Stimulant Medication Shortens the Duration of Impairing Emotional Outbursts

Lauren M. Spring MD, Joseph E. Schwartz PhD, Gabrielle A. Carlson MD
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Abstract

Objective

Emotional dysregulation, often presenting as severe emotional outbursts, is being increasingly recognized as a source of considerable impairment for individuals with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to conduct a secondary analysis of data examining the impact of standing stimulant medication on the duration of emotional outbursts.

Method

The as needed (PRN)–medicated outbursts of psychiatrically hospitalized children, 5 to 12 years of age, were tracked by psychiatric nurses using the Behavioral Activity Rating Scale from the time of PRN administration until the child became calm. The impact of extended-release (ER), immediate-release (IR) stimulant and dose, type and reason for outburst/PRN (aggression, agitation, distress), standing concomitant psychotropic medications and time of day, and days since admission were examined.

Results

Forty-seven children had a total of 405 outbursts, 96 of which occurred when no stimulant was prescribed and 309 with stimulant medication. Controlling for time of day and standing neuroleptic dose, outbursts that occurred on an ER stimulant medication were statistically significantly shorter than those that occurred on no stimulant by about 20 minutes (52.7 vs 72.4 minutes), or 30 minutes for aggressive outbursts. Results were unchanged when further controlling for stimulant type and dose, α-agonist, days since admission, PRN medication type, or reason for PRN/outburst. Immediate-release stimulants and short-acting stimulants did not shorten outburst duration.

Conclusion

In children with ADHD with severe outbursts, ER stimulants were associated with shorter outburst duration than IR stimulants.

Plain language summary

This study examined psychiatrically hospitalized children with attention-deficit/hyperactivity disorder who had emotional outbursts requiring as-needed medication. Children who took extended-release stimulant medication (stimulants that are designed to last throughout the day) had shorter outbursts (by about 20 minutes) than children on no stimulant medication or short-acting stimulant medication.
兴奋剂能缩短情绪失控的持续时间
情绪失调,通常表现为严重的情绪爆发,越来越多地被认为是注意力缺陷多动障碍(ADHD)患者严重损害的一个原因。本研究的目的是对长期服用兴奋剂药物对情绪爆发持续时间的影响进行二次分析。方法对5 ~ 12岁精神科住院儿童按需服药(PRN)至患儿平静期间,由精神科护士采用行为活动评定量表进行跟踪。检查了缓释(ER)、速释(IR)兴奋剂的影响、剂量、爆发/PRN(攻击、躁动、痛苦)的类型和原因、长期服用精神药物的时间、入院后的天数。结果47例患儿共发生405次情绪爆发,其中96例发生在未使用兴奋剂时,309例发生在使用兴奋剂时。控制一天中的时间和固定的抗精神病药剂量,服用ER兴奋剂的发作时间比未服用ER兴奋剂的发作时间短约20分钟(52.7分钟vs 72.4分钟),或30分钟的攻击性发作时间。在进一步控制兴奋剂类型和剂量、α-激动剂、入院天数、PRN用药类型和PRN/爆发原因后,结果没有变化。立即释放的兴奋剂和短效兴奋剂不缩短爆发持续时间。结论在严重爆发的ADHD患儿中,ER刺激剂比IR刺激剂能缩短爆发持续时间。本研究调查了患有注意力缺陷/多动障碍的精神科住院儿童,这些儿童有情绪爆发,需要按需用药。服用缓释性兴奋剂药物(设计为全天持续的兴奋剂)的儿童比不服用兴奋剂药物或短效兴奋剂药物的儿童爆发时间更短(大约20分钟)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAACAP open
JAACAP open Psychiatry and Mental Health
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