PEMOLINE FOR CHILDREN AND ADOLESCENTS WITH CONDUCT DISORDER - A PILOTINVESTIGATION

An uncontrolled pilot study assessed the possible clinical efficacy of pemoline for treating conduct symptoms in 10 boys with conduct disord er and attention-deficit hyperactivity disorder. Children, ages 8 to 1 4, who did not respond satisfactorily to short-term methylphenidate tr eatment (either partial treatment response, noncompliance with multipl e dosing, or side effect intolerance), received a 7-week open trial of pemoline (up to 112.5 mg daily). For the five partial responders, pem oline was added to the methylphenidate (30-60 mg daily); in the remain ing five, pemoline was substituted for methylphenidate. Two clinicians conducted independent assessments using the Children's Global Assessm ent Scale (C-GAS) and a Diagnostic and Statistical Manual of Mental Di sorders (DSM-III-R) conduct disorder symptom checklist prior to and on completion of the trial. Pemoline treatment appeared to reduce the va rious symptoms of conduct disorder. Marked behavioral improvement was observed in four children, partial improvement occurred in three, and the remaining three showed little benefit. Adverse effects were genera lly minimal and well tolerated, even when pemoline was used in combina tion with methylphenidate: One child had severe appetite loss and slee p onset delay; three others had moderate sleep problems. These prelimi nary data suggest that pemoline, alone or in combination with methylph enidate, might be useful for reducing symptoms of conduct disorder.