Disruptive Mood Dysregulation Disorder Clinical Trial
Official title:
Aripiprazole Added on Methylphenidate in the Treatment of Youths With Comorbid ADHD and DMDD
Objectives:
1. To investigate the effectiveness of adjuvant with aripiprazole to methylphenidate for
disruptive mood dysregulation disorder (DMDD) in youths with
attention-deficit/hyperactivity disorder (ADHD)
2. To investigate the neural basis of chronic irritability in youths with functional
magnetic resonance imaging (fMRI)
3. To compare the clinical characteristics of youths with comorbid ADHD and DMDD to youths
with ADHD only
Background:
Disruptive mood dysregulation disorder (DMDD) in children and adolescents with
attention-deficit/hyperactivity disorder (ADHD) is a common clinical challenge and leads to
severe impact and burden on both the patients and their family. Although methylphenidate
(MPH) showed good efficacy in the treatment of ADHD, there is still lack of well-established
pharmacological treatment for DMDD. Furthermore, little research focuses on the effect of
pharmacological treatment on neural correlates of chronic irritability. Previous literature
suggested the potential role of atypical antipsychotics in the treatment of DMDD. Therefore,
this study aimed to investigate the effectiveness of adjuvant of aripiprazole (APZ) to MPH in
patients with comorbid ADHD and DMDD. In addition, the investigators explored the clinical
manifestation and neural basis of DMDD using inventories, neuropsychological tests and
neuroimaging studies.
Methods:
The investigators enrolled patients with ADHD+DMDD (n = 31) and ADHD only (n = 27). Those
subjects were evaluated with inventories of emotional and behavioral problems,
neuropsychological tests, as well as fMRI with challenging tests which aimed to induce
frustration at baseline assessment. Then, subjects of ADHD+DMDD group received 6 weeks'
combination treatment of MPH+ APZ with flexible dosage according to clinical judgment. All
the initial evaluations were administered again after treatment. The comparison of clinical
characteristics and neuroimaging findings between ADHD+DMDD group and ADHD only group will be
conducted. In addition, the effectiveness of treatment will be analyzed. The effects of
pharmacological treatment on neural correlates of chronic irritability will also be
investigated.
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