Aripiprazole in Children and Adolescents with Conduct Disorder: A Single-Center, Open-Label Study

Objective: The aim of this study was to determine the effectiveness and safety of aripiprazole in children and adolescents with both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). Methods: 20 children and adolescents, ranging in age from 6-16 years, participated in a single-center, open-label study (19 to completion). We began treating patients with 2.5 mg of aripiprazole in an open-label fashion for 8 weeks. Outcome measures included the Turgay DSM-IV-based child and adolescent behavior disorders screening and rating scale (T-DSM-IV), the clinical global impressions-severity and improvement scales (CGI-S and CGI-I), the child behavior checklist (CBCL), the teachers report form (TRF) and the extrapyramidal symptom rating scale (ESRS), along with laboratory assessments. Results: The mean daily dosage of aripiprazole at the end of 8 weeks was 8.55 mg (SD = 1.73), with a maximum dosage of 10 mg. Based on the global improvement subscale of the CGI, we classified 12 of 19 patients (63.1%) as responders (very much or much improved). We observed significant improvements after aripiprazole treatment with regard to inattention, hyperactivity/impulsivity, ODD, and CD subscales of the T-DSM-IV (parent, teacher and clinician forms). We also observed significant improvements on many of the CBCL and TRF subscales (e.g., attention problems as well as delinquent and aggressive behavior). The participants tolerated aripiprazole, and no patient was excluded from the study because of adverse drug events. Conclusion: Aripiprazole is an effective and well-tolerated treatment for ADHD and CD symptoms; however, additional studies (specifically, placebo-controlled and double-blind studies) are needed to better define the clinical use of aripiprazole in children and adolescents with ADHD-CD.