Drug Protocol May Improve DMDD Prognosis

NEW ORLEANS—A unique medication protocol consisting of an anticonvulsant and a dopamine agonist lowered rehospitalization rates among children with disruptive mood dysregulation disorder (DMDD), according to a study presented at Psych Congress 2017.

“The DSM-5 diagnosis of DMDD has minimal research available exploring psychopharmacological approaches to address the hallmark symptoms of severe, recurrent temper outbursts and persistent irritability,” researchers wrote in a poster abstract. “Treated with currently applied medication protocols, a poor long-term functional prognosis has been demonstrated.”

The study included 91 children, 6 to 17 years of age, who met diagnostic criteria for DMDD. All had received inpatient treatment for severe aggression, impulsive behaviors, and mood instability.

The patients were discharged with prescriptions for an anticonvulsant (oxcarbazepine), which targeted mood lability and angry outbursts, and a dopamine agonist (amantadine hydrochloride), which targeted symptoms of impulsivity, irritability, and concentration problems. Outpatient providers were asked to comply with the protocol as patients’ clinical presentations allowed.

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Over the next year, 8% of patients who remained on the anticonvulsant-dopamine agonist protocol required rehospitalization, compared with 26% of patients who ceased the medication protocol. The relationship between rehospitalization rates and compliance was significant.

“The protocol,” researchers concluded, “provides significantly lower rates of rehospitalization and potentially improved functional prognosis” for children with DMDD.

—Jolynn Tumolo

Reference

Matthews D, Matthews G. Disruptive mood dysregulation disorder: a unique pediatric neuropsychopharmacological approach. Poster presented at Psych Congress 2017; September 16-19, 2017; New Orleans, LA. Poster 101.