A Double-Blind, Randomized Study of Extended-Release Molindone for Impulsive Aggression in ADHD

Gianpiera Ceresoli-Borroni, Azmi Nasser, Toyin Adewole, Tesfaye Liranso, Jiahong Xu, Stefan Schwabe, Robert L. Findling

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate efficacy and safety of SPN-810 (extended-release molindone) in a Phase-2b, randomized, double-blind, placebo-controlled, dose-ranging study of children (6–12 years) with ADHD and persistent impulsive aggression (IA). Method: After lead-in, children were randomized to (a) placebo (N = 31); (b) low-dose (N = 29, 12/18 mg/day); (c) medium-dose (N = 30, 24/36 mg/day); and (4) high-dose (N = 31, 36/54 mg/day) groups. Treatment included ~2.5-week titration, 3-week maintenance, and 1-week tapering/conversion, alongside existing monotherapy (stimulants/nonstimulants) and behavioral therapy. The primary endpoint was change in Retrospective-Modified Overt Aggression Scale (R-MOAS) score at end of study, with safety monitored. Results: A total of 95 (78.5%) children completed the study. Aggression (R-MOAS) improved with low and medium doses (low dose: p =.031; medium dose: p =.024; high dose: p =.740). The most common adverse events were headache (10.0%), sedation (8.9%), and increased appetite (7.8%). Conclusion: These results suggest SPN-810 may be effective in reducing residual IA behaviors in children with ADHD. Research is still needed to support the benefit–risk profile of SPN-810 in pediatric populations.

Original languageEnglish (US)
Pages (from-to)1564-1577
Number of pages14
JournalJournal of Attention Disorders
Issue number11
StatePublished - Sep 2021
Externally publishedYes


  • attention-deficit/hyperactivity disorder
  • impulsive aggression
  • maladaptive aggression
  • molindone
  • stimulants

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Clinical Psychology


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