Name that Trial
So what where they thinking?
And they used this treatment options
And this is what they found
We should use it like this
100

This is the title for the study for which TADS stands for:

What is Treatment of Adolescents with Depression Study?

100

This is what the PATS study investigators wanted to evaluate:

What is to evaluate the short-term (5 weeks) efficacy and long-term (40 weeks) safety of methylphenidate  in preschoolers with attention-deficit/hyperactivity disorder. Three hundred kids (3.5-5y/o) participated in the 8-phase, 70-week trial that included screening, parent training,open-label safety lead-in, double-blind crossover titration, double-blind parallel efficacy, open-label maintenance, and double-blind discontinuation.

100

These treatments were studied in the POTS:

What is sertraline and CBT for the management of OCD.  Participants were randomly assigned to receive CBT alone, sertraline alone, combined CBT and sertraline, or pill placebo for 12 weeks.

100

This is what the TADS researchers found

What is that combination treatment was superior to all other arms.  Fluoxetine alone is a superior treatment to CBT alone. Rates of response for fluoxetine with CBT were 71.0% (95% confidence interval [CI], 62%-80%); fluoxetine alone, 60.6% (95% CI, 51%-70%); CBT alone, 43.2% (95% CI, 34%-52%); and placebo, 34.8% (95% CI, 26%-44%). 

Clinically significant suicidal thinking, which was present in 29% of the sample at baseline, improved significantly in all 4 treatment groups, with combination treatment showing greatest reduction. 

100

TADS

We should attempt to get both CBT and an SSRI on board for adolescents with depression.  Fluoxetine was safe and helpful across the study, with high rates of remission even in the absence of CBT.  

Importantly this study has been criticized for not assessing longer term use of fluoxetine in these kids beyond week 12.

200

This is the title for the study for which POTS stands for:

What is Pediatric OCD Treatment Study? 

200

This is what the POTS study investigators wanted to evaluate:

What is the efficacy of CBT alone and medical management with the selective serotonin reuptake inhibitor sertraline alone, or CBT and sertraline combined, as initial treatment for children and adolescents with OCD

200

This treatments were studied in the PATS 

What is parent training and methylphenidate?

200

This is what the authors of CAMS found after 12 weeks of treatment

Remission rates ranged from 46% to 68% for COMB, 34% to 46% for SRT, 20% to 46% for CBT, and 15% to 27% for PBO (sites). 

Rates of remission were significantly lower than rates of response for the entire sample. 

Youth who received combination treatment did much better and had higher rates of remission compared to all other treatment groups. 

Both monotherapies had higher remission rates compared to placebo, but rates were not different from each other. 

Predictors of remission were younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders and absence of social phobia.

200

POTS

Children and adolescents with OCD should begin treatment with the combination of CBT plus a selective serotonin reuptake inhibitor or CBT alone.  CBT alone is site specific- so we should think well before referring.  If the therapist is not skilled enough it might be better to start an SSRI... 

300

This is the title for the study for which CAMS stands for:

What is Child/Adolescent Anxiety Multimodal Study? 

300

This is what the CAMS study investigators wanted to evaluate

What is the relative efficacy of CBT, sertraline, and their combination against placebo for the treatment of separation anxiety disorder (SAD), generalized anxiety disorder (GAD) and social phobia (SoP) in children and adolescents.

300

These are the treatment options used into the CAMS study

What is sertraline, CBT and COMB

300

This is what the authors of the TEOSS study found

Risperidone and olanzapine did not demonstrate superior efficacy over molindone for treating early-onset schizophrenia and schizoaffective disorder.

300

CAMS

Kids with anxiety do better on combination treatment and generally need longer or augmented treatment courses.  Social phobia is hard to treat in children, even under ideal circumstances. 


SSRIs are well tolerated and safe in children and adolescents with anxiety.

Longer follow-up of these children didn't show much difference across active groups (and farther away from placebo) suggesting that difference of response in the acute phase of treatment across groups shrinks with time.  


400

This is the title for the study for which PATS stands for: 

What is the Preschool ADHD treatment study?

400

This is what the TADS investigators wanted to evaluate

What is the effectiveness of CBT, SSRI (fluoxetine) and their combination in the treatment of depression in adolescents

400

These medications were tested by the TEOSS study

What is the the comparative efficacy and safety of two second-generation antipsychotics (olanzapine and risperidone) with a first-generation antipsychotic (molindone) in the treatment of early-onset schizophrenia and schizoaffective disorder.

400

The PATS investigators found that:

What is that compared with placebo, significant decreases in ADHD symptoms were found on MPH at 2.5 mg (p<.01), 5 mg (p<.001), and 7.5 mg (p<.001) t.i.d. doses, but not for 1.25 mg (p<.06). The mean optimal MPH total daily dose for the entire group was 14.2 +/- 8.1 mg/day (0.7+/-0.4 mg/kg/day).

400

PATS

Preschoolers can respond to stimulant treatment when indicated, but at smaller doses and with lower effect sizes than for school aged children.  

20 year follow-up of these kids shows that about half remains on treatment, some on adjuvant antipsychotic use, all with dissimilar outcomes and rates of success- looks for those studies! 

500

This is the title for the study for which TEOSS stands for:

What is Treatment of Early-Onset Schizophrenia Spectrum disorders Study? 

500

This is what the TEOSS study investigators wanted to evaluate:

What is if second-generation antipsychotics are truly more affective and safer than first generation antipsychotics in the treatment of EOSS

500

These treatments were studied in the TADS

Participants were randomized to twelve weeks of (1) fluoxetine alone (10 to 40 mg/d), (2) CBT alone, (3) CBT with fluoxetine (10 to 40 mg/d), or (4) placebo. 

Placebo and fluoxetine alone were administered double-blind; CBT alone and CBT with fluoxetine were unblinded. 

500

This is what the researchers of POTS found:

What is:  the rate of clinical remission for combined treatment was 53.6% (95% confidence interval [CI], 36%-70%); for CBT alone, 39.3% (95% CI, 24%-58%); for sertraline alone, 21.4% (95% CI, 10%-40%); and for placebo, 3.6% (95% CI, 0%-19%). 

The remission rate: COMB=CBT but diff from sertraline alone. 

CBT = to sertraline alone, but different from placebo.

The 3 active treatments proved acceptable and well tolerated, with no evidence of treatment-emergent harm to self or to others.

500

TEOSS

The results question the nearly exclusive use of second-generation antipsychotics to treat early-onset schizophrenia and schizoaffective disorder. The safety findings related to weight gain and metabolic problems raise important public health concerns, given the widespread use of second-generation antipsychotics in youth for nonpsychotic disorders.