Pemoline for Children and Adolescents with Conduct Disorder: A Pilot Investigation

Abstract

An uncontrolled pilot study assessed the possible clinical efficacy of pemoline for treating conduct symptoms in 10 boys with conduct disorder and attention-deficit hyperactivity disorder. Children, ages 8 to 14, who did not respond satisfactorily to short-term methylphenidate treatment (either partial treatment response, noncompliance with multiple dosing, or side effect intolerance), received a 7-week open trial of pemoline (up to 112.5 mg daily). For the five partial responders, pemoline was added to the methylphenidate (30-60 mg daily); in the remaining five, pemoline was substituted for methylphenidate. Two clinicians conducted independent assessments using the Children's Global Assessment Scale (CGAS) and a Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) conduct disorder symptom checklist prior to and on completion of the trial. Pemoline treatment appeared to reduce the various 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 generally minimal and well tolerated, even when pemoline was used in combination with methylphenidate: One child had severe appetite loss and sleep onset delay; three others had moderate sleep problems. These preliminary data suggest that pemoline, alone or in combination with methylphenidate, might be useful for reducing symptoms of conduct disorder.