Taylor F B, Russo J
Rainier Associates, Tacoma, Washington 98467, USA.
J Clin Psychopharmacol. 2001 Apr;21(2):223-8. doi: 10.1097/00004714-200104000-00015.
The objective of this study was to compare the efficacy of the alpha-2a agonist guanfacine with that of dextroamphetamine for the treatment of adult attention-deficit/hyperactivity disorder (ADHD). Seventeen adult outpatients who met DSM-IV criteria for ADHD participated in a double-blind, placebo-controlled, crossover study comparing drug effects on ADHD symptoms. Measures of change included the DSM-IV ADHD Behavior Checklist for Adults and the Copeland Symptom Checklist for Adult Attention Deficit Disorders. Cognitive measures of attention included the Stroop and Controlled Oral Word Association Test using the letters "C," "F," and "L" (COWAT, CFL version). For each trial, the drug was administered daily and titered up to optimal doses of maximum efficacy but with a minimum of side effects, and then data were collected. Both drugs significantly reduced ADHD symptoms on the DSM-IV Adult Behavior Checklist for Adults over placebo (p < 0.05). The Stroop Color subscale showed significant improvement for both drugs (p < 0.05), but the Color-Word measures showed significant improvement for guanfacine only (p < 0.01). The average dose of guanfacine was 1.10 (SD = 0.60), and the most common side effect of guanfacine was fatigue. No subjects discontinued drug trials. This preliminary study indicates that guanfacine may be a well-tolerated treatment option for adult ADHD.
本研究的目的是比较α-2a激动剂胍法辛与右旋苯丙胺治疗成人注意力缺陷多动障碍（ADHD）的疗效。17名符合DSM-IV成人ADHD标准的门诊患者参与了一项双盲、安慰剂对照的交叉研究，比较药物对ADHD症状的影响。变化指标包括成人DSM-IV ADHD行为清单和成人注意力缺陷障碍的科普兰症状清单。注意力的认知指标包括使用字母“C”“F”和“L”的斯特鲁普测试和受控口语单词联想测试（COWAT，CFL版本）。每次试验中，药物每日给药，并滴定至最大疗效的最佳剂量，但副作用最小，然后收集数据。与安慰剂相比，两种药物在成人DSM-IV成人行为清单上均显著减轻了ADHD症状（p<0.05）。斯特鲁普颜色分量表显示两种药物均有显著改善（p<0.05），但颜色-单词测量仅显示胍法辛有显著改善（p<0.01）。胍法辛的平均剂量为1.10（标准差=0.60），胍法辛最常见的副作用是疲劳。没有受试者停止药物试验。这项初步研究表明，胍法辛可能是成人ADHD耐受性良好的治疗选择。
