The aim of this study was to describe the long-term safety and effectiveness of quetiapine in conduct disorder (CD).
This was an 18-week outpatient follow-up study of an acute trial that enrolled aggressive children ages 6-12 years with a primary diagnosis of CD. To be enrolled into this study, subjects had to have successfully completed participation in the initial 8-week, open-label, outpatient quetiapine trial. Psychometric measures included the Rating of Aggression Against People and/or Property Scale (RAAPP), the Nisonger Child Behavior Rating Form (NCBRF), the Conners' Parent Rating Scale (CPRS-48), the Clinical Global Impressions Scale of Severity (CGI-S), and the Children's Global Assessment Scale.
Nine males with a mean age of 8.9 (SD = 1.2) years were treated. The median quetiapine dose at end of study was 150 mg/day (range 75-350). Mean psychometric scores did not change substantively from baseline. No patients experienced extrapyramidal side effects. Three subjects discontinued due to study nonadherence. No patients discontinued treatment due to an adverse event.
These preliminary data suggest that quetiapine might be a generally safe and effective maintenance treatment for aggressive children with CD who initially respond to an acute therapeutic trial of quetiapine. More research is needed to confirm or refute these initial findings.
[Show abstract][Hide abstract] ABSTRACT: Modelling error can be the cause of bad performance when optimal feed-rate profiles computed for a particular model are applied to the actual plant. This paper suggests the modification of the input trajectory from batch to batch, by using information from previous batches to modify the trajectories that are applied to the subsequent ones. The proposed approach does not required the remodeling of the process, but instead it redermines the input profile directly, so that a steady improvement is accomplished from batch to batch.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine whether quetiapine is superior to placebo in the treatment of adolescents with conduct disorder.
This was a 7-week, randomized, double-blind, placebo-controlled pilot study with two parallel arms. Nine youths were randomly assigned to receive quetiapine, and 10 youths were randomly assigned to receive placebo. Patients were assessed weekly throughout the trial. Quetiapine was dosed twice daily, and medications could be titrated flexibly through the end of study week 5. The dose was fixed for the final 2 weeks of the study. The primary outcome measures were the clinician-assessed Clinical Global Impressions-Severity (CGI-S) and-Improvement (CGI-I) scales. Secondary outcome measures included parent-assessed quality of life, the overt aggression scale (OAS), and the conduct problems subscale of the Conners' Parent Rating Scale (CPRS-CP).
The final mean dose of quetiapine was 294 +/- 78 mg/day (range 200-600 mg/day). Quetiapine was superior to placebo on all clinician-assessed measures and on the parent-assessed quality of life rating scale. No differences were found on the parent-completed OAS and CPRS-CP. Quetiapine was well tolerated. One patient randomized to quetiapine developed akathisia, requiring medication discontinuation. No other extrapyramidal side effects occurred in patients receiving active drug.
This methodologically controlled pilot study provides data that quetiapine may have efficacy in the treatment of adolescents with conduct disorder. Because of the preliminary nature of the study, further research with larger samples is needed to confirm these findings.
Journal of Child and Adolescent Psychopharmacology 05/2008; 18(2):140-56. DOI:10.1089/cap.2006.0007 · 2.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Children with psychiatric illness may display pathologic aggression (PA) that is destructive, severe, chronic, and unresponsive to psychosocial and psychopharmacological treatment of their underlying condition(s) and psychosocial interventions specifically targeting PA. For this subset of children with PA, pharmacotherapy may be an appropriate treatment option to optimize their functioning. This article reviews pharmacological treatment studies for PA in children and the safety and efficacy of risperidone, olanzapine, lithium, divalproex sodium, methylphenidate, and typical antipsychotics in this patient population. While safety needs to be emphasized when prescribing medication for these patients, serious health and safety risks are also raised when PA is not effectively treated. Future research is needed to evaluate whether the long-term risks associated with the pharmacological treatment of PA outweigh the potential benefits to the child.
International Review of Psychiatry 05/2008; 20(2):151-7. DOI:10.1080/09540260801887819 · 1.80 Impact Factor
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