Faraone Stephen V, Biederman Joseph, Roe Christine
Pediatric Psychopharmacology Unit of the Child Psychiatry Service, Massachusetts General Hospital, Boston.
J Clin Psychopharmacol. 2002 Oct;22(5):468-73. doi: 10.1097/00004714-200210000-00005.
Because methylphenidate is currently the most widely prescribed medication for attention-deficit/ hyperactivity disorder, several studies have used it as the active comparator medication for evaluating the efficacy of a newer stimulant, Adderall. These prior studies show Adderall to be superior to placebo and suggest it is at least as effective as the standard-release form of methylphenidate and has a longer duration of action. Although these initial studies provide useful information for clinicians treating children with attention-deficit/hyperactivity disorder, they are difficult to interpret because findings vary among studies and among the different types of measures used within each study. To provide a clearer picture of what conclusions can be drawn from these studies, we performed a meta-analysis. Data from the four available studies suggest that Adderall has a small but statistically significant advantage over the standard-release form of methylphenidate. This advantage was observed for both symptom measures and global ratings but was strongest for global ratings. The effect of Adderall was significant for clinician and parent ratings but not for teacher ratings and was significant for both fixed-dose and best-dose designs.
由于目前哌甲酯是治疗注意力缺陷/多动障碍最常用的处方药，多项研究将其用作活性对照药物，以评估新型兴奋剂阿得拉的疗效。这些先前的研究表明，阿得拉优于安慰剂，并且表明它至少与速释型哌甲酯一样有效，且作用持续时间更长。尽管这些初步研究为治疗注意力缺陷/多动障碍儿童的临床医生提供了有用信息，但由于各研究之间以及每项研究中使用的不同类型测量方法之间的结果存在差异，因此难以解读。为了更清楚地了解从这些研究中可以得出哪些结论，我们进行了一项荟萃分析。四项现有研究的数据表明，阿得拉与速释型哌甲酯相比具有微小但具有统计学意义的优势。在症状测量和整体评分方面均观察到了这一优势，但在整体评分方面最为明显。阿得拉的效果在临床医生和家长评分中具有显著性，但在教师评分中不具有显著性，并且在固定剂量和最佳剂量设计中均具有显著性。
