Stimulant drug treatment in childhood-onset schizophrenia with comorbid ADHD: an open-label case series

J Child Adolesc Psychopharmacol. 2004 Fall;14(3):448-54. doi: 10.1089/cap.2004.14.448.

Abstract

The administration of psychostimulants to children with psychotic symptoms is controversial. This study reports the stimulant drug response of 5 children, aged 8-15 years, with childhood-onset schizophrenia (COS) and comorbid attention deficit hyperactivity disorder (ADHD). Four COS inpatients were given stimulants for comorbid ADHD after stabilization of psychosis on antipsychotic medication. A fifth COS inpatient received stimulants while still actively psychotic, despite concurrent neuroleptic treatment. Data from the 10-item Brief Conners Teachers Ratings Scale (BCTRS) were examined the week before, and the week after, stimulant addition. A paired t test, conducted using Conners Teachers data from these 4 subjects, indicated significant improvement in ADHD symptoms (p = 0.02). Data obtained from a retrospective chart review indicated no significant worsening of psychosis. The 2 subjects treated with mixed salts of dextroamphetamine sulfate and amphetamine sulfate remained on that medication at 6 months and at the 2-year follow-up. Our results suggest that ADHD comorbid with COS may be safely treated with a stimulant, once the psychosis is stabilized. A systematic investigation of this question may be warranted.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Comorbidity
  • Dextroamphetamine / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Retrospective Studies
  • Schizophrenia / drug therapy*
  • Schizophrenia / epidemiology

Substances

  • Central Nervous System Stimulants
  • Dextroamphetamine