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J Am Acad Child Adolesc Psychiatry. 2015 Jul;54(7):550-6. doi: 10.1016/j.jaac.2015.04.004. Epub 2015 Apr 27.

Pharmacotherapy of the Preschool ADHD Treatment Study (PATS) Children Growing Up.

Author information

1
National Institute of Mental Health (NIMH), Bethesda, MD. Electronic address: bvitiell@nih.gov.
2
independent statistical contractor.
3
Columbia University Medical Center and New York State Psychiatric Institute (NYSPI), New York.
4
New York University School of Medicine, New York.
5
University of California, Los Angeles.
6
Duke University School of Medicine, Durham, NC.
7
University of California, Irvine when this work was conducted and now are with AVIDA Inc., Newport Beach, CA.
8
Johns Hopkins University School of Medicine, Baltimore.

Abstract

OBJECTIVE:

To describe the long-term psychopharmacological treatment of children first diagnosed with attention-deficit/hyperactivity disorder (ADHD) as preschoolers.

METHOD:

In a systematic, prospective, naturalistic follow-up, 206 (68.0%) of the 303 children who participated in the Preschool ADHD Treatment Study (PATS) were reassessed 3 years (mean age 7.4 years) and 179 (59.1%) were reassessed 6 years (mean age 10.4 years) after completion of the controlled study. Pharmacotherapy and clinical data were obtained from the parents. Pharmacotherapy was defined as use of a specific class of medication for at least 50% of the days in the previous 6 months.

RESULTS:

At year 3, a total of 34.0% of the participants were on no pharmacotherapy, 41.3% were on stimulant monotherapy, 9.2% were on atomoxetine alone or with a stimulant, 8.3% were on an antipsychotic usually together with a stimulant, and the remaining 7.2% were on other pharmacotherapy; overall, 65.0% were on an indicated ADHD medication. At year 6, a total of 26.8% of the participants were on no pharmacotherapy, 40.2% were on stimulant monotherapy, 4.5% were on atomoxetine alone or with a stimulant, 13.4% were on an antipsychotic, and 15.1% were on other pharmacotherapy; overall, 70.9% were on an indicated ADHD medication. Antipsychotic treatment was associated with more comorbidity, in particular disruptive behavior disorders and pervasive development disorders, and a lower level of functioning.

CONCLUSION:

In this study, the long-term pharmacotherapy of preschoolers with ADHD was heterogeneous. Although stimulant medication continued to be used by most children, about 1 child in 4 was off medication, and about 1 in 10 was on an antipsychotic.

KEYWORDS:

ADHD; medication; preschoolers; stimulant

PMID:
26088659
PMCID:
PMC4475273
DOI:
10.1016/j.jaac.2015.04.004
[Indexed for MEDLINE]
Free PMC Article

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