Trial Outcomes & Findings for Characterization and Sequential Pharmacotherapy of Severe Mood Dysregulation (NCT NCT01714310)

NCT ID: NCT01714310

Last Updated: 2018-02-26

Results Overview

A dimensional clinician rating of overall SMD related impairment, modified by the National Institute of Mental Health to assess specific domains pertinent to Severe Mood Dysregulation. Minimum score = 1. Maximum score = 7. Higher scores means greater impairment.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

34 participants

Primary outcome timeframe

Baseline through week 12.

Results posted on

2018-02-26

Participant Flow

At completion of open lisdexamfetamine, participants who achieved Clinical Global Impression Severity (CGI-S) SMD score \< 4 were deemed sufficiently improved, and not randomized to adjunctive treatment. N=4 participants were sufficiently improved and completed study participation at study week 4, prior to randomization

Participant milestones

Participant milestones
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at study week 4 and continuing to study week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at study week 4 and continuing through study week 12.
Open Lisdexamfetamine
All eligible participants initially titrated to optimal dose open lisdexamfetamine beginning at baseline (week 0) and continuing to the end of study week 4.
Open Lisdexamfetamine Titration
STARTED
0
0
34
Open Lisdexamfetamine Titration
COMPLETED
0
0
30
Open Lisdexamfetamine Titration
NOT COMPLETED
0
0
4
Double Blind Adjunctive Treatment
STARTED
12
14
0
Double Blind Adjunctive Treatment
COMPLETED
10
11
0
Double Blind Adjunctive Treatment
NOT COMPLETED
2
3
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at study week 4 and continuing to study week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at study week 4 and continuing through study week 12.
Open Lisdexamfetamine
All eligible participants initially titrated to optimal dose open lisdexamfetamine beginning at baseline (week 0) and continuing to the end of study week 4.
Open Lisdexamfetamine Titration
Protocol Violation
0
0
1
Open Lisdexamfetamine Titration
Adverse Event
0
0
3
Double Blind Adjunctive Treatment
Adverse Event
1
1
0
Double Blind Adjunctive Treatment
Protocol Violation
1
2
0

Baseline Characteristics

Characterization and Sequential Pharmacotherapy of Severe Mood Dysregulation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine from baseline through week 3.
Fluoxetine
n=12 Participants
Randomized participants who competed open-label lisdexamfetamine titration from baseline through week 3, who continued to meet eligibility criteria, and then proceeded to adjunctive fluoxetine therapy from week 4 through week 12.
Placebo
n=14 Participants
Randomized participants who competed open-label lisdexamfetamine titration from baseline through week 3, who continued to meet eligibility criteria, and then proceeded to adjunctive placebo from week 4 through week 12.
Total
n=60 Participants
Total of all reporting groups
Age, Continuous
10.24 years
STANDARD_DEVIATION 2.58 • n=5 Participants
9.97 years
STANDARD_DEVIATION 2.30 • n=7 Participants
10.22 years
STANDARD_DEVIATION 2.74 • n=5 Participants
NA years
STANDARD_DEVIATION NA • n=4 Participants
Sex: Female, Male
Female
13 Participants
n=5 Participants
5 Participants
n=7 Participants
5 Participants
n=5 Participants
23 Participants
n=4 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
7 Participants
n=7 Participants
9 Participants
n=5 Participants
37 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
6 Participants
n=5 Participants
5 Participants
n=7 Participants
0 Participants
n=5 Participants
11 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
28 Participants
n=5 Participants
7 Participants
n=7 Participants
14 Participants
n=5 Participants
49 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
White
27 Participants
n=5 Participants
8 Participants
n=7 Participants
13 Participants
n=5 Participants
48 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
5 Participants
n=5 Participants
4 Participants
n=7 Participants
1 Participants
n=5 Participants
10 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Wechsler Abbreviated Scale of Intelligence
103.16 units on a scale
STANDARD_DEVIATION 14.30 • n=5 Participants
105.58 units on a scale
STANDARD_DEVIATION 15.56 • n=7 Participants
101.69 units on a scale
STANDARD_DEVIATION 14.34 • n=5 Participants
NA units on a scale
STANDARD_DEVIATION NA • n=4 Participants
Clinical Global Impression SMD Severity
4.82 units on a scale
STANDARD_DEVIATION .52 • n=5 Participants
4.75 units on a scale
STANDARD_DEVIATION .46 • n=7 Participants
4.83 units on a scale
STANDARD_DEVIATION .72 • n=5 Participants
NA units on a scale
STANDARD_DEVIATION NA • n=4 Participants
Affective Reactivity Index Parent Report
8.91 units on a scale
STANDARD_DEVIATION 2.47 • n=5 Participants
10.00 units on a scale
STANDARD_DEVIATION 1.95 • n=7 Participants
8.57 units on a scale
STANDARD_DEVIATION 2.17 • n=5 Participants
NA units on a scale
STANDARD_DEVIATION NA • n=4 Participants

PRIMARY outcome

Timeframe: Baseline through week 12.

