Comparison of Risperidone and Aripiprazole as adjuvant Therapy in children with Atention deficit/hyperactivity disorder accopained by oppositional defiant disorder treated by Methylphenidate.

The aim of current study is to compare the Risperidone and Aripiprazole as adjuvant therapy in children with Atention Deficit/hyperactivity disorder accopained by oppositional defiant disorder treated by Methylphenidate through a double-blind, randomized, controlled trial.

This study was conducted on 60 patients with ADHD with ODD in the range of 12-6 years old who were diagnosed by a child and adolescent psychiatrist which were eligible for inclusion in the study. Participants were randomly divided into two intervention groups and one control group and each participant was assigned a code. For 20 patients in group one, Ritalin and Risperidone tablets, and for 20 patients in the second group, Ritalin and Aripiprazole, and for the other 20 patients Ritalin and Placebo are given. Before starting the study, in the second, fourth and fourth weeks after the start of the study, the Parents' Conors Questionnaire and ADHDRating Scale were assessed and drug complications were assessed based on the Drug Complaint Questionnaire.

The research consisted of 60 patients with ADHD who referred to the Sanandaj Besat Hospital. Patients were randomly divided into intervention and control groups. One group receive methylphenidate and risperidone, and another group receive methylphenidate and aripiprazole, and control group receive the methylphenidate and placebo, The results of intervention at the beginning of the research and the second, fourth and eighth weeks are measured by the questionnaire.

Inclusion criteria 1- Diagnosis of ADHD and ODD based on DSM5 2-Age between 6 -12 years 3-without effective medication taking on mental status at least 2 weeks before the study. Exclusion criteria 1- Intelectual disability based on clinical suspicious 2-presence of uncontroled siezure 3-Drug sideeffects and hypersensivity 4-Recieving of any other drugDiagnosis of ADHD and ODD based on DSM5 5-History of psychological disorder except ADHD and ODD 6-presence of medical deasese such as cardiac deasese

The research consisted of 60 participants who were randomly devided in both intervention and control groups. Intervention group: A group of randomly selected patients received methylphenidate tablets (10 mg) for the first week (one quarter of the tablet at 8:00 am and one quarter of the tablet at 4:00 PM) and the second week (half the tablet at 8:00 am and half the tablet at 4:00 PM). ) and from the third week afterwards (one tablet at 8:00 am and one tablet at 4:00 PM) Along with Risperidone powder for the first week (0.25 mg at 8:00 am and 0.25 mg at 8:00 pm) and the second week (0.5 mg at 8:00 am and 0.5 mg at 8:00 pm) and after the third week (one milligram at 8:00 am and one milligram at 8:00 pm). Intervention group: A group of randomly selected patients receive methylphenidate tablets (10 mg) for the first week (one quarter of the tablet at 8:00 am and one quarter of the tablet at 4:00 PM) and the second week (half the tablet at 8:00 am and half the tablet at 4:00 PM) and from the third week afterwards (one tablet at 8:00 am and one tablet at 4:00 PM) along with Aripiprazole for the first week (1.25 mg at 8:00 am and at 8:00 pm) and for the seconed week (2.5 mg at 8:00 am and at 8:00 pm) from the third week afterwards (5 mg at 8:00 am and at 8:00 pm). control group: this group receive methylphenidate tablets (10 mg) for the first week (one quarter of the tablet at 8:00 am and one quarter of the tablet at 4:00 PM) and the second week (half the tablet at 8:00 am and half the tablet at 4:00 PM) and from the third week afterwards (one tablet at 8:00 am and one tablet at 4:00 PM) along with placebo at 8:00 am and at 8:00 pm during 8 week of the study.

Treatment for ADHD and ODD patients

Individual based-simple randomization

The drug is prepared by the pharmacist and in coding packages which only the pharmacist is aware of its coding and deliverd by researcher to the patient. Neither the investigator, nor the patient nor the analyst, knows the contents of the drug packages and the way they are coded.