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In a recent chart-review study (Journal Watch Psychiatry Oct 6 2004), pediatric patients with bipolar disorder and attention deficit hyperactivity disorder had poor outcomes after treatment with mood stabilizers. In a new study, researchers investigated whether adding treatment with stimulants to treat the comorbid ADHD would improve outcome.
Forty subjects with the two disorders (mean age, 9 years) were treated openly with divalproex for 8 weeks (mood-stabilization phase). The 32 subjects (80%) who had at least a 50% decrease in mood-scale scores then entered into a randomized, double-blind, crossover trial of add-on mixed amphetamine salts (10 mg/day) or placebo; each crossover arm lasted 2 weeks. After the crossover phase, the researchers…