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A Pilot Study of Methyiphenidate, Clonidine, or the Combination in ADHD Comorbid with Aggressive Oppositional Defiant or Conduct Disorder

Division of Child and Adolescent Psychiatry and Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA; Department of Psychiatry, 7th floor, University of Massachusetts Medical School, 55 Lake Ave., North, Worcester, MA 01655

Russell A. Barkley, PhD

Heather T. Davis, RN, MS, CS

Division of Child and Adolescent Psychiatry and Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA

A pilot comparison of the safety and efficacy of methylphenidate (MPH) combined with clonidine, clonidine monotherapy, or MPH monotherapy in 6to 16-year-old children diagnosed with attention deficit hyperactivity disorder (ADHD) and comorbid aggressive oppositional defiant disorder or conduct disorder was completed. Study design was a 3-month, randomized, blinded, group comparison with eight subjects per group. No placebo comparison was used. All three treatment groups showed significant improvements in attention deficits, impulsivity, oppositional, and conduct disordered symptoms as assessed by parent and teacher rating scales and laboratory measures. Significant differences among treatment groups were found only on a few measures. Only the clonidine monotherapy group showed significantly decreased fine motor speed. These results suggest the safety and efficacy of clonidine alone or in combination with MPH for the treatment of ADHD and aggressive oppositional and conduct disorders.

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