AN OPEN TRIAL OF VENLAFAXINE IN THE TREATMENT OF ATTENTION-DEFICIT HYPERACTIVITY DISORDER IN CHILDREN AND ADOLESCENTS/

A 5-week open trial of venlafaxine was conducted in 16 children and ad olescents (mean age 11.6 years) with attention-deficit/hyperactivity d isorder (ADHD) in order to estimate the appropriate dosage range and t o determine the extent of side effects. Subjects were evaluated using a structured clinical interview and a computerized diagnostic assessme nt, and subjects diagnosed with ADHD and without comorbid depression w ere asked to enter the study. Conners Parent Rating Scale (CPRS) and C onners Continuous Performance Test (CPT) were performed at baseline an d at the end of the 5-week trial. Two subjects were lost to follow-up. Of the remaining 14 patients, 7 subjects displayed a decrease of at l east one standard deviation from their baseline on one of the CPRS sub scale scores and had subjective reports from parents of improved behav ior. There were no statistically significant effects of venlafaxine on reaction times or on the number of commission and omission errors on CPT. Three ADHD subjects displayed a worsening of their hyperactivity and required discontinuation of venlafaxine, and nausea led to drug di scontinuation in 1 patient. The mean daily dose of venlafaxine was 60 mg (1.4 mg/kg), administered 2-3 divided doses, there were no effects on blood pressure or heart rate. In this sample, low doses of venlafax ine appeared to be effective in reducing behavioral but not cognitive symptoms of ADHD in 7 of 16 children and adolescents (44%), and advers e effects were not tolerable in 4 of 16 patients (25%). These prelimin ary results suggest that venlafaxine may aggravate symptoms of hyperac tivity, consistent with the behavioral activation reported with fluoxe tine and sertraline in children.