Population: Compares groups lisdexamfetamine plus fluoxetine vs. lisdexamfetamine plus placebo over 12 week trial. Some participants discontinued as trial progressed.

A dimensional clinician rating of overall SMD related impairment, modified by the National Institute of Mental Health to assess specific domains pertinent to Severe Mood Dysregulation. Minimum score = 1. Maximum score = 7. Higher scores means greater impairment.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Clinical Global Impression-Severity-Severe Mood Dysregulation
Baseline
4.91 units on a scale
Standard Error .53
3.62 units on a scale
Standard Error .48
4.30 units on a scale
Standard Error .32
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 4
4.42 units on a scale
Standard Error .34
4.57 units on a scale
Standard Error .31
4.31 units on a scale
Standard Error .19
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 5
4.15 units on a scale
Standard Error .36
3.51 units on a scale
Standard Error .32
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 6
3.67 units on a scale
Standard Error .34
3.90 units on a scale
Standard Error .33
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 7
3.61 units on a scale
Standard Error .37
3.59 units on a scale
Standard Error .34
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 8
3.42 units on a scale
Standard Error .39
3.37 units on a scale
Standard Error .34
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 10
3.45 units on a scale
Standard Error .42
3.11 units on a scale
Standard Error .35
Clinical Global Impression-Severity-Severe Mood Dysregulation
Week 12
3.51 units on a scale
Standard Error .38
3.30 units on a scale
Standard Error .36

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Participants discontinued as trial progressed.

A dimensional rating of ADHD symptoms, with scores ranging from 0 - 54, and higher scores indicating greater symptom severity.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
ADHD-IV Rating Scale
Baseline
34.50 units on a scale
Standard Error 1.97
34.31 units on a scale
Standard Error 1.87
34.20 units on a scale
Standard Error 1.15
ADHD-IV Rating Scale
Week 4
14.92 units on a scale
Standard Error 1.97
18.64 units on a scale
Standard Error 1.82
16.59 units on a scale
Standard Error 1.21
ADHD-IV Rating Scale
Week 12
16.29 units on a scale
Standard Error 2.10
11.93 units on a scale
Standard Error 1.99

SECONDARY outcome

Timeframe: Baseline through week 3.

Population: Participants were assessed on this measure only during the Open Lisdexamfetamine phase. Some participant discontinued as trial progressed.

Parent completed dimensional measure of ADHD symptoms, with score range from 0 - 30 and higher scores indicating more severe symptoms.

Outcome measures

Outcome measures
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Conners Parent Global Index
Baseline
15.91 units on a scale
Standard Error .82
Conners Parent Global Index
Week 1
9.54 units on a scale
Standard Error .82
Conners Parent Global Index
Week 2
10.60 units on a scale
Standard Error .85
Conners Parent Global Index
Week 3
8.60 units on a scale
Standard Error .87

SECONDARY outcome

Timeframe: Baseline to week 3.

Population: Participants were assessed on this measure only during the Open Lisdexamfetamine phase. Some participants discontinues as trial progressed.

A sub scale of the Conners Global Index, with scores ranging from 0 - 12, with higher scores indicating more impairment.

Outcome measures

Outcome measures
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Conners Global Index Emotional Lability Subscale - Parent Report
Baseline
8.81 units on a scale
Standard Error .52
Conners Global Index Emotional Lability Subscale - Parent Report
Week 1
5.90 units on a scale
Standard Error .52
Conners Global Index Emotional Lability Subscale - Parent Report
Week 2
6.33 units on a scale
Standard Error .53
Conners Global Index Emotional Lability Subscale - Parent Report
Week 3
5.45 units on a scale
Standard Error .55

SECONDARY outcome

Timeframe: Baseline through week 3.

