P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study

B Vitiello; J L Hill; J Elia; E Cunningham; S V McLeer; D Behar

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P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study

Journal article

Peer reviewed

P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study

B Vitiello, J L Hill, J Elia, E Cunningham, S V McLeer and D Behar

The journal of clinical psychiatry, v 52(12), pp 499-501

Dec 1991

PMID: 1752851

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Abstract

Administration, Oral

Adolescent

Age Factors

Aggression - drug effects

Attention Deficit Disorder with Hyperactivity - drug therapy

Attention Deficit Disorder with Hyperactivity - psychology

Child

Child Behavior Disorders - drug therapy

Child Behavior Disorders - psychology

Child, Preschool

Depressive Disorder - drug therapy

Depressive Disorder - psychology

Diphenhydramine - administration & dosage

Double-Blind Method

Hospitalization

Humans

Hypnotics and Sedatives - administration & dosage

Injections, Intramuscular

Male

Mental Disorders - drug therapy

Mental Disorders - psychology

Pilot Projects

Placebos

Psychiatric Status Rating Scales

Self-Injurious Behavior - drug therapy

Self-Injurious Behavior - psychology

The administration p.r.n. (as needed) of sedative medications is a widespread practice in the management of acute dyscontrol of child psychiatric inpatients. Its efficacy, however, has never been tested in a controlled clinical trial. Twenty-one male inpatients, aged 5-13 years, participated in a double-blind, placebo-controlled study of the p.r.n. use of diphenhydramine, a sedative antihistaminic often used in child psychiatry wards. The patients' DSM-III-R diagnoses were conduct disorder, attention-deficit hyperactivity, and major depression. Each patient in acute dyscontrol blindly received either oral or intramuscular doses of diphenhydramine 25-50 mg (N = 9) or placebo (N = 12). The Conners Abbreviated 10-Item Teacher Rating Scale and the Clinical Global Impressions scale were completed before and 0.5, 1, and 2 hours after the dose. Repeated measures ANOVA showed significant time effects, but no difference due to drug. The intramuscular route tended to be more effective than the oral, regardless of whether active drug or placebo was given. The data indicate that if p.r.n. administrations are effective, this is a placebo effect. Likewise, intramuscular administrations are more effective because of a route effect ("the needle") and not because of a specific pharmacologic activity.

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Title: P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study
Creators: B Vitiello - Department of Psychiatry, Medical College of Pennsylvania, Philadelphia
J L Hill
J Elia
E Cunningham
S V McLeer
D Behar
Publication Details: The journal of clinical psychiatry, v 52(12), pp 499-501
Resource Type: Journal article
Language: English
Academic Unit: [Retired Faculty]
Web of Science ID: WOS:A1991GW88200005
Scopus ID: 2-s2.0-0026334719
Other Identifier: 991019184310404721

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Collaboration types: Domestic collaboration
Web of Science research areas: Psychiatry; Psychology, Clinical

P.r.n. medications in child psychiatric patients: a pilot placebo-controlled study

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