Psychiatry, New York University School of Medicine, New York, NY (Dr Campbell). Dr Luebbert is now Associate Medical Director of Community Behavioral Health, Philadelphia.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Pediatric Bipolar Disorder
Leibenluft and Rich
Focus 2008;6:331-347.
ABSTRACT
| FULL TEXT
An update on interventions for conduct disorder
Scott
Adv. Psychiatr. Treat. 2008;14:61-70.
ABSTRACT
| FULL TEXT
Scientifically Unsupported and Supported Interventions for Childhood Psychopathology: A Summary
Lilienfeld
Pediatrics 2005;115:761-764.
ABSTRACT
| FULL TEXT
Oppositional Defiant Disorder and Conduct Disorder: A Review Of The Past 10 Years, Part II
Burke et al.
Focus 2004;2:558-576.
ABSTRACT
| FULL TEXT
Treatment Recommendations for the Use of Antipsychotics for Aggressive Youth (TRAAY), Part I: A Review
Schur et al.
Focus 2004;2:596-607.
ABSTRACT
| FULL TEXT
Suicide Risk in Bipolar Disorder During Treatment With Lithium and Divalproex
Goodwin et al.
JAMA 2003;290:1467-1473.
ABSTRACT
| FULL TEXT
Long-Term Safety and Efficacy of Risperidone for the Treatment of Disruptive Behavior Disorders in Children With Subaverage IQs
Turgay et al.
Pediatrics 2002;110:e34-34.
ABSTRACT
| FULL TEXT
Psychiatric Aspects of Impulsivity
Moeller et al.
Am. J. Psychiatry 2001;158:1783-1793.
ABSTRACT
| FULL TEXT
Lithium reduced aggression and was safe in aggressive children and adolescents with conduct disorder admitted to hospital
Hamilton
Evid. Based Ment. Health 2001;4:17-17.
FULL TEXT
|