Population: Participants were assessed on this measure only during the Open Lisdexamfetamine phase. Some participants discontinued as trial progressed.

A dimensional parent report measure of restless-impulsive symptoms, with scores ranging from 0 to 21, and higher scores indicating greater impairment.

Outcome measures

Outcome measures
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Conners Global Index Restless-Impulsive Subscale Parent Report
Baseline
15.91 units on a scale
Standard Error .82
Conners Global Index Restless-Impulsive Subscale Parent Report
Week 1
9.55 units on a scale
Standard Error .82
Conners Global Index Restless-Impulsive Subscale Parent Report
Week 2
10.60 units on a scale
Standard Error .85
Conners Global Index Restless-Impulsive Subscale Parent Report
Week 3
8.60 units on a scale
Standard Error .87

SECONDARY outcome

Timeframe: Baseline through week 3.

Population: Participants were assessed on this measure only during the Open Lisdexamfetamine phase. Some participants discontinued as trial progressed.

Teacher completed dimensional measure of ADHD symptoms, with scores ranging from 0 - 30, and higher scores indicating more severe impairment.

Outcome measures

Outcome measures
Measure
Fluoxetine
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Conners Teacher Global Index
Baseline
18.13 units on a scale
Standard Error 1.87
Conners Teacher Global Index
Week 1
13.21 units on a scale
Standard Error 1.87
Conners Teacher Global Index
Week 2
10.18 units on a scale
Standard Error 1.93
Conners Teacher Global Index
Week 3
8.31 units on a scale
Standard Error 1.61

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

A parent completed dimensional measure of emotional reactivity, with scores ranging from 0-12, and higher scores indicating greater severity.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Affective Reactivity Index - Parent Report
Baseline
10.00 units on a scale
Standard Error .96
8.57 units on a scale
Standard Error .88
9.29 units on a scale
Standard Error .92
Affective Reactivity Index - Parent Report
Week 4
7.58 units on a scale
Standard Error .96
7.71 units on a scale
Standard Error .88
6.87 units on a scale
Standard Error .59
Affective Reactivity Index - Parent Report
Week 5
6.58 units on a scale
Standard Error .96
6.21 units on a scale
Standard Error .88
Affective Reactivity Index - Parent Report
Week 6
6.42 units on a scale
Standard Error .96
5.32 units on a scale
Standard Error .90
Affective Reactivity Index - Parent Report
Week 7
6.69 units on a scale
Standard Error 1.00
6.49 units on a scale
Standard Error 1.00
Affective Reactivity Index - Parent Report
Week 8
6.49 units on a scale
Standard Error 1.00
5.62 units on a scale
Standard Error .90
Affective Reactivity Index - Parent Report
Week 10
6.74 units on a scale
Standard Error 1.07
4.89 units on a scale
Standard Error .97
Affective Reactivity Index - Parent Report
Week 12
6.39 units on a scale
Standard Error 1.00
5.30 units on a scale
Standard Error .94

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

A parent rated retrospective dimensional assessment of oppositional and aggressive behaviors, with scores ranging from 0-40, and higher scores indicating greater severity.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Revised Modified Overt Aggression Scale - Total Score
Baseline
22.23 units on a scale
Standard Error 4.44
33.68 units on a scale
Standard Error 4.08
26.03 units on a scale
Standard Error 2.61
Revised Modified Overt Aggression Scale - Total Score
Week 4
14.44 units on a scale
Standard Error 4.30
25.35 units on a scale
Standard Error 3.98
17.93 units on a scale
Standard Error 2.67
Revised Modified Overt Aggression Scale - Total Score
Week 5
13.72 units on a scale
Standard Error 4.31
20.60 units on a scale
Standard Error 4.19
Revised Modified Overt Aggression Scale - Total Score
Week 6
10.00 units on a scale
Standard Error 4.20
20.55 units on a scale
Standard Error 3.98
Revised Modified Overt Aggression Scale - Total Score
Week 7
13.19 units on a scale
Standard Error 4.45
21.89 units on a scale
Standard Error 4.32
Revised Modified Overt Aggression Scale - Total Score
Week 8
14.09 units on a scale
Standard Error 4.45
21.33 units on a scale
Standard Error 4.08
Revised Modified Overt Aggression Scale - Total Score
Week 10
12.61 units on a scale
Standard Error 4.60
17.68 units on a scale
Standard Error 4.47
Revised Modified Overt Aggression Scale - Total Score
Week 12
14.29 units on a scale
Standard Error 4.45
18.34 units on a scale
Standard Error 4.32

SECONDARY outcome

Timeframe: Percentage improved at week 4 for Open Lisdexamfetamine group and at week 12 for fluoxetine and placebo groups.

