Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 28;13(1):6921.
doi: 10.1038/s41598-023-33979-2.

Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis

Ji-Woo Seok  1   2 , Brigette Soltis-Vaughan  1 , Brandon J Lew  1 , Aatiya Ahmad  1 , R J R Blair  3 , Soonjo Hwang  4
Affiliations

Psychopharmacological treatment of disruptive behavior in youths: systematic review and network meta-analysis

Ji-Woo Seok et al. Sci Rep. .

Erratum in

Abstract

To conduct a systematic review of the comparative efficacy of various psychotropic medications for the treatment of disruptive behavior (DBs) in youths. To this aim, we systematically reviewed randomized clinical trials (RCTs) of various psychotropic medications targeting symptoms of DBs and applied network meta-analysis to investigate their relative efficacy. Fifty-five RCTs meeting the inclusion criteria were selected. To predict and interpret relative treatment efficacy, we compared the efficacy of various psychotropic medications prescribed for DB symptoms based on their mechanism of action. Network meta-analysis revealed that for reducing DBs, second-generation antipsychotics, stimulants, and non-stimulant ADHD medications were more efficacious than placebo, and second-generation antipsychotics were the most efficacious. The dopaminergic modulation of top-down inhibitory process by these medications is discussed in this review. This study offers information on the relative efficacy of various psychotropic medications for the treatment of DB, and insight into a potential neurobiological underpinning for those symptoms. It also illustrates the potential utility of these neurobiological mechanisms as a target for future treatment studies.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
The result of NMA for disruptive symptoms. (A) The network graph representing treatment arms included in the network for disruptive symptoms, the thickness of the lines shows the number of studies. (B) Random effect model forest plot for comparison of each treatment arm vs. placebo. (C) Ranking of medications for disruptive symptoms using SUCRA values. (D) Comparison of the included agent groups: standardized mean differences (95% CI). Each cell represents the effect of the column-defining agent group compared to the row-defining agent group. DRA Dopamine receptor antagonist/aripiprazole, NDRI Norepinephrine–dopamine reuptake inhibitor/stimulant, SDA Serotonin dopamine antagonist/second-generation antipsychotics, sNRI Selective norepinephrine reuptake inhibitors/non-stimulant ADHD medication, SNDRI Serotonin-norepinephrine-dopamine reuptake inhibitor, SNRI Serotonin-norepinephrine reuptake inhibitors/tricyclic antidepressants, SSRI selective serotonin reuptake inhibitor.
See this image and copyright information in PMC

References

    1. Breitenstein SM, Hill C, Gross D. Understanding disruptive behavior problems in preschool children. J. Pediatr. Nurs. 2009;24(1):3–12. doi: 10.1016/j.pedn.2007.10.007. - DOI - PubMed
    1. Shaw DS, Owens EB, Vondra JI, Keenan K, Winslow EB. Early risk factors and pathways in the development of early disruptive behavior problems. Dev. Psychopathol. 1996;8(4):679–699. doi: 10.1017/S0954579400007367. - DOI
    1. Eyberg SM, Nelson MM, Boggs SR. Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. J. Clin. Child Adolesc. Psychol. 2008;37(1):215–237. doi: 10.1080/15374410701820117. - DOI - PubMed
    1. Milone, A., Sesso, G. Disruptive Behavior Disorders: Symptoms, Evaluation and Treatment. 225 (Multidisciplinary Digital Publishing Institute, 2022). - PMC - PubMed
    1. Campbell, S. B. Behavior Problems in Preschool Children: Clinical and Developmental Issues. (Guilford Press, 2006).

Publication types

MeSH terms

Substances