A double-blind placebo-controlled study of lithium in hospitalized aggressive children and adolescents with conduct disorder

Arch Gen Psychiatry. 2000 Jul;57(7):649-54. doi: 10.1001/archpsyc.57.7.649.


Background: A subgroup of children and adolescents with conduct disorder are characterized by severe and persistent aggression. Although there is no agreed on treatment for such aggression, lithium carbonate has shown promise in some studies involving children. Our study was designed to critically assess the efficacy of lithium in the treatment of aggression in children and adolescents using a measure specific for aggression.

Methods: Subjects were inpatients with conduct disorder hospitalized because of severe and chronic aggression. A parallel-groups design was used in this double-blind, placebo-controlled trial with randomization to lithium or placebo. Only those who met the aggression criterion during the 2-week placebo-baseline period were randomized to 4 weeks of treatment. Outcome measures included Clinical Global Impressions, the Global Clinical Judgements (Consensus) Scale, and the Overt Aggression Scale.

Results: Eighty-six inpatients enrolled in the study; 40 (33 male and 7 female; median age, 12.5 years) entered and completed the treatment phase. Lithium was statistically and clinically superior to placebo. Sixteen of 20 subjects in the lithium group were responders on the Consensus ratings vs 6 of 20 in the placebo group (P=.004). Ratings on the Overt Aggression Scale decreased significantly for the lithium group vs the placebo group (P=.04). More than half of the subjects in the lithium group experienced nausea, vomiting, and urinary frequency.

Conclusions: Lithium is a safe and effective short-term treatment for aggression in inpatients with conduct disorder, although its use is associated with adverse effects.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Aggression / drug effects*
  • Child
  • Child Behavior Disorders / diagnosis
  • Child Behavior Disorders / drug therapy*
  • Child Behavior Disorders / psychology
  • Conduct Disorder / diagnosis
  • Conduct Disorder / drug therapy*
  • Conduct Disorder / psychology
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Hospitalization*
  • Humans
  • Lithium Carbonate / administration & dosage
  • Lithium Carbonate / adverse effects
  • Lithium Carbonate / therapeutic use*
  • Male
  • Nausea / chemically induced
  • Placebos
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Severity of Illness Index
  • Treatment Outcome
  • Urination Disorders / chemically induced
  • Vomiting / chemically induced


  • Placebos
  • Lithium Carbonate