Population: Some participants discontinued as trial progressed.

Percentage improved by treatment group

Outcome measures

Outcome measures
Measure
Fluoxetine
n=10 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=11 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Clinical Global Impression - Improvement
7 Participants
7 Participants
8 Participants

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Participants discontinued as trial progressed.

A dimensional measure assessed in cms.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Height
Baseline
140.25 cm.
Standard Error 3.82
144.63 cm.
Standard Error 3.53
142.37 cm.
Standard Error 2.12
Height
Week 1
140.05 cm.
Standard Error 3.81
144.76 cm.
Standard Error 3.53
142.35 cm.
Standard Error 2.12
Height
Week 2
139.95 cm.
Standard Error 3.82
144.81 cm.
Standard Error 3.53
142.43 cm.
Standard Error 2.12
Height
Week 3
140.26 cm.
Standard Error 3.82
144.88 cm.
Standard Error 3.53
142.59 cm.
Standard Error 2.12
Height
Week 4
140.56 cm.
Standard Error 3.82
144.54 cm.
Standard Error 3.53
142.59 cm.
Standard Error 2.12
Height
Week 5
140.11 cm.
Standard Error 3.82
144.82 cm.
Standard Error 3.53
Height
Week 6
140.21 cm.
Standard Error 3.82
145.44 cm.
Standard Error 3.53
Height
Week 7
140.55 cm.
Standard Error 3.82
145.14 cm.
Standard Error 3.53
Height
Week 8
140.81 cm.
Standard Error 3.82
144.98 cm.
Standard Error 3.53
Height
Week 10
140.83 cm.
Standard Error 3.82
145.30 cm.
Standard Error 3.54
Height
Week 12
140.98 cm.
Standard Error 3.82
145.60 cm.
Standard Error 3.53

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

Weight in kg.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Weight
Baseline
37.96 kg.
Standard Error 5.26
47.26 kg.
Standard Error 4.87
42.59 kg.
Standard Error 3.16
Weight
Week 1
37.29 kg.
Standard Error 5.26
46.39 kg.
Standard Error 4.87
41.83 kg.
Standard Error 3.16
Weight
Week 2
36.96 kg.
Standard Error 5.26
45.56 kg.
Standard Error 4.87
41.29 kg.
Standard Error 3.16
Weight
Week 3
36.55 kg.
Standard Error 5.26
45.06 kg.
Standard Error 4.87
40.73 kg.
Standard Error 3.16
Weight
Week 4
36.20 kg.
Standard Error 5.26
45.22 kg.
Standard Error 4.87
40.67 kg.
Standard Error 3.16
Weight
Week 5
36.08 kg.
Standard Error 5.26
44.80 kg.
Standard Error 4.87
Weight
Week 6
35.73 kg.
Standard Error 5.26
44.34 kg.
Standard Error 4.87
Weight
Week 7
35.30 kg.
Standard Error 5.26
44.72 kg.
Standard Error 4.87
Weight
Week 8
35.08 kg.
Standard Error 5.26
44.08 kg.
Standard Error 4.87
Weight
Week 10
34.61 kg.
Standard Error 5.26
44.16 kg.
Standard Error 4.87
Weight
Week 12
34.73 kg.
Standard Error 5.26
43.05 kg.
Standard Error 4.87

