Stimulants Appear to Decrease Anxiety in Youth With ADHD

DENVER – Psychostimulants administered for attention-deficit/hyperactivity disorder quelled comorbid anxiety in the majority of patients in a retrospective study.

Moreover, concomitant therapy with an atypical antipsychotic agent did not necessarily protect against an increase in anxiety in a 134-patient study.

The 134 youths, mean age 10.2 years, all met DSM-IV criteria for attention-deficit/hyperactivity disorder (ADHD).

They were evaluated in terms of the change over time in anxiety scores on the parent-completed Achenbach Child Behavior Checklist.

Eighty children were on psychostimulant medication only. The other 54 were on a psychostimulant plus an atypical antipsychotic agent, Dr. Drake D. Duane said at the meeting.

Twenty-four patients had clinically significant anxiety, as deemed by a baseline Achenbach anxiety T score greater than 65 prior to going on psychostimulant-only therapy. Upon follow-up after a minimum of 4 months on psychostimulant therapy, 20 of the 24 (83%) had a reduction in their parent-reported anxiety T score to less than 65.

Only 3 patients (5%) with a baseline anxiety score less than 65 had an increase in anxiety score to more than 65 while on psychostimulant-only therapy, according to Dr. Duane of the Institute for Developmental Behavioral Neurology at Arizona State University, Tempe.

Fifteen of the 54 patients placed on a psychostimulant plus an atypical antipsychotic medication had a pretreatment anxiety score above 65; 7 (47%) of them showed an on-treatment drop below the 65-point threshold.

Twelve of the 39 patients (31%) with an initial anxiety score less than 65 showed an on-treatment increase in anxiety score to greater than 65.

Dr. Duane declared having no financial conflicts.