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

Heart rate in beats per minute.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Pulse
Baseline
82.28 beats per minute.
Standard Error 3.26
84.64 beats per minute.
Standard Error 3.22
80.84 beats per minute.
Standard Error 2.30
Pulse
Week 1
95.08 beats per minute.
Standard Error 3.16
85.21 beats per minute.
Standard Error 2.91
88.15 beats per minute.
Standard Error 2.13
Pulse
Week 2
88.25 beats per minute.
Standard Error 3.15
81.64 beats per minute.
Standard Error 2.91
84.33 beats per minute.
Standard Error 2.13
Pulse
Week 3
96.32 beats per minute.
Standard Error 3.26
85.79 beats per minute.
Standard Error 3.01
90.71 beats per minute.
Standard Error 2.26
Pulse
Week 4
93.08 beats per minute.
Standard Error 3.15
83.21 beats per minute.
Standard Error 2.91
88.45 beats per minute.
Standard Error 2.23
Pulse
Week 5
94.16 beats per minute.
Standard Error 3.26
83.00 beats per minute.
Standard Error 3.23
Pulse
Week 6
87.33 beats per minute.
Standard Error 3.15
90.55 beats per minute.
Standard Error 3.12
Pulse
Week 7
91.94 beats per minute.
Standard Error 3.55
90.00 beats per minute.
Standard Error 3.22
Pulse
Week 8
87.17 beats per minute.
Standard Error 3.40
85.10 beats per minute.
Standard Error 3.00
Pulse
Week 10
95.83 beats per minute.
Standard Error 3.55
82.90 beats per minute.
Standard Error 3.52
Pulse
Week 12
92.75 beats per minute.
Standard Error 3.55
90.62 beats per minute.
Standard Error 3.23

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

Systolic Blood Pressure measured in mmHG

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Systolic Blood Pressure
Baseline
107.85 mm Hg.
Standard Error 4.01
106.68 mm Hg.
Standard Error 3.92
107.40 mm Hg.
Standard Error 2.69
Systolic Blood Pressure
Week 1
99.42 mm Hg.
Standard Error 3.89
111.71 mm Hg.
Standard Error 3.60
106.03 mm Hg.
Standard Error 2.53
Systolic Blood Pressure
Week 2
104.83 mm Hg.
Standard Error 3.89
110.36 mm Hg.
Standard Error 3.60
107.48 mm Hg.
Standard Error 2.53
Systolic Blood Pressure
Week 3
109.20 mm Hg.
Standard Error 4.01
109.89 mm Hg.
Standard Error 3.70
110.73 mm Hg.
Standard Error 2.67
Systolic Blood Pressure
Week 4
112.00 mm Hg.
Standard Error 3.89
110.07 mm Hg.
Standard Error 3.60
111.77 mm Hg.
Standard Error 2.65
Systolic Blood Pressure
Week 5
109.57 mm Hg.
Standard Error 4.01
104.20 mm Hg.
Standard Error 3.93
Systolic Blood Pressure
Week 6
111.58 mm Hg.
Standard Error 3.89
108.98 mm Hg.
Standard Error 3.80
Systolic Blood Pressure
Week 7
112.04 mm Hg.
Standard Error 4.31
112.80 mm Hg.
Standard Error 3.92
Systolic Blood Pressure
Week 8
111.20 mm Hg.
Standard Error 4.31
110.94 mm Hg.
Standard Error 3.96
Systolic Blood Pressure
Week 10
112.25 mm Hg.
Standard Error 4.31
105.67 mm Hg.
Standard Error 4.23
Systolic Blood Pressure
Week 12
116.15 mm Hg.
Standard Error 4.31
113.90 mm Hg.
Standard Error 3.93

SECONDARY outcome

Timeframe: Baseline through week 12.

Population: Some participants discontinued as trial progressed.

Diastolic Blood pressure measured in mmHG.

Outcome measures

Outcome measures
Measure
Fluoxetine
n=12 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 continuing to week 12.
Placebo
n=14 Participants
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at week 4 continuing through week 12.
Open Lisdexamfetamine
n=34 Participants
All eligible participants initially titrated to optimal dose open lisdexamfetamine starting at baseline (week 0) and continuing through study week.
Diastolic Blood Pressure
Baseline
68.86 mm Hg.
Standard Error 2.36
66.40 mm Hg.
Standard Error 2.34
67.39 mm Hg.
Standard Error 1.56
Diastolic Blood Pressure
Week 1
71.33 mm Hg.
Standard Error 2.27
69.50 mm Hg.
Standard Error 2.10
69.15 mm Hg.
Standard Error 1.45
Diastolic Blood Pressure
Week 2
66.00 mm Hg.
Standard Error 2.27
66.79 mm Hg.
Standard Error 2.10
66.63 mm Hg.
Standard Error 1.45
Diastolic Blood Pressure
Week 3
68.74 mm Hg.
Standard Error 2.36
62.82 mm Hg.
Standard Error 2.18
67.21 mm Hg.
Standard Error 1.56
Diastolic Blood Pressure
Week 4
71.17 mm Hg.
Standard Error 2.27
66.21 mm Hg.
Standard Error 2.10
69.31 mm Hg.
Standard Error 1.53
Diastolic Blood Pressure
Week 5
71.17 mm Hg.
Standard Error 2.36
65.17 mm Hg.
Standard Error 2.34
Diastolic Blood Pressure
Week 6
69.58 mm Hg.
Standard Error 2.27
70.61 mm Hg.
Standard Error 2.25
Diastolic Blood Pressure
Week 7
68.14 mm Hg.
Standard Error 2.58
70.64 mm Hg.
Standard Error 2.34
Diastolic Blood Pressure
Week 8
68.06 mm Hg.
Standard Error 2.46
68.40 mm Hg.
Standard Error 2.17
Diastolic Blood Pressure
Week 10
70.81 mm Hg.
Standard Error 2.58
67.06 mm Hg.
Standard Error 2.56
Diastolic Blood Pressure
Week 12
77.11 mm Hg.
Standard Error 2.58
70.05 mm Hg.
Standard Error 2.34

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline through week 12.

Clinician completed dimensional assessment of anxiety symptoms.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline through week 12.

Clinician completed dimensional rating of depressive symptoms.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline through week 12.

Dimensional self-report of irritability, with total score 1-12, and higher scores indicating greater severity.

Outcome measures

Outcome data not reported

Adverse Events

Fluoxetine

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 10 other events
Deaths: 0 deaths

Open Lisdexamfetamine

Serious events: 0 serious events
Other events: 30 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Fluoxetine
n=12 participants at risk
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive fluoxetine at week 4 and continuing though week 12.
Placebo
n=14 participants at risk
All participants initially enrolled in open lisdexamfetamine treatment, followed by randomization to adjunctive placebo at study week 4 and continuing through week 12.
Open Lisdexamfetamine
n=34 participants at risk
All eligible participants initially titrated to optimal dose open lisdexamfetamine from baseline through week 4.
Gastrointestinal disorders
Stomach pain/ache
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
11.8%
4/34 • Number of events 5 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Gastrointestinal disorders
Nausea/vomiting
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
5.9%
2/34 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Gastrointestinal disorders
Diarrhea
16.7%
2/12 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
8.8%
3/34 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Wish to be dead
8.3%
1/12 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/34 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Suicidal ideation without intent
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/34 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Nervous system disorders
Headache
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.7%
5/34 • Number of events 8 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
General disorders
Feeling drowsy/sleep
8.3%
1/12 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
11.8%
4/34 • Number of events 5 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
General disorders
Dry mouth
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
21.4%
3/14 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
11.8%
4/34 • Number of events 6 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Gastrointestinal disorders
Constipation
25.0%
3/12 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/34 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Renal and urinary disorders
Frequent urination
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
General disorders
Restless/uncomfortable urge to move
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 4 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Cardiac disorders
Heart skips beats
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/34 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Cardiac disorders
Racing heart
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
5.9%
2/34 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Cardiac disorders
Chest pain
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
5.9%
2/34 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Gastrointestinal disorders
Heartburn
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/34 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Trouble sleeping
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
28.6%
4/14 • Number of events 6 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
26.5%
9/34 • Number of events 15 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Sleeplessness
8.3%
1/12 • Number of events 6 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 4 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
11.8%
4/34 • Number of events 9 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Nightmares
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Nervous system disorders
Excessive sweating
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
8.8%
3/34 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Nervous system disorders
Tremor/shakiness
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
0.00%
0/14 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
General disorders
Decreased appetite
58.3%
7/12 • Number of events 24 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
42.9%
6/14 • Number of events 11 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
61.8%
21/34 • Number of events 51 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Nervous system disorders
Tics
16.7%
2/12 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
21.4%
3/14 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
11.8%
4/34 • Number of events 7 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Euphoria
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
7.1%
1/14 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Talks less with others
8.3%
1/12 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 2 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
2.9%
1/34 • Number of events 1 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Nervous system disorders
Bites fingernails
25.0%
3/12 • Number of events 5 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.3%
2/14 • Number of events 6 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
14.7%
5/34 • Number of events 7 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
Psychiatric disorders
Prone to crying
0.00%
0/12 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
21.4%
3/14 • Number of events 3 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.
17.6%
6/34 • Number of events 9 • Baseline through study week 12.
Adverse events were collected via structured ratings, including the Columbia Suicide Severity Rating Scale and the Side Effects Rating Scale.

Additional Information

James J. McGough, M.D.

University of California, Los Angeles

Phone: 310-794-7841

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place